Bereaved by suicide and affected by suicide: how many receive help?

Every year about 600 suicide deaths and 11,000 suicide attempts are recorded in Denmark. Next to each suicidal act are numerous relatives and other next of kin who are deeply affected. Specialised support for bereaved and affected is being provided by volunteer organisations and it is unclear how many receive help. This research project will seek to map how many bereaved by suicide and affected by suicidal behaviour receive support from Nefos, one of the Danish volunteer organisations.


The project has received support from the Partnership for Suicide Prevention, Danish Health Authority

DRISP:  Annette Erlangsen


Partner:

  • Elene Fleischer, PhD Netværk for selvmordsramte (NEFOS)

MYPLAN – a self-help tool for management of crisis

People who have had a suicide attempt have a significantly higher risk of repeated suicidal behaviour. MYPLAN was created with the intention of being a self-help tool for management of suicidal crisis. This project consists of 1) a qualitative study of stakeholders on improvements to MYPLAN; 2) a randomized clinical trial to evaluate MYPLAN’s efficacy in reducing suicide intent among persons at risk of suicide, and 3) a person-centered evaluation of the MYPLAN to identify barriers and facilitators to its general implementation. The RCT was initiated in 2019 and is currently ongoing. Following studies have been published :
The project received support from the Danish TRYG Foundation.

Publications

https://trialsjournal.biomedcentral.com
https://www.tandfonline.com


DRISP: Charlotte Mühlmann Kate Andreassen Aamund, Jette Louise S. Larsen, Annette Erlangsen

Partners:

  • Hanne Frandsen, Mental Health Centre Copenhagen, Region H
  • Niels Buus, Mental Health Nursing, Sydney Nursing School, University of Sydney, Australia

TEENS trial

Non-suicidal self-injury (NSSI) is very prevalent among adolescents estimated to a lifetime prevalence in non-clinical samples of 17%; increasing in psychiatric populations. NSSI an important predictor of later suicidal behavior. Evidence for treatment is spares but internet-based interventions guided by a therapist have been suggested. We aim to investigate the effect of internet-based ERITA compared to weekly journaling as add-on to treatment as usual in 13-17-year-old patients with NSSI referred to child– and adolescent mental health services. This pilot feasibility study (n=25) is an RCT. The experimental interventions are add-on to treatment as usual. Primary outcome is the frequency of NSSI assessed after 12 weeks. Also, adherence to treatment will be assessed.

DRISP: Britt Morthorst

Partners:

  • Child and Adolescent Mental Health Services in the Capital Region of Denmark
  • Johan Bjureberg, PhD, Karolinska Instituttet, Stockholm, Sweden
  • Clara Hellner, MD, PhD, Karolinska Instituttet, Stockholm, Sweden

Clinical development project

The aim is to implement three questionnaires regarding protective and risk factors in suicide behavior in the treatment of children and adolescents. The implementation will contribute with a quality boost to the clinical work in the Suicide Prevention Clinic for children and adolescents by structured collecting and using tested scales to assess children and adolescents’ suicide risk, experience of mental stress as well as own strengths and weaknesses (resilience). The three scales that are to be used are: K10 (the experience of psychological stress), READ (resilience) and Columbia (the frequency and the intensity of suicide behavior). For the time being this is a clinical development project that may lead to a research project on a later stage.

DRISP: Britt Morthorst

Partners:

  • Child and Adolescent Mental Health Services in the Capital Region of Denmark
  • Center for Suicide Prevention, Region South Denmark

Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes

In this nationwide cohort study, an increased risk of mental and physical disorders, mortality, and adverse social events were noted among people bereaved by spousal suicide. Bereavement by suicide differed from bereavement by other manners of death. Surviving partners are affected on a broad range of mental, physical, and social health outcomes, suggesting a need for more proactive outreach. The findings have been published in JAMA Psychiatry.
The project was supported by the American Foundation for Suicide Prevention and the Danish Health Insurance Foundation.

DRISP: Annette Erlangsen og Merete Nordentoft

Partner:

  • Bo Runeson, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • James M. Bolton, Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
  • Holly C. Wilcox, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
  • Julie L Forman, Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • Jesper Krogh, Research Unit, Mental Health Centre Copenhagen, Denmark
  • Katherine Shear, Columbia School of Social Work, Columbia University College of Physicians and Surgeons, New York, New York
  • Yeates Conwell, Center for the Study and Prevention of Suicide, Department of Psychiatry, and Office for Aging, University of Rochester Medical Center, Rochester, New York

Workplace bullying and suicidal behaviour

Although workplace bullying is considered a stressful life-event, there is scarce evidence about its’ role as a risk factor for suicide attempt and death by suicide. The aim of this project is to examine whether people who report to have been exposed to workplace bullying have higher rates of suicidal behaviour than those not exposed.

The project has received support from the Psychiatric Research Foundation, Region Southern Denmark

DRISP: Annette Erlangsen

Partners:

  • Paul Maurice Conway, Institut for Psykologi, Københavns Universitet
  • Thomas Clausen, Det Nationale Forskningscenter for Arbejdsmiljø, København
  • Annie Høgh, Institut for Psykologi, Københavns Universitet
  • Elsebeth Stenager, Department of Regional Health Research, University of Southern

Suicidal behaviour after among victims of physical or sexual abuse

Abuse of children and youth is an important problem to emphasize and prevent. This project conducts a large, representative, study of victims of sexual and physical abuse.
The project has received support from the Danish Health Care Foundation.

DRISP: Annette Erlangsen & Merete Nordentoft

Partners

  • Holly Wilcox, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
  • Prof Elizabeth J. Letourneau, Moore Center for the Prevention of Child Sexual Abuse Johns Hopkins Bloomberg School of Public Health
  • Kairi Kolves, Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre in for Research and Training in Suicide Prevention at Griffith University




Suicidal behaviour among persons with ADHD

Persons diagnosed with ADHD have been found to have an increased risk of suicidal behaviour but the pathway remains to be thoroughly explored. The aim of this study was to determine whether persons with ADHD were more likely to present with suicidal behaviour, ie. suicide attempts, and deaths by suicide if they had a comorbid psychiatric disorder.

The findings of the study revealed that having a comorbid disorder was associated with a significantly higher rate of suicidal behavior; comorbid schizophrenia or substance abuse disorder were associated with the largest increase.

The project was carried out in cooperation with Prof Søren Dalgaard from Aarhus University and has received support from the Danish Lundbeck Foundation.

Published in British Journal of Psychiatry.

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/suicidal-behaviour-among-persons-with-attentiondeficit-hyperactivity-disorder/6CECF48A64E415C871D233B2607114ED



DRISP: Cecilie Aaling, Annette Erlangsen, Merete Nordentoft

Partners:

  • Professor Søren Dalsgaard, DM National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark

The SAFE project

The period immediately after a psychiatric discharge is associated with very high suicide risk. With the SAFE project, carried out at the Psychiatric Center Copenhagen in the period March 2018 to May 2020, the purpose is to examine whether the risk of suicidal behavior can be reduced by introducing a more systematic discharge process. The SAFE project implements three procedures 1) before the patient is discharged, there is face-to-face contact with the outpatient unit that will follow up on the patient after discharge 2) involvement of relatives before discharge or during the week after discharge 3) the outpatient team makes a home visit in the first week after discharge where a suicide risk assessment is carried out and a crisis plan is updated.

DRISP: Trine Madsen, Eybjørg A Heygum Egilsdóttir, Annette Erlangsen, Merete Nordentoft