'He just gave up': an exploratory study into the perspectives of paid carers on supporting older people living in care homes with depression, self-harm, and suicide ideation and behaviours

This study explored the concept of ‘giving up’ from the perspective of care staff working in care homes, and their everyday communication and hidden knowledge concerning what they think about this taboo topic and the context it reflects. Moving to a care home is a major transition where cumulative losses can pose risks to mental health in later life. If not recognised, this vulnerability can lead to depression which extends to suicide ideation and behaviours in the form of self-harm and self-neglect. Care homes are a significant place of care until death, yet a discourse of silence means that self-harm and suicide is under-reported or not attended to with specialist expertise. The layperson’s concept of an older person ‘giving up’ on life is hardly discussed in the literature. This co-produced qualitative study used an inductive approach to explore this phenomenon through focus groups with 33 care staff across four care homes in South-East England. Findings paint a complex picture, highlighting tensions in providing the right support and creating spaces to respond to such challenging situations. ‘Giving up’ requires skilled detailed assessment to respond to risks alongside improved training and support for paid carers, to achieve a more holistic strategy which capitalises on significant relationships within a wider context

Needs, expectations and consequences for the child growing up in a family with a parent with mental illness

Parental mental illness is considered one of the strongest risk-factors for development of offspring psychopathology. The lack of pan-European guidelines for empowering children of parents with mental illness led to EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The first task in this project, was to analyse needs, expectations and consequences for children, with respect to living with a parent with mental illness. The aim this paper is to report results of these analyses. The qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland (N=96). There were 3 types of focus groups: (1) professionals (doctors, nurses, psychologists, social workers), (2) adult children and partners of a person with mental illness, (3) parents who have experienced mental illness during their parenthood. Framework analysis method was used. Results of the study highlighted that the main consequences for children of parental mental illness were role reversal, emotional and behavioural problems, lack of parent’s attention and stigma. The main needs of these children were emotional support, security and multidisciplinary help. Implications for practice are: (1) professionals working with parents with mental illness should be aware of the specific consequences for the children; (2) to empower children they should focus on them, but not excluding parents from the parental roles; (3) the multi-agency collaboration is necessary; (4) schools should provide counselling and teach staff and students about mental health problems to reduce stigm

E P U B Epidemiology of suicide attempts in a psychiatric setting in Northern Italy Epidemiologia dei tentati suicidi in un Servizio di Salute Mentale del Nord Italia (Rovigo)

Summary Objectives An observational study was carried out to investigate suicide attempts in the period from January 1, 2006 to December 31, 2010 in the population of legal age from the territory of Rovigo in Northern Italy. (p < 0.05; Methods All intentional self-poisoning or self-injury event

Epidemiology of suicide attempts in a psychiatric setting in Northern Italy

Objectives An observational study was carried out to investigate suicide attempts in the period from January 1, 2006 to December 31, 2010 in the population of legal age from the territory of Rovigo in Northern Italy. Methods All intentional self-poisoning or self-injury events, irrespective of motivation, that came to the attention of Mental Health Services was recorded. Personal data (age, sex, marital status, occupation, educational level and family composition), clinical data (main diagnostic group, method used in the attempt, previous contact with the Service, previous suicide attempts, site of first psychiatric consultation) were recorded for every person encountered by the psychiatrist involved in the first evaluation. All the people recruited were also asked to fill in a self-administered interview composed of three questionnaires: QD - questionnaire of depression by CBA \u2013 cognitive behavioral assessment; BSI \u2013 borderline syndrome index and RFL \u2013 reason for living inventory. Results Two-hundred and sixty-five suicide attempts with a psychiatric evaluation were considered in a population of 149,300 people over a period of 5 years. A higher distribution in females and younger people was found. There is a high percentage of unemployed people (23.1%), especially among males (29.3%) (\u3c72 test:4.02; p < .05). In the majority of cases the means of the suicidal attempt is drug poisoning (59%) and violent methods (hanging, gas poisoning, jumping, fire arms and drowning) represent the 25.2% of all the sample, with a higher percentage for male subjects (35.9%; OR: 2.66 [95% CI: 1.34-5.29]). The great majority of people were assessed in Emergency Rooms (64.1%) and after the psychiatric evaluation, 69.2% of the people were hospitalized in psychiatric wards. The main diagnostic group is personality disorders (33.3%) followed by mood disorders (24.4%): there is a significant sex difference with more females with mood disorders (\u3c72 test: 6.88; p < .01) and more males with alcohol/substance disorders (\u3c72 test: 19.4; p <.01). In 40.6% of cases had at least one contact with Mental Health Services before while a relevant percentage of people (43.2%) had a positive history for previous attempts. People with a positive history of suicidal attempts were at major risk of borderline personality (OR: 2.01 [95% CI: 1.02-3.95]) while it was less evident in people with a higher presence of reason for living by the RFL questionnaire (p < 0.05; adjusted OR: 0.39 [95% CI: 0.16-0.94])

The Opinions of GP\u27s patients about suicide, assisted suicide, euthanasia, and suicide prevention

A survey about opinions on end-of-life issues of a population represented by 1,171 people in the waiting room of general practitioners' surgeries was conducted in a province of northern Italy. Most subjects did not consider suicide as a reasonable option even in cases of a serious and incurable disease. Moreover, subjects did not consider euthanasia as a possible option either; however, they did express an opposite attitude when considering euthanasia in a third-person perspective. People with a personal history of suicidal behavior appear to present as a different population, overall expressing more open attitudes

Life Span History of Non-fatal Suicidal Behaviours in a Large Sample of General Practitioners' Patients: Data from Rovigo, Northern Italy.

A survey about history of non-fatal suicidal behaviour was performed on 1,171 subjects in the waiting room of general practitioners' practices in the territory of Rovigo (Northern Italy). The mean age of interviewed subjects was 52.9 \ub1 17.0, with a majority of female individuals. Two and two percent admitted previous experience of non-suicidal self-injury, 4.7 % admitted having had serious suicidal thoughts/plans, and 1.8 % reported at least one suicide attempt. Compared to the rest of the sample, people with history of suicidal behaviours resulted to be of younger age (p < .05), whilst their level of well-being was poorer (p < .001). When compared to the results of the Italian arm of the European Study of the Epidemiology of Mental Disorders, carried out on general population samples, the present study produces higher rates of suicidality, despite the much higher mean age of the interviewed subjects compared to the general populatio