Attitudes toward suicidal behaviour in outpatient clinics among mental health professionals in Oslo

Background: To investigate attitudes among professions in mental health care outpatient clinics in Child and Adolescent Psychiatry (CAP) (i.e., children and adolescents) or District Psychiatric Centres (DPC) (i.e., adults aged 18–67 years). Methods: Professionals in four outpatient units in Oslo were enrolled (N = 229: 77%). The Understanding of Suicidal Patient Scale (USP) (range, 11 = positive to 55 = negative) and Attitudes towards Suicide (ATTS) (1 = totally disagree, 5 = totally agree) were assessed. Questions about competence, religion, experiences of and views on suicidal behaviour and treatment were explored. Results: All professionals reported positive attitudes (USP 18.7) and that suicide could be prevented (ATTS 4.3). Professionals who had received supervision or were specialists had more positive attitudes. Professionals in CAP were less satisfied with available treatment. Psychiatric disorders were considered the most common reason for suicidal behaviour, and psychotherapy the most relevant treatment. The professionals confirmed that patients with other disorders of comparable severity are followed up more systematically. Conclusions: The professionals showed positive attitudes with minor differences between CAP and DPC. Keywords: Attitudes, suicide, suicidal behaviour, suicide ideation, health professionals

Attitudes towards suicidal behaviour in outpatient clinics among mental health professionals in Oslo

BACKGROUND: To investigate attitudes of professionals working in mental health care outpatient clinics in Child and Adolescent Psychiatry (CAP) (for children and adolescents aged 0–18 years) and District Psychiatric Centres (DPC) (for adults aged 18–67 years). METHODS: Professionals in four outpatient units in Oslo were enrolled (n = 229: 77%). The Understanding of Suicidal Patient scale (USP) (11 = positive to 55 = negative) and Attitudes Towards Suicide questionnaire (ATTS) (1 = totally disagree to 5 = totally agree) were used to assess professionals’ attitudes. Questions explored competence, religion, experiences of and views on suicidal behaviour and its treatment. RESULTS: All the professionals indicated positive attitudes (USP 18.7) and endorsed the view that suicide was preventable (ATTS 4.3). Professionals who had received supervision or were specialists had attitudes that were more positive. Professionals in CAP were less satisfied with available treatment. Psychiatric disorders were considered the most common cause of suicidal behaviour, and psychotherapy the most appropriate form of treatment. The professionals confirmed that patients with other disorders of comparable severity are followed up more systematically. CONCLUSIONS: The professionals showed positive attitudes with minor differences between CAP and DPC

Effect of Systematic Follow-Up by General Practitioners after Deliberate Self-Poisoning: A Randomised Controlled Trial.

To assess whether systematic follow-up by general practitioners (GPs) of cases of deliberate self-poisoning (DSP) by their patients decreases psychiatric symptoms and suicidal behaviour compared with current practice.Randomised clinical trial with two parallel groups.General practices in Oslo and the eastern part of Akershus County.Patients aged 18-75 years admitted to hospital for DSP. We excluded patients diagnosed with psychoses, without a known GP, those not able to complete a questionnaire, and patients admitted to psychiatric in-patient care or other institutions where their GP could not follow them immediately after discharge.The GPs received a written guideline, contacted the patients and scheduled a consultation within one week after discharge, and then provided regular consultations for six months. We randomised the patients to either intervention (n = 78) or treatment as usual (n = 98).Primary outcome measure was the Beck Scale for Suicide Ideation (SSI). Secondary outcomes were Beck Depression Inventory (BDI) and Beck Hopelessness Scale (BHS), self-reported further self-harm and treatment for DSP in a general hospital or an emergency medical agency (EMA). We assessed patients on entry to the trial and at three and six months. We collected data from interviews, self-report questionnaires, and hospital and EMA medical records.There were no significant differences between the groups in SSI, BDI, or BHS mean scores or change from baseline to three or six months. During follow-up, self-reported DSP was 39.5% in the intervention group vs. 15.8% in controls (P = 0.009). Readmissions to general hospitals were similar (13% in both groups (P = 0.963), while DSP episodes treated at EMAs were 17% in the intervention group and 7% in the control group (P = 0.103).Structured follow-up by GPs after an episode of DSP had no significant effect on suicide ideation, depression or hopelessness. There was no significant difference in repeated episodes of DSP in hospitals or EMAs. However, the total number of incidents of deliberate self-harm reported by the patients was significantly higher in the intervention group.Trial registration ClinicalTrials.gov Identifier: NCT01342809

Scores for the Intervention and Control groups on Beck Suicide Ideation Scale, Beck Hopelessness Inventory and Beck Depression Inventory Across three time periods.

<p>Between-within subjects effect analysis of variance (ANOVA).</p><p>p-values given in the table for</p><p>°Between intervention and time</p><p>°°within factors effect and</p><p>°°°interaction effect.</p><p>Scores for the Intervention and Control groups on Beck Suicide Ideation Scale, Beck Hopelessness Inventory and Beck Depression Inventory Across three time periods.</p

Participant flow chart.

<p>Participant flow chart.</p

Demographic and clinical baseline characteristics.

<p>^#Chi-square test.</p><p>° Students t-test.</p><p>Demographic and clinical baseline characteristics.</p

Beck Suicidal Intent Scale, Beck Suicide Ideation Scale, Beck Depression Inventory, Beck Hopelessness Scale and Self-reported intention at baseline.

<p>*It was possible to answer in more than one category; therefore, the total exceeds 100%.</p><p>^#Chi-square test.</p><p>°Students t-test.</p><p>Beck Suicidal Intent Scale, Beck Suicide Ideation Scale, Beck Depression Inventory, Beck Hopelessness Scale and Self-reported intention at baseline.</p