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APSI: a proposed integrative model for suicide prevention

Published online by Cambridge University Press:  27 June 2014

J. Kelly ,
N. Sammon  and
M. Byrne
J. Kelly
Affiliation:
Assistant Psychologist, Roscommon Service Area, HSE West, Ireland
N. Sammon
Affiliation:
Research Assistant, Roscommon Service Area, HSE West, Ireland
M. Byrne*
Affiliation:
Principal Psychologist Manager, Roscommon Service Area, HSE West, Ireland
*
*Address for correspondence: Dr M. Byrne, Psychology Department, Roscommon Service Area, HSE West, Golf Links Road, Roscommon Town, Co. Roscommon, Ireland. (Email: michaelj.byrne@hse.ie)
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Abstract

Background

Deaths by suicide have been increasing in recent years in Ireland, many of whom have co-morbid mental health difficulties and/or have attended primary care services 1 month before death.

Aims

To profile how ‘Access to Psychological Services Ireland’ (APSI) provides stepped-care therapies for mild-to-moderate adult mental health presentations and the potential effectiveness of this model based on comparison to a review of evidence-based strategies in suicide prevention. A secondary aim is to highlight how APSI has the potential to target those at risk of suicide and provide an integrative after-care service to complement secondary care mental health services.

Findings

In a context of inter-agency working, APSI provides an integrated continuum of suicide prevention interventions that map onto or intervene across the continuum of suicide behaviour. Hence, APSI appears to implement what the literature suggests will work in preventing suicide. However, outcome research is needed to establish APSI’s impact in preventing suicide.

Recommendations

It is recommended that Irish-based research is conducted to establish APSI’s impact in preventing suicide with a view to rolling out APSI as a national mental health clinical care programme.

Keywords

Delivery of healthcareintegratedprimary carepsychological servicessuicide prevention
Type
Review Paper
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 3 , September 2014 , pp. 203 - 212
Copyright
© College of Psychiatrists of Ireland 2014 

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References

Appleby, L, Dennehy, JA, Thomas, CS, Farragher, EB, Lewis, G (1999). Aftercare and clinical characteristics of people with mental illness who commit suicide: a case control study. Lancet 353, 1397–1400.Google Scholar
Brown, GK, Ten Have, T, Henriques, GR, Xie, SX, Hollander, JE, Beck, AT (2005). Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. Journal of the American Medical Association 294, 563–570.Google Scholar
Bryan, CJ, Rudd, MD (2006). Advances in the assessment of suicide risk. Journal of Clinical Psychology 62, 185–200.CrossRefGoogle ScholarPubMed
Byrne, M, Onyett, S (2010). Teamwork within Mental Health Services in Ireland (http://wwwmhcirlie/Publications/Mindmap_Teamworkpdf). Accessed 4 April 2013.Google Scholar
Casey, PR, Dunn, G, Kelly, BD, Birkbeck, G, Dalgad, OS, Lehtinen, V, Britta, S, Ayuso-Mateos, JL, Dowrick, C (2006). Factors associated with suicidal ideation in the general population: five-centre analysis from the ODIN study. The British Journal of Psychiatry 189, 410–415.Google Scholar
Centers for Disease Control and Prevention (CDCP) (2011). Suicidal thoughts and behaviors among adults aged ⩾18 years – United States, 2008–2009. Surveillance Summaries 60, 1–28.Google Scholar
Central Statistics Office (2011). This is Ireland Highlights from 2011 Census, Part 1. Central Statistics Office: Dublin.Google Scholar
Cheng, ATA (1995). Mental illness and suicide: a case-control study in East Taiwan. Journal of the American Medical Association 52, 594–603.Google Scholar
Clarke, CS, Bannon, FJ, Denihan, A (2003). Suicide and religiosity: Masaryk’s theory revisited. Social Psychiatry & Psychiatric Epidemiology 38, 502–506.Google Scholar
Connor, KR, Wood, J, Pisani, AR, Kemp, J (2013). Evaluation of a suicide prevention training curriculum for substance abuse treatment providers based on Treatment Improvement Protocol Number 50. Journal of Substance Abuse Treatment 44, 13–16.Google Scholar
Craig, BJ, Rudd, DM (2006). Advances in the assessment of suicide risk. Journal of Clinical Psychology 62, 185–200.Google Scholar
Crowley, P, Kilroe, J, Bourke, S (2004). Youth suicide prevention (http://wwwchildhealthresearcheu/research/add-knowledge/Youth%20suicide%20preventionpdf). Accessed 17 February 2013.Google Scholar
Den Boer, PCAM, Wiersma, D, van den Bosch, RJ (2004). Why is self-help neglected in the treatment of emotional disorders? A meta-analysis. Psychological Medicine 34, 959–971.Google Scholar
Department of Health (DoH) (2012). Preventing suicide in England: a cross-government outcomes strategy to save lives (http://www.dh.gov.uk/health/files/2012/09/Preventing-Suicide-in-England-A-cross-government-outcomes-strategy-to-save-lives.pdf). Accessed 20 February 2013.Google Scholar
Dhossche, DM, Ulusarac, A, Syed, W (2001). A retrospective study of general hospital patients who commit suicide shortly after being discharged from the hospital. Journal of the American Medical Association 161, 991–994.Google Scholar
Gilbody, S, Bower, P, Fletcher, J, Sutton, AJ (2006). Collaborative care for depression: a cumulative meta-analysis and review of longer-terms outcomes. Archives of Internal Medicine 166, 2314–2321.Google Scholar
Glied, S, Herzog, K, Frank, R (2010). Review: the net benefits of depression management in primary care. Medical Care Research and Review 67, 251–274.Google Scholar
Goldney, RD (2005). Suicide prevention: a pragmatic review of recent studies. Crisis 26, 128–140.Google Scholar
Gunnell, D, Frankel, S (1994). Prevention of suicide: aspirations and evidence. British Medical Journal 308, 1227–1233.Google Scholar
Health Service Executive (2012). A vision for psychiatric/mental health nursing: a shared journey for mental health (http://www.hse.ie/eng/services/Publications/corporate/NursingMidwifery%20Services/A%20Vision%20for%20Psychiatric%20Mental%20Health%20Nursing.pdf). Accessed 19 February 2013.Google Scholar
Hegerl, U, Althaus, D, Niklewski, G, Schmidtke, A (2005). Optimierte Versorgung depressiver Patienten und Suizidprävention: Ergebnisse des, Nurnberger Bundnisses gegen Depression. [Optimal care of depressive patients and suicide prevention: results of the Nuremberg coalition against depression]. Dtsch Arztebl International 100, 2137–2142.Google Scholar
Heginbotham, C (1999). The psychodynamics of mental health care. Journal of Mental Health 8, 253–260.Google Scholar
Hepner, KA, Rowe, M, Rost, K, Hickey, SC, Sherbourne, CD, Ford, DE, Meredith, LS, Rubenstein, LV (2007). The effect of adherence to practice guidelines on depression outcomes. Annals of Internal Medicine 147, 320–329.Google Scholar
Hill, SA, Pritchard, C, Laugharne, R, Gunnell, D (2005). Changing patterns of suicide in a poor, rural county over the 20th century. Social Psychiatry and Psychiatric Epidemiology 40, 601–604.CrossRefGoogle Scholar
Hirsch, JK (2006). A review of the literature on rural suicide: risk and protective factors, incidence, and prevention. Crisis 27, 189–199.CrossRefGoogle Scholar
Hunkeler, EM, Katon, W, Tang, L, Williams, JW, Kroenke, K, Lin, EHB, Harpole, LH, Unützer, J (2006). Long term out- comes from the IMPACT randomised trial for depressed elderly patients in primary care. British Medical Journal 332, 259–263.Google Scholar
Irish Medical Organisation (2008). IMO Position Paper on Suicide Prevention. Irish Medical Organisation: Dublin.Google Scholar
Jorm, AF, Christensen, H, Griffiths, KM (2005). The impact of beyond blue: the national depression initiative on the Australian public’s recognition of depression and beliefs about treatment. Australian and New Zealand Journal of Psychiatry 39, 248–254.CrossRefGoogle Scholar
Katz, IR, Kemp, JE, Blow, FC, McCarthy, JF, Bossarte, RM (2013). Changes in suicide rates and in mental health staffing in the Veterans Health Administration, 2005–2009. Psychiatric Services 64, 620–625.Google Scholar
Kelleher, KJ, Taylor, JL, Rickert, VI (1992). Mental health services for rural children and adolescents. Clinical Psychology Review 12, 841–852.Google Scholar
Kelleher, MJ, Keeley, HS, Corcoran, P (1997). The service implications of regional differences in suicide rates in the Republic of Ireland. Irish Medical Journal 90, 262–264.Google ScholarPubMed
Kelly, BD, Doherty, AM (2013). Impact of recent economic problems on mental health in Ireland. International Psychiatry 10, 6–8.Google Scholar
King, EA, Baldwin, DS, Sinclair, JMA, Baker, NG, Campbell, M, Thompson, C (2001). The Wessex recent in-patient suicide study. I. Case control study of 234 recently discharged psychiatric patient suicides. British Journal of Psychiatry 178, 531–536.CrossRefGoogle Scholar
Kirwan, P (1991). Suicide in a rural Irish population. Irish Medical Journal 84, 14–15.Google Scholar
Knesper, DJ (2010). American Association of Suicidology, & Suicide Prevention Resource Center. Continuity of Care for Suicide Prevention and Research: Suicide Attempts and Suicide Deaths Subsequent to Discharge from the Emergency Department or Psychiatry Inpatient Unit. Education Development Center Inc.: Newton, MA.Google Scholar
Large, M, Sharma, S, Cannon, E, Ryan, C, Nielsson, O (2011). Risk factors for suicide within a year from psychiatric hospital: a systematic meta-analysis. Australian and New Zealand Journal of Psychiatry 45, 619–628.Google Scholar
Luoma, JB, Martin, CE, Pearson, JL (2002). Contact with mental health and primary care providers before suicide: a review of the evidence. American Journal of Psychiatry 159, 909–916.Google Scholar
MacSharry, M (2013). Actions speak louder than words: a structural approach to a societal issue (http://wwwfiannafailie/content/pages/9528/). Accessed 17 February 2013.Google Scholar
Mann, JJ, Apter, A, Bertolote, J, Beautrais, A, Currier, D, Haas, A, et al. (2005). Suicide prevention strategies: a systematic review. Journal of the American Medical Association 294, 2064–2074.Google Scholar
McHugh, P, Byrne, M (2013). Profile of the Shared Care Activities of Mental Health Teams in Ireland. HSE: Roscommon.Google Scholar
National Office for Suicide Prevention (2007). Annual report: reducing suicide requires a collective concerted effort from all groups on society (http://www.nosp.ie/annual_report_07_2.pdf). Accessed 20 February 2013.Google Scholar
National Office for Suicide Prevention (2011). Annual report (http://www.nosp.ie/annual_report_2011.pdf). Accessed 4 June 2013.Google Scholar
National Suicide Research Foundation (2013). Suicides in Republic of Ireland from 2001–2011 (http://wwwnsrfie/cms/?q=node/36) Accessed 17 October 2013.Google Scholar
NICE (2004). Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. CG 9. NICE: London.Google Scholar
NICE (2009). Depression. The Treatment and Management of Depression in Adults. CG 90. NICE: London.Google Scholar
NICE (2011a). Generalized Anxiety Disorder and Panic Disorder (with or without Agoraphobia) in Adults. Management in Primary, Secondary and Community Care. NICE: London.Google Scholar
NICE (2011b). Self-harm: Longer-Term Management. NICE: London.Google Scholar
Owens, C, Loyd, KR, Campbell, J (2004). Access to health care prior to suicide: findings from a psychological autopsy study. British Journal of General Practice 54, 279–281.Google Scholar
Rutz, W, Walinder, J, Von Knorring, L, Rihmer, Z, Pihlgren, H (1997). Prevention of depression and suicide by education and medication: impact on male suicidality. An update from Gotland study. International Journal of Psychiatry in Clinical Practice 1, 39–46.Google Scholar
Rygnestad, T (1992). Suicide in Norway. Changes in the 20th century with special emphasis on the development during the last 20 years. Tidsskr Nor Laegeforen 112, 38–42.Google Scholar
Schulberg, HC, Hyg, MS, Bruce, ML, Lee, PW, Williams, JW, Dietrich, AJ (2004). Preventing suicide in primary care patients: the primary care physician’s role. General Hospital Psychiatry 26, 337–345.Google Scholar
Scowcroft, E (2013). Suicide statistics report: data for 2009–2011 (http://www.samaritans.org/sites/default/files/kcfinder/files/research/Samaritans%20Suicide%20Statistics%20Report%202013.pdf). Accessed 17 October 2013.Google Scholar
Sharrock, J, Grigg, M, Happell, B, Keeble-Devlin, B (2006). The mental health nurse: a valuable addition to the consultation-liaison team. International Journal of Mental Health Nursing 15, 35–43.Google Scholar
Slee, N, Garnefski, N, van der Leeden, R, Arensman, E, Spinhoven, P (2008). Cognitive–behavioural intervention for self-harm: randomised controlled trial. The British Journal of Psychiatry 192, 202–211.Google Scholar
Statistics Canada (2002). Suicides and Suicide Rate by Sex and Age Groups. Health Statistics Division: Ottawa, Ontario, Canada.Google Scholar
Substance Abuse and Mental Health Services Administration (2009). Suicide assessment five-step evaluation and triage. Retrieved from: http://store.samhsa.gov/shin/content//SMA09-4432/SMA09-4432.pdf. Accessed 5 June 2013Google Scholar
Suyemoto, KL (1998). The functions of self-mutilation. Clinical Psychology Review 18, 531–554.Google Scholar
Swift, JK, Callahan, JL (2009). The impact of client treatment preferences on outcome: a meta-analysis. Journal of Clinical Psychology 65, 368–381.Google Scholar
Tarrier, N, Taylor, K, Gooding, P (2008). Cognitive-behavioral interventions to reduce suicide behavior: a systematic review and meta-analysis. Behavioral Modification 32, 77–108.CrossRefGoogle ScholarPubMed
Tedstone-Doherty, D, Moran, R, Kartalova-O’Doherty, Y (2008). Psychological Distress, Mental Health Problems and Use of Health Services in Ireland. Health Research Board: Dublin.Google Scholar
Tierney, C (2013). Minister accepts process that closed acute unit in Ballinasloe, The Irish Times, 11 October (http://www.irishtimes.com/minister-accepts-process-that-closed-acute-unit-in-ballinasloe-1.155693). Accessed 5 June 2013.Google Scholar
Unützer, J, Katon, W, Callahan, CM, Williams, JW, Hunkeler, E, Harpole, L, Marc Hoffing, M, Della Penna, RD, Hitchcock Noël, P, Lin, EHB, Areán, PA, Hegel, MT, Tang, L, Belin, TR, Sabine Oishi, S, Langston, C (2002). Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. Journal of the American Medical Association 288, 2836–2845.Google Scholar
Vannoy, SD, Fancher, T, Meltvedt, C, Unützer, J, Duberstein, P, Kravitz, RL (2010). Suicide inquiry in primary care: creating context, inquiring and following up. Annals of Family Medicine 8, 33–39.CrossRefGoogle ScholarPubMed
World Health Organization (2010). Suicide prevention (SPURE) (http://www.who.int/mental_ health/prevention/suicide/suicideprevent/en/). Accessed 13 May 2013.Google Scholar
World Health Organization (2012). Public health action for the prevention of suicide (http://appswhoint/iris/bitstream/10665/75166/1/9789241593570_engpdf). Accessed 13 May 2013.Google Scholar