Naoko Ide

Suicidal ideation and behaviour in the aftermath of marital separation: Gender differences

BACKGROUND The limited studies on the consequences of the separation process on suicidal behaviour seem to indicate that separated people are at increased risk of suicide. AIMS The current study aims to compare suicidality immediately after the separation among males and females, and to analyse possible differences in predictors of serious suicidal ideation. METHOD Separated males and females who had contacted relationship counselling services, help-line services, and a variety of support and self-help groups were asked to participate in the study. Participants were required to be 18 years old or older, and have separated from their married/de facto partner within the previous 18 months but not yet divorced. For categorial variables odds ratios with 95% CI and for continuing variables t-tests were calculated. Multinomial logistic regression was applied to estimate the independent contribution of significant predictors. RESULTS Separated males (n=228) were at an increased risk of developing suicidality during the separation process compared to separated females (n=142), even after adjusting for age, education, employment and children with the separated partner. The psycho-social risk factors identified in the development of serious suicidal ideation were mental health problems (during the previous year), history of suicide attempts and internalised shame. For separated males, significant predictors also included lower education, separation-related shame and stress from legal negotiations, especially about property/financial issues. CONCLUSIONS The findings provide a better understanding of suicidal behaviours in the aftermath of marital or de facto separation. This knowledge could be used in the implementation of future suicide prevention strategies in people who are going through the process of a marital/de facto separation.

Separation as an Important Risk Factor for Suicide: A Systematic Review

Examining how different phases of relationship separation effects the development of suicidal behaviors has been largely ignored in suicide studies. The few studies conducted suggest that individuals experiencing the acute phase of marital/de facto separation may be at greater risk of suicide compared with those experiencing long-term separation (divorce). To clarify the effects of these factors on detection and prevention of suicidal behaviors, a critical review of the English-language literature on this topic from 1966 to 2008 was undertaken. No studies reliably indicate the impacts of acute separation versus long-term divorce on suicidality. Moreover, research has not specifically addressed the interaction between the psychosocial factors influencing suicidal behaviors in the context of a marital/de facto separation. Considering the large proportion of suicides that occur in the context of marital/de facto separation, our limited understanding of the factors involved in the development of these suicidal behaviors is of concern.

Is suicide prevention properly taught in medical schools

Objective: To determine the need and feasibility of developing a national suicide prevention (SP) curriculum for undergraduate medical students. Design: Exploratory study using semi-structured phone interviews and surveys. Data was obtained from ten (out of 15) Australian Medical Schools (AMS), 373 medical students from one Queensland medical school, and 24 Australian General Practitioners, between April and June, 2006. Results: Convergent views of AMS, medical students, and GPs revealed a high need and support for SP curricula, especially on skills-based education. Students who previously received SP education rated themselves significantly higher on skills-based SP abilities than those who had not. Over one-third of GPs had not received SP training from their universities (37.5%), yet 66% had experienced a case of suicide among their patients, and a third recorded on average a case of suicide every two years. The majority of students and GPs rated themselves as least competent on skills-based SP capabilities, yet rated these capabilities very high in importance for the medical profession. Whilst 80% of AMS provides some form of SP education, the quantity and quality of this is divergent. All AMS indicated support for a more uniformed SP curriculum, identified priority SP topics and delivery mechanisms, and 80% agreed to participate in a future piloting of a SP curriculum. Conclusions: SP curriculum may positively impact on students perceived competency. Skills-based SP curricula were highly recommended to improve ‘hands-on’ assessment, intervention and management capabilities. Further consultation is required with all AMS to specify structure and resource needs for a national SP curriculum.

Do we need education on right‐to‐die issues? Medical perspectives from Australia

An increasing demand for physicians’ involvement in life‐ending decisions has led to extensive debate on euthanasia and right‐to‐die issues by social, political and medical groups. The Commonwealth Department of Health and Aged Care commissioned an evaluation of the need to educate undergraduate medical students on suicide prevention, euthanasia and life‐ending issues.Introduction An increasing demand for physicians’ involvement in life-ending decisions has led to extensive debate on euthanasia and right-to-die issues by social, political and medical groups. The Commonwealth Department of Health and Aged Care commissioned an evaluation of the need to educate undergraduate medical students on suicide prevention, euthanasia and life-ending issues. Methods Semi-structured interviews were conducted on samples of medical school coordinators, medical students and general practitioners (GPs). Key academics in Curriculum and/or Accreditation Committees from 10 of 15 Australian Medical Schools (AMS) participated in a survey on the possible implementation of suicide prevention, euthanasia and life-ending issues in undergraduate courses. Medical students (n = 373) were asked to rate their attitude toward the same issues. Twenty-four GPs from six different states (rural/urban environments) were asked to rate the level of importance of a specific curriculum on suicide prevention, euthanasia and life-ending issues. Results Medical students showed high interest in learning about euthanasia and life-ending issues (76.8%), quality of life and quality of death (85.1%), and different types of euthanasia and physician-assisted suicide (70%). They reported that physicians should be involved in ending-life decisions (89%). Forty per cent of AMS thought education on euthanasia and life-ending issues was essential. Fifty-four per cent of GPs considered education in euthanasia and related issues a high priority. Discussion The increasing aging population and the high prevalence of chronic illness call for a growing involvement of physicians in this difficult area of medical practice. Globally, the need for undergraduate education on these matters is perceived as important and urgent.

Has the Suicide Rate Risen with the 2011 Queensland Floods

This study compared the prevalence and characteristics of suicides following the January 2011 Queensland floods to the 11 years prior (for the period January–June) for two severely affected locations: Ipswich and Toowoomba. Findings showed no significant increase in suicide rates during the 6 months after the floods. This may be explained by the elevated level of social support and care available in this period, which protected residents against risk factors for suicide. Nonetheless, the floods may have a delayed effect on suicide mortality. This highlights the importance of continued monitoring of suicidal behaviors and providing support to the people affected.

Review of suicide-prevention programs in Queensland: State- and community-level activities

OBJECTIVE Information regarding the availability of suicide-prevention programs in Australia is sparse and rather difficult to obtain. This study aimed to report and describe suicide and/or self-harm-prevention programs in Queensland. METHODS Programs were classified by type of intervention, predominant type of program, setting of delivery and targeted population-at-risk. RESULTS Sixty-six organisations were identified, providing a total of 101 suicide-prevention programs. The majority of programs operated at the prevention or treatment level, with less than half providing continuing (long-term) care. The programs targeted 12 different risk groups and were most frequently delivered within community settings. CONCLUSIONS The findings show a diverse distribution of activities across the levels of prevention and different risk populations. This survey demonstrates the existence of remarkable gaps in coverage and provision of programs for specific high-risk groups.