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ANNEX A: PAPERS OUTSTANDING
The following papers were identified for possible inclusion in the review, but we were unable to retrieve full text copies at the time. We are very grateful to Professor Stephen Platt for subsequently forwarding the papers from Crisis to us. We have not been able to include these in the main text of the review, but we provide a summary of key details from each paper below. Outcomes from these papers would not have altered any conclusions or recommendations set out in this report.
Bergmans,Y., Links,P.S. A description of a psychosocial/psychoeducational intervention for persons with recurrent suicide attempts. Crisis, 2002, 23 (4), 156-160
This paper describes a Psychosocial/Psychoeducational intervention for people who have repeatedly attempted suicide. The intervention was developed for people without active psychosis or any history of interpersonal violence, with referrals typically being made from hospital and community settings following a suicidal crisis. The authors describe the intervention as a multi-modal approach based on the underlying principle of 'validating' the client's experience and expertise. The intervention has been set up primarily as a series of facilitated group sessions, although clients are also encouraged to call facilitators, within the parameters of pre-set rules, if they experience a crisis. The content of the group sessions includes modules on protective behaviours, education regarding the role of diagnoses in identifying suffering, affect regulation, interpersonal relations and problem solving. The paper presented very little evaluation of the therapy, as to date only 48 people have completed one cycle of the group intervention. The authors report that the intervention is promising on the basis of a 70% completion rate (excluding initial drop-outs), a median of 83% of sessions attended, a return rate of 44% for a second therapy cycle and self-report by 84% of people involved in a final group discussion to the effect that they believed their self-harm behaviours had "decreased or changed".
Bilsker,D., Forster,P. Problem-solving intervention for suicidal crises in the psychiatric emergency service. Crisis, 2003, 24 (3), 134-136
In this short paper, the authors discuss how a cognitive-behavioural problem-solving approach to intervention could be adapted for delivery in the setting of an emergency psychiatric unit. They illustrate the discussion with details of their own approach to this form of intervention. The paper provides additional background material, but would not have been included in the review as there was no attempt to provide an empirical evaluation of the approach described.
Brunet,A.F., Lemay,L.; Belliveau,G. Correspondence as adjunct to crisisline intervention in a suicide prevention center. Crisis, 1994, 15 (2), 65-76
This paper presents outcomes from a small (N=5) pilot study of a correspondence-based intervention offered by a telephone crisis line. Five frequent callers to the telephone service were offered the opportunity to enter into written correspondence with five volunteers manning the telephone lines. Over six months, the authors report that the mean number of crisis calls by the five frequent callers dropped from a mean of 21.8 per month to a mean of 9.1 calls per month. The urgency of the calls, as reported on the basis of a four point scale (with a score of 4 indicating that planning for suicide is underway) remained stable, reducing only slightly from a mean of 3.7 to a mean of 3.4. All five frequent callers expressed a high degree of satisfaction with the correspondence approach. The authors also report a case study of outcomes for one of the participants. Whilst this study is clearly very limited in terms of participant numbers, outcomes are in line with review outcomes supporting the likely positive benefits of ongoing contact and support.
Csernansky J 11th World Congress of Psychiatry, 6th Aug Hamburg, Germany, 1999. Risperidone vs Haloperidol: Relapse Prevention. 1999 Aug 6 11; Hamburg, Germany 1999:2.
We are still unable to retrieve a copy of this paper.
Gauthier S et al. The effects of a school-based suicide prevention program on teachers. Apprentissage et Socialisation. 1993 vol:16 pp:33-41
We are still unable to retrieve a copy of this paper.
Maltsberger JT. Suicide in old age: psychotherapeutic intervention. Crisis 1991 Sep.12(2):25-32
This paper presents a discussion of the author's understanding of pathways to suicide in older people and how certain aspects of the psychotherapeutic process may help to divert older people from suicide. The paper presents no empirical data and hence would not have met criteria for inclusion in the review.
Mulder AM, Methorst GJ, U, Diekstra RF. Prevention of suicidal behaviour in adolescents: the role and training of teachers. Crisis 1989 Apr . 10(1):36-51
This paper presents a non-systematic review of the literature for the prevention of adolescent suicidal behaviour. The authors also present preliminary evaluation data for an intervention they have developed for seriously depressed and suicidal adolescents. The intervention is described as an information and training programme directed at making teachers more aware of 'youth suicide problems'. Three versions of the programme were evaluated in the school setting. In the first version, the programme was presented as a one day seminar. In the second version, the programme took the form of a plenary group session providing information, followed by training and discussion in small group sessions. In the third version, the format was as per version one, but mental health care professionals were specifically trained to present the programme to small groups of teachers. Outcomes reported by the authors were restricted to a survey of respondents' perceptions of and satisfaction with the third version of the programme. 83% of participants rated a morning session (discussions around attitudes towards suicide) they had attended as good or very good and 70% of the same participants rated the afternoon session (how to recognise signs of depression and suicidal behaviour) as very good. 77% of participants considered themselves as 'fairly capable' of recognizing signs of depression following the programme. No empirical data relating to subsequent outcomes for suicidal behaviour or ideation amongst the participants' students are presented, so this paper would not have met the inclusion criteria for the current review.
Upanne M, A model for analyzing suicide prevention. Crisis, 2000, 21 (2), 80-89
This paper presents the outcomes from a small (N=31) long term (9 year) qualitative study of how the perceptions of psychologists regarding suicide prevention changed during the course of a 9 year National Suicide Prevention Project in Finland. The authors also discuss a theoretical model for analysing suicide prevention. The suicide prevention project was based on countrywide psychological autopsy investigations in which the psychologists took part. The authors report that the majority of participants (81%) stated that "some changes had taken place in their thinking over the project years". 39% reported that their thinking had "really changed" and 45% that it had "become more focussed but not essentially changed". The authors present further details of the changes which had taken place in the psychologists' thinking by presenting suicide 'foci' reported by at least 3 psychologists as having become more important to them. These foci included social marginalization, suicide risks, depression, suicides amongst children and young people, crises, Finnish life values and young people's healthy development. The paper did not present data regarding any outcomes for suicidal behaviour or suicidal ideation and so would not have met the inclusion criteria for the current review.
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