TY - JOUR
T1 - Two-day assertive-case-management educational program for medical personnel to prevent suicide attempts
T2 - A multicenter pre–post observational study
AU - Kawashima, Yoshitaka
AU - Yonemoto, Naohiro
AU - Kawanishi, Chiaki
AU - Otsuka, Kotaro
AU - Mimura, Masaru
AU - Otaka, Yasushi
AU - Okamura, Kazuya
AU - Kinoshita, Toshihiko
AU - Shirakawa, Osamu
AU - Yoshimura, Reiji
AU - Eto, Nobuaki
AU - Hashimoto, Satoshi
AU - Tachikawa, Hirokazu
AU - Furuno, Taku
AU - Sugimoto, Tatsuya
AU - Ikeshita, Katsumi
AU - Inagaki, Masatoshi
AU - Yamada, Mitsuhiko
N1 - Funding Information:
We especially thank Dr Takao Ishii, Dr Masaki Shiraishi, Ms Atsuko Iwaki (Sapporo Medical University Hospital), Dr Endo Jin, Dr Katumi Sanjo, Ms Akie Kondou, Mr Hikaru Nakamura (Iwate Medical University Hospital), Dr Daisuke Fujisawa, Dr Yoko Kawahara (Keio University Hospital), Professor Yoshiro Okubo (Nippon Medical School Hospital), Ms Tomoko Kawashima (National Center of Neurology and Psychiatry), Dr Keisuke Inoue, Ms Suhoko Yamada (Yokohama City University Medical Center), Dr Yohko Shiraishi (Yokohama City University Hospital), Ms Migiwa Hirano (Shonan Eastern General Hospital), Professor Toshifumi Kishimoto, Mr Shigero Shimoda, Ms Mai Sugimoto (Nara Medical University Hospital), Dr Hiroyuki Oda, Ms Hisako Yamada (Kansai Medical University Medical Center), Mr Atsushi Niwa, Mr Shohei Wada (Kindai University Hospital), Mr Takuya Suenaga (Hospital of the University of Occupational and Environmental Health), Professor Hiroaki Kawasaki, Dr Kohei Harada, Ms Mayuko Matsuo (Fukuoka University Hospital), and Mr Manabu Hamano (Kumamoto Medical Center) for their helpful assistance in developing and conducting the suicide‐prevention training program. We also thank Ms Mayumi Matsutani and Ms Hiromi Muramatsu for their research assistance. We thank Edanz Group ( www.edanzediting.com/ac ) for editing a draft of this manuscript. This study was supported by the Ministry of Health, Labour, and Welfare, the Research and Development Grants for Comprehensive Research for Persons with Disabilities (Mental Disorder Area) from the Japan Agency for Medical Research and Development (17dk0307050h003), and JSPS KAKENHI (JP16J11981). These funders had no role in the study design, data collection, data analysis, interpretation of data, writing of the report, or decision to submit the article for publication.
Funding Information:
We especially thank Dr Takao Ishii, Dr Masaki Shiraishi, Ms Atsuko Iwaki (Sapporo Medical University Hospital), Dr Endo Jin, Dr Katumi Sanjo, Ms Akie Kondou, Mr Hikaru Nakamura (Iwate Medical University Hospital), Dr Daisuke Fujisawa, Dr Yoko Kawahara (Keio University Hospital), Professor Yoshiro Okubo (Nippon Medical School Hospital), Ms Tomoko Kawashima (National Center of Neurology and Psychiatry), Dr Keisuke Inoue, Ms Suhoko Yamada (Yokohama City University Medical Center), Dr Yohko Shiraishi (Yokohama City University Hospital), Ms Migiwa Hirano (Shonan Eastern General Hospital), Professor Toshifumi Kishimoto, Mr Shigero Shimoda, Ms Mai Sugimoto (Nara Medical University Hospital), Dr Hiroyuki Oda, Ms Hisako Yamada (Kansai Medical University Medical Center), Mr Atsushi Niwa, Mr Shohei Wada (Kindai University Hospital), Mr Takuya Suenaga (Hospital of the University of Occupational and Environmental Health), Professor Hiroaki Kawasaki, Dr Kohei Harada, Ms Mayuko Matsuo (Fukuoka University Hospital), and Mr Manabu Hamano (Kumamoto Medical Center) for their helpful assistance in developing and conducting the suicide-prevention training program. We also thank Ms Mayumi Matsutani and Ms Hiromi Muramatsu for their research assistance. We thank Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. This study was supported by the Ministry of Health, Labour, and Welfare, the Research and Development Grants for Comprehensive Research for Persons with Disabilities (Mental Disorder Area) from the Japan Agency for Medical Research and Development (17dk0307050h003), and JSPS KAKENHI (JP16J11981). These funders had no role in the study design, data collection, data analysis, interpretation of data, writing of the report, or decision to submit the article for publication.
Publisher Copyright:
© 2020 The Authors Psychiatry and Clinical Neurosciences © 2020 Japanese Society of Psychiatry and Neurology
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Aim: Suicide attempters have a high risk of repeated suicide attempts and completed suicide. There is evidence that assertive case management can reduce the incidence of recurrent suicidal behavior among suicide attempters. This study evaluated the effect of an assertive-case-management training program. Methods: This multicenter, before-and-after study was conducted at 10 centers in Japan. Participants were 274 medical personnel. We used Japanese versions of the Attitudes to Suicide Prevention Scale, the Gatekeeper Self-Efficacy Scale, the Suicide Intervention Response Inventory (SIRI), and the Attitudes Toward Suicide Questionnaire. We evaluated the effects with one-sample t-tests, and examined prognosis factors with multivariable analysis. Results: There were significant improvements between pre-training and post-training in the Attitudes to Suicide Prevention Scale (mean: −3.07, 95% confidence interval [CI]: −3.57 to −2.57, P < 0.001), the Gatekeeper Self-Efficacy Scale (mean: 10.40, 95%CI: 9.48 to 11.32, P < 0.001), SIRI-1 (appropriate responses; mean: 1.15, 95%CI: 0.89 to 1.42, P < 0.001), and SIRI-2 (different to the expert responses; mean: −4.78, 95%CI: −6.18 to −3.38, P < 0.001). Significant improvements were found on all Attitudes Toward Suicide Questionnaire subscale scores, except Unjustified Behavior. The effect of training was influenced by experience of suicide-prevention training and experience of working with suicidal patients. Conclusion: The training program (which was developed to implement and disseminate evidence-based suicide-prevention measures) improved attitudes, self-efficacy, and skills for suicide prevention among medical personnel. Specialized suicide-prevention training and experience with suicidal patients are valuable for enhancing positive attitudes and self-efficacy; furthermore, age and clinical experience alone are insufficient for these purposes.
AB - Aim: Suicide attempters have a high risk of repeated suicide attempts and completed suicide. There is evidence that assertive case management can reduce the incidence of recurrent suicidal behavior among suicide attempters. This study evaluated the effect of an assertive-case-management training program. Methods: This multicenter, before-and-after study was conducted at 10 centers in Japan. Participants were 274 medical personnel. We used Japanese versions of the Attitudes to Suicide Prevention Scale, the Gatekeeper Self-Efficacy Scale, the Suicide Intervention Response Inventory (SIRI), and the Attitudes Toward Suicide Questionnaire. We evaluated the effects with one-sample t-tests, and examined prognosis factors with multivariable analysis. Results: There were significant improvements between pre-training and post-training in the Attitudes to Suicide Prevention Scale (mean: −3.07, 95% confidence interval [CI]: −3.57 to −2.57, P < 0.001), the Gatekeeper Self-Efficacy Scale (mean: 10.40, 95%CI: 9.48 to 11.32, P < 0.001), SIRI-1 (appropriate responses; mean: 1.15, 95%CI: 0.89 to 1.42, P < 0.001), and SIRI-2 (different to the expert responses; mean: −4.78, 95%CI: −6.18 to −3.38, P < 0.001). Significant improvements were found on all Attitudes Toward Suicide Questionnaire subscale scores, except Unjustified Behavior. The effect of training was influenced by experience of suicide-prevention training and experience of working with suicidal patients. Conclusion: The training program (which was developed to implement and disseminate evidence-based suicide-prevention measures) improved attitudes, self-efficacy, and skills for suicide prevention among medical personnel. Specialized suicide-prevention training and experience with suicidal patients are valuable for enhancing positive attitudes and self-efficacy; furthermore, age and clinical experience alone are insufficient for these purposes.
KW - disseminate
KW - emergency department
KW - evidence-based suicide prevention
KW - multicenter study
KW - training program
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U2 - 10.1111/pcn.12999
DO - 10.1111/pcn.12999
M3 - Article
C2 - 32166827
AN - SCOPUS:85083060756
SN - 1323-1316
VL - 74
SP - 362
EP - 370
JO - Psychiatry and Clinical Neurosciences
JF - Psychiatry and Clinical Neurosciences
IS - 6
ER -