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Perry I.J.,University College Cork | Corcoran P.,National Suicide Research Foundation | Fitzgerald A.P.,University College Cork | Keeley H.S.,Child and Adolescent Mental Health Services | And 2 more authors.
PLoS ONE | Year: 2012

Background: Suicide is a significant public health issue with almost one million people dying by suicide each year worldwide. Deliberate self harm (DSH) is the single most important risk factor for suicide yet few countries have reliable data on DSH. We developed a national DSH registry in the Republic of Ireland to establish the incidence of hospital-treated DSH at national level and the spectrum and pattern of presentations with DSH and repetition. Methods and Findings: Between 2003 and 2009, the Irish National Registry of Deliberate Self Harm collected data on DSH presentations to all 40 hospital emergency departments in the country. Data were collected by trained data registration officers using standard methods of case ascertainment and definition. The Registry recorded 75,119 DSH presentations involving 48,206 individuals. The total incidence rate fell from 209 (95% CI: 205-213) per 100,000 in 2003 to 184 (95% CI: 180-189) per 100,000 in 2006 and increased again to 209 (95% CI: 204-213) per 100,000 in 2009. The most notable annual changes were successive 10% increases in the male rate in 2008 and 2009. There was significant variation by age with peak rates in women in the 15-19 year age group (620 (95% CI: 605-636) per 100,000), and in men in the 20-24 age group (427 (95% CI: 416-439) per 100,000). Repetition rates varied significantly by age, method of self harm and number of previous episodes. Conclusions: Population-based data on hospital-treated DSH represent an important index of the burden of mental illness and suicide risk in the community. The increased DSH rate in Irish men in 2008 and 2009 coincided with the advent of the economic recession in Ireland. The findings underline the need for developing effective interventions to reduce DSH repetition rates as a key priority for health systems. © 2012 Perry et al.


McMahon E.M.,National Suicide Research Foundation | Corcora P.,National Suicide Research Foundation | Mcauliffe C.,National Suicide Research Foundation | Keeley H.,Child and Adolescent Mental Health Services | And 2 more authors.
Crisis | Year: 2013

Background: There is evidence for an association between suicidal behavior and coping style among adolescents. Aims: The aims of this study were to examine associations between coping style, mental health factors, and self-harm thoughts and acts among Irish adolescents, and to investigate whether coping style mediates associations between mental health factors (depression, anxiety, and self-esteem) and self-harm. Method: A cross-sectional school-based survey was carried out. Information was obtained on history of self-harm, life events, and demographic, psychological, and lifestyle factors. Results: Emotion-oriented coping was strongly associated with poorer mental health and self-harm thoughts and acts. Problem-Oriented Coping was associated with better mental health. Mediating effects of Emotion-Oriented Coping on associations between mental health factors and deliberate self-harm (DSH) was found for both genders and between Problem-Oriented Coping and mental health factors for girls. Similar mediating effects of coping style were found when risk of self-harm thoughts was examined. Limitations: Since the methodology used was cross-sectional, it is impossible to draw conclusions regarding causal relationships between coping style and associated factors. The coping measure used was brief. Conclusions: Promotion of positive coping skills and reduction of emotion-focused approaches may build resilience to self-harm thoughts and acts among adolescents experiencing mental health problems.


Leahy-Warren P.,The College of Nursing and Midwifery | Mulcahy H.,The College of Nursing and Midwifery | Phelan A.,The College of Nursing and Midwifery | Corcoran P.,National Suicide Research Foundation | Corcoran P.,University College Cork
Midwifery | Year: 2014

The aim of this research was to identify factors associated with mothers breast feeding and to identify, for those who breast fed, factors associated with breast feeding for as long as planned. Background: breast feeding rates in Ireland are amongst the lowest in Europe. Research evidence indicates that in order for mothers to be successful at breast feeding, multiplicities of supports are necessary for both initiation and duration. The nature of these supports in tandem with other influencing factors requires analysis from an Irish perspective. Design: cross-sectional study involving public health nurses and mothers in Ireland. This paper presents the results of the mothers' evaluation. Method: mothers (n=1715) with children less than three years were offered a choice of completing the self-report questionnaires online or by mail. Data were analysed and reported using descriptive and inferential statistics. Findings: four in every five participants breast fed their infant and two thirds of them breast fed as long as planned. The multivariate logistic regression analysis identified that third level education, being a first time mother or previously having breast fed, participating online, having more than two public health nurse visits, and having a positive infant feeding attitude were independently and statistically significantly associated with breast feeding. Among mothers who breast fed, being aged at least 35 years, participating online, having a positive infant feeding attitude and high breast feeding self-efficacy were independently and statistically significantly associated with breast feeding for as long as planned. Conclusions: findings from this study reinforce health inequalities therefore there needs to be a renewed commitment to reducing health inequalities in relation to breast feeding. Relevance to clinical practice: this study has identified factors associated with initiation and duration of breast feeding that are potentially modifiable through public health interventions. © 2013 Elsevier Ltd.


Larkin C.,National Suicide Research Foundation | Di Blasi Z.,University College Cork | Arensman E.,National Suicide Research Foundation
PLoS ONE | Year: 2014

Background: Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. Objective: This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. Data sources: PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. Results: A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. Conclusions: Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode. The current review will enhance prediction of self-harm and assist in the efficient allocation of intervention resources. © 2014 Larkin et al.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-4.2-4 | Award Amount: 2.81M | Year: 2008

The implementation of a prevention-oriented injury surveillance in the EU is a major demand towards the Member States in the recent EC Council Recommendations on the prevention of injury and the promotion of safety. Needed in particular are valid and reliable indicators for the array of external causes of injury morbidity, like involved activities, products and mechanisms, and for the most severe consequences of injuries besides death long term and chronic disabilities . Whereas no single EU health statistics fulfills that demand to date, the integration of two existing data sources the prevention-oriented European Injury Database (IDB ) and the routine Hospital Discharge Registers (HDR) is considered the most promising approach to that avail. However, substantial methodological improvement in IDB sampling, research into the operationalization of disability indicators for the HDR, and technological advancement for a streamlined data collection for both data systems are required. The INTEGRIS project aims to provide the necessary research and technology input for the IDB-HDR integration through an evaluated demonstration project in six Member States. This aim links to chapter 4.2 of the call 2007 Responding to EU policy needs in Health Statistics in the field of hospital based injury statistics, 4.2.4: Health Statistics and Rare Events (HEALTH-2007) in particular. The resulting IDB-HDR data model and INTEGRIS prototype shall meet the statistical quality criteria of Eurostat (European Statistical System) and the public health requirements of the EU Health Indicators (ECHI ). A successful evaluation provided, an EU-level implementation plan will be proposed for adoption by the relevant stakeholders and decision makers.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-3.3-4 | Award Amount: 3.84M | Year: 2008

Suicide is a serious public health problem in the EU calling for effective interventions. The aim of this project is to provide EU member states with an evidence based prevention concept, concrete materials and instruments for running and evaluating these interventions and recommendations for the proper implementation of the intervention. These aims will be achieved by the following objectives: > Analysis of differences in suicide rates among European countries and harmonisation of procedures for definition, assessment and evaluation of suicidality > Development of a state of the art intervention concept for the prevention of suicidality that considers current evidence-based best practices and international experiences with multilevel interventions, such as that of the European Alliance Against Depression > Implementation of comparable multilevel community based prevention interventions in four European model regions > Evaluation of the interventions in a pre-post, controlled and cross-nationally comparable design concerning effectiveness with respect to both suicides and non-fatal suicidal acts, efficiency (including health economic evaluations), involved processes and finally the interplay between the single intervention measures > Distribution of an optimised suicide preventive intervention concept, corresponding materials and instruments, and recommendations for implementation to policy makers and stakeholders


Meaney S.,National Suicide Research Foundation
Irish medical journal | Year: 2012

The incidence of injury presentations to emergency departments in the Republic of Ireland has not been established. Data were collected relating to all injuries that presented on every eighth day in July-December 2005 to the three hospitals in Cork City. In total, 2,967 injury presentations were recorded. The total, male and female age-adjusted rate of injury presentations was 11,322, 13,933 and 8,550 per 100,000, respectively. The peak male rate was among 15-29 year-olds (26,735 per 100,000), 2.5 times the female rate in the same age range (10,719 per 100,000). The peak female rate was among over 85 year-olds (18,543 per 100,000). Place of injury, activity at time of injury and underlying substance/object causing injury were unspecified for 44%, 46% and 43% of recorded injuries. Improving the recording of injury data needs to be prioritised in Irish emergency departments ideally in conjunction with the development of a national injury surveillance system.


Corcoran P.,National Suicide Research Foundation
International psychogeriatrics / IPA | Year: 2010

Hospital-treated deliberate self harm and suicide among older adults have rarely been examined at a national level. The Irish Central Statistics Office provided suicide and undetermined death data for 1980-2006. The National Registry of Deliberate Self Harm collected data relating to deliberate self harm presentations made in 2006-2008 to all 40 Irish hospital emergency departments. Rates of female suicide among older adults (over 55 years) were relatively stable in Ireland during 1980-2006 whereas male rates increased in the 1980s and decreased in more recent decades. Respectively, the annual male and female suicide and undetermined death rate was 22.1 and 7.6 per 100,000 in 1997-2006. Male and female deliberate self harm was 3.0 and 11.0 times higher at 67.4 and 83.4 per 100,000, respectively. Deliberate self harm and suicide decreased in incidence with increasing age. Deliberate self harm generally involved drug overdose (male: 72%; female 85%) or self-cutting (male: 15%; female 9%). The most common methods of suicide were hanging (41%) and drowning (29%) for men and drowning (39%) and drug overdose (24%) for women. City and urban district populations had the highest rates of hospital-treated self harm. The highest suicide rates were in urban districts. Older Irish adults have high rates of hospital-treated deliberate self harm but below average rates of suicide. Drowning was relatively common as a method of suicide. Restricting availability of specific medications may reduce both forms of suicidal behavior.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-3.3-1;HEALTH-2007-3.3-4 | Award Amount: 4.78M | Year: 2009

Promoting healthy behaviors is multi-faceted and no health is possible without mental health. The ultimate outcome of unhealthy and risk-taking behaviors is suicide. Risk-taking and suicidal behavior can be prevented. A pilot intervention study will be implemented to assess the effects of three different health promoting / suicide prevention programs in 11000 students across 11 European countries: 1. TeenScreen - screening by professionals of at-risk students through a questionnaire. 2. QPR (Question, Persuade & Refer) a gatekeepers program, training all adult staff at schools (teachers, counselors, nurses etc.) and parents on how to recognize & refer a student at-risk of suicide or suffering from mental illness to mental-health help resources; 3. A general health promotion program targeting students awareness on healthy/unhealthy behaviors; Objectives of the research program are: I. Gather information on health and well-being in adolescents - Produce an epidemiological database for adolescents in Europe containing data on students healthy and at-risk lifestyles and their relation with health measured by well-being, depression and suicidality. II. Perform interventions in adolescents leading to better health trough decreased risk-taking and suicidal behaviors III. Evaluate outcomes of interventions in adolescents from a multidisciplinary perspective including social, psychological and economical aspects IV. Recommend an effective trans-cultural model for promoting health for adolescents in Europe -Provide information for evidence-based prevention programs for adolescents in culturally diverse populations -Increase awareness and knowledge in policy makers, professionals and the public. -Disseminate results through a public website, media, health promotion conferences and through events focused on adolescents such as pop concerts or sport events.


Grant
Agency: European Commission | Branch: FP7 | Program: MC-ITN | Phase: FP7-PEOPLE-2012-ITN | Award Amount: 3.69M | Year: 2013

MARATONE is a Marie Curie Initial Training Network proposal that directly addresses the need for high-level training and career pathways in mental health to increase the inter-sectorial and trans-national employability of young scientists in the academic, public and private sectors to meet the enormous challenge of the 2009 EU Parliament Resolution on Mental Health. The Resolution set out recommendations for a comprehensive and integrated mental health strategy for Europe. MARATONE is designed to address the biggest challenge to implementing this ambitious strategy: the lack of training for career pathways for young scientists in multidisciplinary mental health research. MARATONE is built on the innovative theoretical premise of horizontal epidemiology, the view that psychosocial difficulties associated with mental health disorders are not exclusively determined by the diagnosis of the particular disorder in a vertical, silo-like pattern but horizontally in a manner that reflects commonalities in the lived experience of people with diverse mental health problems. Grounded in this theoretical foundation, MARATONEs multidisciplinary network of partners will collaboratively develop methodologies for measuring the individual and social impact of mental health disorders, so as to create strategies for the social and private sector responses to mental ill health in the form of health promotion and prevention programmes, and at the national level, strategies for human rights protections in policies and programming. The consortium will provide young researchers with scientific expertise in mental health, as well as basic technical and communication skills, including research development and management, international human rights commitments, and commercial exploitation and dissemination.

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