Suicide Behavior among Guyanese Orphans: Identification of suicide risk and protective factors in a Low-Middle-Income-Country

Objective: Suicide is the leading cause of death among youth in Guyana, a low- and middle-income country (LMIC), which globally ranks first in female adolescent suicides over the last decade. Worldwide, Guyana has experienced the largest increase in youth suicide, despite focused public health efforts to reduce suicide. Further, youth in Guyana, who are clients of the orphanage system and have faced early childhood trauma, may have an additive risk for suicide. Guided by an ideation-to-action theoretical framework for suicide prevention, the goal of the proposed research study is to describe and identify risk and protective factor correlates of youth suicidal behaviour among those at highest risk for suicide – orphans who reside in a LMIC institutional setting. Methods: In a preliminary sample of 25 orphan youth, one licensed psychologist and two social workers administered the DSM-5 Level 1 Cross-Cutting Symptom Measure and Behavioural Assessment Schedule for Children, 2nd Edition (BASC-2) during a semi-structured interview. Results: Nine of the 25 (36%) orphans reported a previous suicide attempt. Youth who endorsed suicidal behaviour had clinically elevated interpersonal relations scale scores when compared to youth who did not. Conclusions: Interpersonal skills may be protective for youth at highest risk for suicide

Psychiatric Aspects of Lyme Disease in Children and Adolescents: A Community Epidemiologic Study in Westchester, New York

To date, no community study has examined the psychiatric aspects and or sequelae of Lyme disease (LO) among children. As part of a community epidemiologic study of psychiatric disorders among children ages 9 through 17 in a Lyme endemic county, parents were asked whether their child had ever been diagnosed as having LD, and 10.1% (36/357) responded yes to the LO question. Of the 36, 29 also agreed to take part in a follow-up interview. Sixteen of the 29 children had had physician-diagnosed LO as well as either an erythema migrans rash or a positive serology. Fifteen of these 16 received treatment within I month of symptom onset; none of these 15 children were symptomatic longer than 4 months. Only one child had physical symptoms at the time of the interview; she was not treated until 4 month~ after symptom onset. This child experienced 5 years of mtermittent arthritis, cognitive deficits, emotional problems, severe fatigue, and a deterioration in school performance. Courses of oral antibiotics were at first associated with a good response, followed by a resurgence of symptoms month<; later. The lifetime prevalence of LD by history among children ages 9 through 17 in an endemic area may be at least 44.8/1000. In general, when LD is diagnosed early, it responds well to treatment. Delayed diagnosis and treatment may lead to a chronic course

Medicaid and Service Use Among Homeless Adults

Expansions of Medicaid eligibility intend to improve access to care, and to shift care from emergency rooms and inpatient hospital care to more appropriate sites. We examine the effect of Medicaid recipiency on the level and site of medical service utilization using data from 1985 and 1987 surveys of New York City homeless single men and women. Simple regressions of Medicaid on the use of health services among homeless adults indicate that Medicaid significantly increases the likelihood that these individuals receive services, especially emergency and inpatient hospital services. We test this result in further analyses that control for health status, use instrumental variables procedures, and examine differences between a similar population in 1985 and 1987. These analyses suggest that Medicaid neither increases nor diminishes access to emergency rooms. We find some evidence that suggests that Medicaid does improve access to non-hospital medical care.

Post-Traumatic Stress Disorder in Children and Adolescents: Some Recent Research Findings

Childhood trauma can have a profound effect on development, with a lifelong impact on physical growth, psychological development, and mental health. This chapter provides a framework for adolescent health professionals to understand the impacts of traumatic stress on children and adolescents. This chapter mainly takes the Wenchuan Earthquake studies in China as an example, and reviews recent research findings on epidemiological characteristics of PTSD and related mental disorders, as well as on possible influencing factors and mechanisms for post-traumatic adaptation in children and adolescents. Important intervention strategies for PTSD in children and adolescents are introduced. Prospects for future research are also discussed

How Americans Feel About Terrorism And Security: Two Years After 9/11

Understanding attitudes, concerns and reactions of individuals and families is critical to emergency planning efforts on all levels. In order to have effective implementation of a disaster plan, people need to be confident in (a) the reliability of information from official sources, (b) the capacity of government to perform effectively in a crisis and (c) the capability of response systems, particularly the health systems and first responders. Absence of confidence in response systems or leadership may undermine the best of crisis plans, leading to unnecessary panic and potential excess loss of life. In August 2003, The National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, in collaboration with The Children's Health Fund, commissioned the Marist Institute for Public Opinion to conduct a survey of adults nearly two years after the multiple terrorist attacks on New York, Washington, D.C. and Pennsylvania. The survey included both a national and a New York City representative sample of households contacted by telephone. Questions covered a wide range of issues including people's concern about potential new additional acts of terrorism in the U.S., the government's ability to protect citizens, and the health system's capacity to respond. Throughout, specific questions were asked of a subset of parents of children from four to eighteen years of age. To the extent possible, specific questions were replicated from four previous surveys commissioned by The Children's Health Fund since September 11, 2001 to identify trends in public attitudes and perceptions

A Diagnostic Aid For Detecting Multiple Mental Disorders In Primary Care: The Symptom Driven Diagnostic System For Primary Care (sdds-pc*).

A high rate of undiagnosed mental disorders in primary care has been well documented for nearly three decades. (Shepherd et al 1966; Regier et al 1978,1993; Goldberg et al 1980; Van Hermert et al 1993; Olfson and Klerman, 1992; Barrett et al 1988). Failure to recognize mental illness has been shown to lead to undertreatment, greater impairment, and a longer duration of illness (Ormel et al 1991). The few efforts to change the diagnostic practice of primary care physicians, either through providing information from a patient screen completed prior to the physician visit or through physician education, have provided equivocal results. (Higgins 1994; Rand et al 1988; Goldberg 1980). The effects of improved physician recognition on decreasing patients’ health care use have also been equivocal, probably because there are many steps between recognition and patient outcome. These steps include accurate diagnosis, proper treatment, patient compliance, and timely follow-up with adjustment in treatment, as needed. Efforts to improve detection of mental disorders have concentrated on developing patient screens, which usually includea list ofpsychiatric symptoms independent of specific diagnoses, (Goldberg et al 1980; Borgquist et al 1993; Von Korff et al 1987) or which screen for one diagnosis; depression or alcoholism (Selzer 1971; Babor et al 1992). The former approach is limited because symptoms are not directly related to a treatable disorder, the latter, because patients may have more than one treatable psychiatric disorder (Kessler et al 1994). Moreover, screens are not widely used in primary care (Nelson and Berwick, 1989). Because most primary care visits are 15 minutes long or less, there is a need to develop rapid assessment methods that can be incorporated into routine care (Barrett 1991; Mitchell et al 1988; Anderson and Mattsson 1989)

Rapport fra 25. juni-utvalget: Evaluering av PST og politiet

Source at https://www.politiet.no/om-politiet/organisasjonen/sarorganene/politidirektoratet/

Investigating the effectiveness of three school based interventions for preventing psychotic experiences over a year period – a secondary data analysis study of a randomized control trial

INTRODUCTION: Psychotic experiences (PEs) are associated with increased risk of later mental disorders and so could be valuable in prevention studies. However, to date few intervention studies have examined PEs. Given this lack of evidence, in the current study a secondary data analysis was conducted on a clustered-randomized control trial (RCT) of 3 school based interventions to reduce suicidal behaviour, to investigate if these may reduce rates of PEs, and prevent PE, at 3-month and 1-year follow-up. METHODS: The Irish site of the Saving and Empowering Young Lives in Europe study, trial registration (DRKS00000214), a cluster-RCT designed to examine the effect of school-based interventions on suicidal thoughts and behaviour. Seventeen schools (n = 1096) were randomly assigned to one of three intervention arms or a control arm. The interventions included a teacher training (gate-keeper) intervention, an interactive educational (universal-education) intervention, and a screening and integrated referral (selective-indicative) intervention. The primary outcome of this secondary data-analysis was reduction in point-prevalence of PEs at 12 months. A second analysis excluding those with PEs at baseline was conducted to examine prevention of PEs. Additional analysis was conducted of change in depression and anxiety scores (comparing those with/without PEs) in each arm of the intervention. Statistical analyses were conducted using mixed-effects modelling. RESULTS: At 12-months, the screening and referral intervention was associated with a significant reduction in PEs (OR:0.12,95%CI[0.02–0.62]) compared to the control arm. The teacher training and education intervention did not show this effect. Prevention was also observed only in the screening and referral arm (OR:0.30,95%CI[0.09–0.97]). Participants with PEs showed higher levels of depression and anxiety symptoms, compared to those without, and different responses to the screening and referral intervention & universal-education intervention. CONCLUSIONS: This study provides the first evidence for a school based intervention that reduce & prevent PEs in adolescence. This intervention is a combination of a school-based screening for psychopathology and subsequent referral intervention significantly reduced PEs in adolescents. Although further research is needed, our findings point to the effectiveness of school-based programmes for prevention of future mental health problems. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-15107-x