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

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)

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries

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Work-related risk factors for suicidal behaviour, protective factors and possibilities for prevention

Work is an important part of adult life. As such it is closely connected to health and mental health. Aspects of occupation, work and employment can represent risk factors for suicidal behaviour or protective factors against it. Aim of this article is to present the known work-related risk factors for suicidal behaviour, protective factors and possibilities for preventive activities in this context. An important risk factor for suicidal behaviour is unemployment. Connection between unemployment and suicidality is complex and can be explained in two ways: (i) underlying vulnerability leads to both unemployment and suicidal behaviour, while (ii) the connection is also thought be causal to some extent. The addressed topic is very important in the period of economic recession, when unemployment rates are high and adverse changes in terms of working conditions can occur. Different psycho-social and other working conditions are also connected to suicidal behaviour. Efficient preventive activities include approaches on multiple levels: active politics of solving economic crisis and improving the labour market conditions, creating and maintaining stimulating working conditions, raising awareness and mental health promotion among the employees, gatekeeper training, and restriction of means for suicide in occupations with access to them. Due to complexity of suicidal behaviour there is a need for further research, which would contribute to better understanding of specific risk factors and especially protective factors in vulnerable groups