Twelve-month service use, suicidality and mental health problems of European adolescents after a school-based screening for current suicidality

Kaess, Michael; Schnyder, Nina; Michel, Chantal; Brunner, Romuald; Carli, Vladimir; Sarchiapone, Marco; Hoven, Christina W.; Wasserman, Camilla; Apter, Alan; Balázs, Judit; Bobes, Julio; Cosman, Doina; Häring, Christian; Kahn, Jean‐Pierre; Keeley, Helen; Keresztény, Ágnes; Podlogar, Tina; Poštuvan, Vita; Värnik, Airi; Resch, Franz; Wasserman, Danuta

doi:10.1007/s00787-020-01681-7

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…In our sample, 43.4% of adolescents with a migration background reported suicidal ideation several days within the past two weeks compared to 35.5% in adolescents without migration background. A European study before COVID-19 reported an elevated risk of suicidality within the last two weeks in 4.9% of adolescent participants [ 41 ]. To our knowledge, there are no studies available on adolescent suicidality during the pandemic; however, a preliminary study conducted in the US revealed a potential association of COVID-19-related fears and confinement measures with suicidal thoughts and attempts in adults [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Migration Status on Adolescents’ Mental Health during COVID-19

et al. 2022

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The purpose of this study was to compare mental health in adolescents with and without migration background after a semester of remote schooling and almost a year of social distancing in Austria. An online survey, supported by the Austrian Federal Ministry of Education, Science and Research, was conducted from 3rd February to 28th February 2021 measuring well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), stress (PSS-10), and disordered eating (EAT-8). A matched-pairs analysis with and without migration background was conducted and was checked with whole sample analysis. From a total of 3052 participants, N = 508 had a migration background (first or second generation) and N = 479 could be matched according to age, gender, region, and education with adolescents without migration background. Matched-pairs analyses showed that migration background is associated with poorer mental health concerning well-being, depression, anxiety, and insomnia scores (all p-values < 0.05). Prevalence of depressive symptoms (64.5% vs. 56.5%), anxiety symptoms (53.5% vs. 46.0%), as well as insomnia (31.9% vs. 21.0%) is higher in adolescents with migration background (all p-values ≤ 0.02). Comparison of the whole sample (N = 3052) confirmed these results. Results suggest that migration status is a risk factor for mental health problems among adolescents during the COVID-19 pandemic and highlight the need to implement easily accessible culture- and language-specific health promotion and prevention strategies.

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Section: Discussionmentioning

confidence: 99%

The Impact of Migration Status on Adolescents’ Mental Health during COVID-19

et al. 2022

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“…On the other hand, students with current suicidality at baseline, experiencing the highest burden and thus a potentially increased treatment motivation, were excluded from the regular ProfScreen intervention. Although these participants were detected through the regular school-based screening, they were excluded from the usual ProfScreen procedure and received an immediate intervention, which was associated with increased follow-up service use [ 34 ]. Thus, a school-based screening might be able to increase actual help-seeking to a greater extinct than is shown by the present findings, as it identifies particularly urgent cases and can provide rapid assistance at this point.…”

Section: Discussionmentioning

confidence: 99%

The impact of school-based screening on service use in adolescents at risk for mental health problems and risk-behaviour

Lustig

Hessels

Schnyder

et al. 2022

Eur Child Adolesc Psychiatry

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Early detection and intervention can counteract mental disorders and risk behaviours among adolescents. However, help-seeking rates are low. School-based screenings are a promising tool to detect adolescents at risk for mental problems and to improve help-seeking behaviour. We assessed associations between the intervention “Screening by Professionals” (ProfScreen) and the use of mental health services and at-risk state at 12 month follow-up compared to a control group. School students (aged 15 ± 0.9 years) from 11 European countries participating in the “Saving and Empowering Young Lives in Europe” (SEYLE) study completed a self-report questionnaire on mental health problems and risk behaviours. ProfScreen students considered “at-risk” for mental illness or risk behaviour based on the screening were invited for a clinical interview with a mental health professional and, if necessary, referred for subsequent treatment. At follow-up, students completed another self-report, additionally reporting on service use. Of the total sample (N = 4,172), 61.9% were considered at-risk. 40.7% of the ProfScreen at-risk participants invited for the clinical interview attended the interview, and 10.1% of subsequently referred ProfScreen participants engaged in professional treatment. There were no differences between the ProfScreen and control group regarding follow-up service use and at-risk state. Attending the ProfScreen interview was positively associated with follow-up service use (OR = 1.783, 95% CI = 1.038–3.064), but had no effect on follow-up at-risk state. Service use rates of professional care as well as of the ProfScreen intervention itself were low. Future school-based interventions targeting help-seeking need to address barriers to intervention adherence.Clinical Trials Registration: The trial is registered at the US National Institute of Health (NIH) clinical trial registry (NCT00906620, registered on 21 May, 2009), and the German Clinical Trials Register (DRKS00000214, registered on 27 October, 2009).

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“…Unfortunately, research regarding the prevalence of (non-) help-seeking behavior in suicidal or at-risk adolescents and young adults is rather scarce. Nevertheless, the few available studies suggest that help-seeking behavior for suicidality is not common among at-risk adolescents ( 19 , 20 ). For example, in a sample of 362 European youths, who were considered at-risk for suicidality at a baseline screening and completed a 12-month follow-up self-report, only 45 (12%) sought professional help ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Suicidal Ideation Among Children and Young Adults in a 24/7 Messenger-Based Psychological Chat Counseling Service

et al. 2022

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BackgroundSuicidality in children and young adults is a pervasive problem: approximately 40% of respondents in epidemiological surveys in German schools reported suicidal ideation, while up to 9% reported a suicide attempt in the past. While there is compelling evidence for the effectiveness of telephone-based hotline services, an increasing preference of adolescents for messenger-based counseling services can be observed. Therefore, the present study aims to investigate the utilization behavior and user satisfaction of users contacting a German messenger-based chat counseling service (“krisenchat”) regarding suicidal ideation.MethodsThe present cross-sectional study analyzed retrospective anonymous data on sociodemographic variables, utilization behavior, and user satisfaction of krisenchat users who used the service between May 2020 and July 2021. Chi-square-tests were used to identify associations of sociodemographic characteristics and utilization behavior with suicidal ideation. Mann-Whitney-U-tests were used to compare the user satisfaction and the recommendation-to-others-rate between suicidal and non-suicidal krisenchat-users.ResultsIn total, chat data of N = 11,031 users were collected. Of the n = 6,962 users included in the final analysis, n = 1,444 (20.7%) contacted krisenchat because of suicidal ideation. The average user experiencing suicidal ideation was 17 years old, female and currently not receiving other treatment. Further, suicidal ideation was significantly and positively associated with age and non-suicidal self-injury. Regarding utilization patterns, there were significant positive associations between suicidal ideation and counseling session count, mean amount of messages sent, and mean amount of words used per message by the user. User satisfaction was high, with 64.7% (n = 413) of users that answered the feedback survey and experiencing suicidal ideation rating the help they received as at least “good” and a recommendation rate of 89.6% (n = 571). Most importantly, no differences were found between users reporting suicidal ideation and those that do not regarding satisfaction and the probability of recommending the service.ConclusionResults imply satisfaction with the counseling service among users with suicidal ideation. Nevertheless, there is a need for further research into messenger-based counseling services regarding the prevention of suicidal behavior in children, youths, and young adults. Longitudinal studies are especially needed to assess the effectiveness of messenger-based interventions.Study RegistrationDRKS00026671.

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Twelve-month service use, suicidality and mental health problems of European adolescents after a school-based screening for current suicidality

Cited by 8 publications

References 40 publications

The Impact of Migration Status on Adolescents’ Mental Health during COVID-19

The Impact of Migration Status on Adolescents’ Mental Health during COVID-19

The impact of school-based screening on service use in adolescents at risk for mental health problems and risk-behaviour

Suicidal Ideation Among Children and Young Adults in a 24/7 Messenger-Based Psychological Chat Counseling Service

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