Frequency Of Suicidal Ideation Research Articles

Identifying depression, diabetes distress, and suicidality among adolescents with diabetes

ABSTRACT This study explored the frequency of adolescents with diabetes who endorse suicidality on the Patient Health Questionnaire (PHQ-9) with varying degrees of depression scores. Additionally, compared whether diabetes distress levels from the Problem Areas in Diabetes-Teen (PAID-T) assessment tool is associated with and without suicidal ideation. Χ2 analysis was used to assess differences in subjects with or without suicidal ideation based on depression severity. Since all the data were nonparametrically distributed (Shapiro–Wilk test, p < .05), Kruskal–Wallis test assessed differences in continuous variables. Overall, 27 of 355 adolescents screened endorsed suicidal ideation. Both PHQ-9 [13 (9–17.8) vs 1 (0–4.5)] and PAID-T [88 (61.8–104.5) vs 40 (30–58.8)] scores were significantly higher in patients with suicidal ideation. The frequency of suicidal ideation increased with the severity of depression. The frequency of severe depression was higher in adolescents with type 2 diabetes (n = 48) than in type 1, but there was no difference in suicidality. Adolescents with no demonstrable or minimal depression can still have potential suicidal ideation. Suicidality is a separate construct that should be screened routinely and apart from any measures screening for distress or adjustment disorders associated with adolescents experiencing life-long chronic conditions in a healthcare follow-up setting.

"A Liability to the University"-Addressing Student Mental Health Needs on Campus.

Students at colleges and universities report high rates of mental disorders, including depression and anxiety, and frequent suicidal ideation. School policies toward such students, however, often have appeared punitive or aimed primarily at reducing the institution's potential liability. A recent lawsuit against Yale University highlighted allegations of practices that violated several federal statutes by failing to provide reasonable accommodations for students with psychiatric disabilities. The resolution of those claims in a sweeping settlement agreement can provide a model for the many other universities that need to align their policies with federal disability law.

Examining the predictive utility of suicidal ideation characteristics in relation to real-time monitoring of suicidal ideation and suicide attempts at follow-up.

Several characteristics of suicidal ideation, including frequency, duration, perceived controllability, and intensity, have been identified. The present study examined whether these characteristics of baseline suicidal ideation uniquely predicted (1) the severity, variability, and frequency of suicidal ideation assessed through real-time monitoring; and (2) suicide attempts at 3-week and 6-month follow-up among recently discharged psychiatric inpatients. A sample of 249 adults (Mage = 40.43, 55.1% female, 91.4% White) completed a baseline assessment of their suicidal ideation characteristics during psychiatric hospitalization, five daily ecological momentary assessments (EMA) for 21 days following discharge, and follow-up assessments of suicide-related outcomes at 3-week and 6-month follow-up. Perceived controllability of suicidal thoughts was uniquely associated with the variability of EMA-assessed suicidal ideation and the presence of suicide attempts at 3-week, but not 6-month follow-up. No other characteristic of baseline suicidal ideation was uniquely associated with EMA-assessed suicidal ideation or the presence of suicide attempts at follow-up. Given links between the perceived controllability of suicidal ideation and (1) momentary variability of suicidal ideation and (2) suicide attempts over the subsequent 3 weeks, perceived controllability of suicidal thinking may be a useful marker of short-term risk that may be malleable to clinical intervention.

Can profiles of behaviors occurring within 48 h of a suicide attempt predict future severity of suicidal thoughts and reattempt?: An examination of hospitalized patients 12 Months post-discharge

Behavioral warning signs (WS) are near-term changes within individuals, which aid in determining imminent risk for suicide attempts. However, those who attempt suicide differ in their engagement of WS, and it is unclear if these differences relate to future risk of suicidal behavior. Using a sample of 132 adults presenting to a hospital following a suicide attempt, the current study sought to determine if differences in engagement in WS for the index attempt prospectively predicted suicide attempt, frequency of ideation, and intensity of suicide ideation 12 months post discharge. Latent class analyses (LCAs) conducted on 6 behaviors (i.e., alcohol use, nightmares, interpersonal negative life events, suicide communication, risky behavior, low sleep, and high sleep) found a 5-class solution optimally fit the data. One identified class, characterized by engagement in risky behaviors the hours before an attempt differed from other identified classes in terms of risk for future suicidal ideation and behaviors. More specifically, participants in “High Risky Behavior” class had higher rates of 12-month suicide reattempt, significantly more frequent suicide ideation, and significantly worse intensity of suicide ideation during the 12 months following their index attempt compared to participants endorsing typical patterns of WS. These results held when adjusting for various traditional baseline covariates (e.g., depressive symptoms). The current study demonstrates that patterns of behavioral WS may be utilized as their own prognostic indicator of future suicidal ideation and behaviors among high-risk individuals reporting a recent suicide attempt, which can inform post-discharge clinical intervention and prevention efforts.

Utility of Single Items within the Suicidal Behaviors Questionnaire-Revised (SBQ-R): A Bayesian Network Approach and Relative Importance Analysis.

The Suicidal Behaviors Questionnaire-Revised (SBQ-R) comprises four content-specific items widely used to assess the history of suicide-related thoughts, plans or attempts, frequency of suicidal ideation, communication of intent to die by suicide and self-reported likelihood of a suicide attempt. Each item focuses on a specific parameter of the suicide-related thoughts and behaviors construct. Past research has primarily focused on the total score. This study used Bayesian network modeling and relative importance analyses on SBQ-R data from 1160 U.S. and 1141 Chinese undergraduate students. The Bayesian network analysis results showed that Item 1 is suitable for identifying other parameters of the suicide-related thoughts and behaviors construct. The results of the relative importance analysis further highlighted the relevancy of each SBQ-R item score when examining evidence for suicide-related thoughts and behaviors. These findings provided empirical support for using the SBQ-R item scores to understand the performances of different suicide-related behavior parameters. Further, they demonstrated the potential value of examining individual item-level responses to offer clinically meaningful insights. To conclude, the SBQ-R allows for the evaluation of each critical suicide-related thought and behavior parameter and the overall suicide risk.

Trauma Exposure, Suicidality, and Symptom Severity Among Young Adults Seeking Counseling Who Report Childhood Emotional Abuse

There is limited research regarding childhood emotional abuse (CEA) and its influence on mental health across development, as most studies of childhood maltreatment to date have focused on childhood sexual and physical abuse. We conducted a cross-sectional study on 2,604 young adults seeking counseling services at a large post-secondary institution in the southwestern United States. Participants were screened for trauma exposure, mental health issues, and suicidality. Findings indicated that CEA was significantly associated with higher rates of exposure to other traumatic events, more severe depression, generalized anxiety, social anxiety, academic distress, eating concerns, family distress, hostility, and substance use. CEA exposure was also significantly associated with more frequent suicidal ideation, suicide attempt, and non-suicidal self-injury prior to seeking counseling services. As CEA was associated with elevated symptom presentation and more severe risk for suicide, recommendations for counseling practice and future research are discussed.

Association between Suicidal Ideation and Blood Cadmium Levels Based on the 3rd to 7th Korea National Health and Nutrition Examination Surveys

Background: This study aimed to determine the association between blood cadmium levels and suicidal ideation.Methods: Using data from the 3rd to 7th Korea National Health and Nutrition Examination Surveys, the geometric mean of blood cadmium levels according to suicidal ideation was compared using multiple linear regression analyses in male and female adults. The frequency of suicidal ideation according to the blood cadmium levels was also compared using multiple logistic regression models.Results: In total, 6,877 men and 6,698 women were included in the study. When adjusting for all potential confounding factors, the geometric mean of blood cadmium levels was significantly higher in participants with suicidal ideation than in those without suicidal ideation in both men (0.92 ng/ml [95% confidence interval 0.87∼0.97 ng/ml] vs. 0.86 ng/ml [0.84∼0.88 ng/ml]; p=.026) and women (1.05 ng/ml [95% confidence interval 1.01∼1.10 ng/ml] vs. 0.99 ng/ml [0.98∼1.02 ng/ml]; p=.006). After adjusting for potential confounders, the frequency of suicidal ideation significantly increased as blood cadmium levels increased in men (p for trend=.014) and women (p for trend=.034).Conclusions: Results revealed an association between blood cadmium levels and suicidal ideation in Korean adults.

From posttraumatic stress symptoms to suicidal ideation among military veterans: Pathways founded on meaning in life and gratitude.

Military veterans experience higher rates of suicidal ideation compared to nonveteran populations. Importantly, suicidal ideation often precedes and predicts fatal and nonfatal suicide attempts, and thus it is critical to better understand factors that increase risk for suicidal ideation to inform suicide prevention efforts in this population. One key predictor of suicidal ideation is exposure to traumatic experiences and their sequelae, particularly posttraumatic stress symptoms (PTSS). However, little work has explored how deficits in well-being contribute to this association among veterans. We tested two aspects of well-being-meaning in life and gratitude-as potential mechanisms underlying the pathway from PTSS to suicidal ideation among 7,388 men and women veterans who recently separated from service. A parallel mediation analysis revealed significant paths from more severe PTSS to more frequent suicidal ideation through diminished meaning in life, B = 0.005, SE = 0.001, 95% CI [0.004, 0.007], and gratitude, B = 0.001, SE = 0.001, 95% CI [< 0.001, 0.002]. Gender differences were also observed. Although the results related to meaning in life appeared to replicate across gender, pathways involving gratitude differed among men and women. Overall, our findings suggest that helping veterans build meaning and appreciation in everyday life may be a proactive and holistic approach to suicide prevention.

Functional impairment, internalized stigma, and well-being: Considerations for recovery-oriented suicide prevention for U.S. Veterans with serious mental illness.

Veterans Health Administration's (VHA) Psychosocial Rehabilitation and Recovery Centers (PRRCs) provide recovery-oriented care to Veterans with serious mental illness (SMI). As part of program evaluation, PRRC providers regularly assess recovery-oriented outcomes. Given the high rates of suicidal thoughts and behaviors among Veterans with SMI, understanding such outcomes in relation to suicide risk is crucial. Among Veterans entering a PRRC (N=4,731), the present study aimed to a) report suicidal ideation frequency in the past two weeks across demographics and psychiatric diagnoses, b) explore rates of current functional impairment, internalized stigma, and well-being, and c) examine differences in suicidal ideation frequency and functional impairment, internalized stigma, and well-being. Measurements before treatment were utilized. Younger (ρ=-.08, p<.001), married (z=-5.23, p<.001) Veterans, those not identifying as Black or African American (z=-4.80, p<.001), not diagnosed with schizophrenia (z=-6.97, <.001), diagnosed with depressive disorders (z=-8.79, <.001), anxiety disorders (z=-5.01, <.001), posttraumatic stress disorder (z=-7.69, <.001), or personality disorders (z=-7.12, <.001) were significantly more likely to endorse suicidal ideation. Veterans in this cohort had higher than average functional impairment (M=18.05, SD=9.85), mild internalized stigma (M=2.36, SD=0.51), and lower than average well-being (M=18.96, SD=3.93). The more often a Veteran reported thinking about suicide in the past two weeks, the more likely the Veteran viewed themselves to be more functionally impaired (p<.001), reported higher levels of internalized stigma (p<.001), and reported lower levels of well-being (p<.001). Findings and limitations, particularly the suicidal ideation frequency measurement, are discussed to contextualize suggestions to integrate recovery-oriented practices and suicide prevention care.

Identifying unique subgroups in suicide risks among psychiatric outpatients

BackgroundThe presence of psychiatric disorders is widely recognized as one of the primary risk factors for suicide. A significant proportion of individuals receiving outpatient psychiatric treatment exhibit varying degrees of suicidal behaviors, which may range from mild suicidal ideations to overt suicide attempts. This study aims to elucidate the transdiagnostic symptom dimensions and associated suicidal features among psychiatric outpatients. MethodsThe study enrolled patients who attended the psychiatry outpatient clinic at a tertiary hospital in South Korea (n = 1, 849, age range = 18–81; 61% women). A data-driven classification methodology was employed, incorporating a broad spectrum of clinical symptoms, to delineate distinctive subgroups among psychiatric outpatients exhibiting suicidality (n = 1189). A reference group of patients without suicidality (n = 660) was included for comparative purposes to ascertain cluster-specific sociodemographic, suicide-related, and psychiatric characteristics. ResultsPsychiatric outpatients with suicidality (n = 1189) were subdivided into three distinctive clusters: the low-suicide risk cluster (Cluster 1), the high-suicide risk externalizing cluster (Cluster 2), and the high-suicide risk internalizing cluster (Cluster 3). Relative to the reference group (n = 660), each cluster exhibited distinct attributes pertaining to suicide-related characteristics and clinical symptoms, covering domains such as anxiety, externalizing and internalizing behaviors, and feelings of hopelessness. Cluster 1, identified as the low-suicide risk group, exhibited less frequent suicidal ideation, planning, and multiple attempts. In the high-suicide risk groups, Cluster 2 displayed pronounced externalizing symptoms, whereas Cluster 3 was primarily defined by internalizing and hopelessness symptoms. Bipolar disorders were most common in Cluster 2, while depressive disorders were predominant in Cluster 3. DiscussionOur findings suggest the possibility of differentiating psychiatric outpatients into distinct, clinically relevant subgroups predicated on their suicide risk. This research potentially paves the way for personalizing interventions and preventive strategies that address cluster-specific characteristics, thereby mitigating suicide-related mortality among psychiatric outpatients.

Meaning in life mediates the association between depressive symptoms and future frequency of suicidal ideation in Spanish university students: A longitudinal study.

There is a need for longitudinal studies that focus on protective factors against suicide in Spain. We analyzed the estimated prevalence of suicidal ideation in a sample of Spanish university students. Second, we explored the relationship between future suicidal ideation, depressive symptoms, suicidal ideation at T1, and meaning in life and its dimensions of meaning and purpose. Third, we analyzed the mediation role of meaning in life between depressive symptoms and suicidal ideation evaluated with Ecological Momentary Assessment (EMA). In this longitudinal study, a total of 718 Spanish university students were assessed at T1, of whom 279 completed questionnaires along with EMA (T2). The estimated prevalence of suicidal ideation was 8.4%. Levels of depressive symptoms were positively correlated with suicidal ideation and negatively with meaning in life and its dimensions of meaning and purpose. Meaning in life and its dimensions mediated the relationship between depressive symptoms and subsequent suicidal ideation. There is a high prevalence of suicidal ideation among Spanish university students, and it is associated with depressive symptoms and meaning in life, with the latter acting as a protective factor. Thus, psychotherapeutic prevention programs from a logotherapeutic perspective could help to reduce students' suicide risk.

Longitudinal associations between exposure to potentially morally injurious events and suicidal ideation among recently discharged veterans – The mediating roles of depression and loneliness

BackgroundExposure to potentially morally injurious events (PMIEs) during military service is associated with heightened suicidal ideation (SI). However, no longitudinal study has established temporal associations between these variables and examined the possible mediating roles of depression and loneliness in this effect. MethodsParticipants were 374 active-duty Israeli combatants who participated in a five-year longitudinal study with four measurement points: T1- one year before enlistment, T2- one month before discharge from army service, and then again six months and twelve months following their discharge (T3 and T4, respectively). Data were assessed through semi-structured interviews and validated self-report questionnaires. ResultsAbove and beyond pre-enlistment personal characteristics (T1) and combat exposure (T2), PMIEs-‘betrayal’ (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of depression. Moreover, both PMIEs-‘betrayal’ and ‘self’ (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of loneliness. LimitationsWe used self-report measures to assess PMIEs and SI, which may suffer from various biases. ConclusionsOur findings are the first to provide evidence of longitudinal, temporal associations between exposure to PMIEs and SI. Notably, potential interventions might consider addressing the loneliness experienced following exposure to PMIEs during military service, among recently discharged traumatized veterans.

Psychosocial Identity, Intimacy and Suicidality in Young Adults

Objective Suicidality in young adults is a serious and growing clinical and social problem. The theory of psychosocial ego development assumes that identity and intimacy are two key factors for adaptation and vulnerability in early adulthood. The aim of the present study was to test whether psychosocial identity and intimacy are related to suicidality in young adults, even when controlling for confounding variables (depressive symptoms, sex, age, health and economic assessment, religious commitment, and pandemic-related distress). Method Respondents aged 18–25 (n = 607) completed the Identity-Confusion and Intimacy-Isolation subscales from the Modified Erikson Psychosocial Stage Inventory, as well as the Patient Health Questionnaire-9, the Suicidal Behaviors Questionnaire-Revised and answered questions about the pandemic-related distress and various sociodemographic factors. Results At the level of bivariate analyses, both identity and intimacy were negatively associated with suicidal risk in the overall sample and with the frequency of suicidal ideation in the suicide risk subsample (n = 242). Weaker identity, but not intimacy, was associated with belonging to a suicide risk group in multivariable logistic regression. Moreover, ordinal regression showed that, in the subgroup with suicide risk, identity was negatively associated with the frequency of suicidal thoughts. Conclusions Identity is a negative correlate of suicidality in young adults. Identity-focused therapy may be a promising target for intervention in suicidal young adults.

Novel Telehealth Adaptations for Evidence-Based Outpatient Suicide Treatment: Feasibility and Effectiveness of the Crisis Care Program.

Background: Suicide rates in the United States have escalated dramatically over the past 20 years and remain a leading cause of death. Access to evidenced-based care is limited, and telehealth is well-positioned to offer novel care solutions. The Crisis Care program is a suicide-specific treatment program delivered within a national outpatient telehealth setting using a digitally adapted version of the Collaborative Assessment and Management of Suicidality (CAMS) as the framework of care. This study investigates the feasibility and preliminary effectiveness of Crisis Care as scalable suicide-specific treatment model. Methods: Patient engagement, symptom reduction, and care outcomes were examined among a cohort of patients (n = 130) over 16 weeks. The feasibility of implementation was assessed through patient engagement. Clinical outcomes were measured with PHQ-9, GAD-7, and the CAMS SSF-4 rating scales. Results: Over 85% of enrolled patients were approved for Crisis Care at intake, and 83% went on to complete at least four sessions (the minimum required to graduate). All patient subgroups experienced declines in depressive symptoms, anxiety symptoms, suicidal ideation frequency, and suicide-specific risk factors. Conclusions: Results support the feasibility and preliminary effectiveness of Crisis Care as a suicide-specific care solution that can be delivered within a stepped-care model in an outpatient telehealth setting.

Suicidal Ideation in People with Traumatic Spinal Cord Injury

Suicidal behavior is considered a worldwide social phenomenon and a serious public health problem. In this regard, people with traumatic spinal cord injury may be associated with low mood, depression, suicidal ideation, and behavior. To evaluate the factors associated with suicidal ideation in people with SCI, this is quantitative, cross-sectional, descriptive study was carried out in a virtual environment. In total, 200 people aged 18 or over with TSCI living in Brazil took part in the study. Data were collected using the Beck Scale for Suicidal Ideation, answered online by participants using SurveyMonkey®. The sample consisted of 200 participants, most of whom were male, from southeast Brazil, with a mean age of 36.22 years, a duration of injury of 134.4 months, and a 32.5% frequency of suicidal ideation, as suicidal ideation was also verified in relation to the variables of schooling, rehabilitation, and consequence of injury. A statistically significant relationship was found between the duration of injury and suicidal ideation. According to the results, a considerable percentage of these individuals still think about suicide. On the other hand, the duration of the injury showed a significant difference in relation to suicidal ideation, and it was observed that the shorter the duration of spinal cord injury, the greater the likelihood of suicidal ideation.

Association between social withdrawal and suicidal ideation in patients with major depressive disorder: The mediational role of emotional symptoms

BackgroundThe study was designed to investigate the associations between social withdrawal, emotional symptoms, and suicide ideation in patients with major depressive disorder (MDD). MethodsThis cross-sectional study included 2678 MDD patients from the National Survey on Symptomatology of Depression (NSSD). Differences in the sociodemographic factors, clinical characteristics, suicide ideation, and emotional symptoms were compared in patients with different frequencies of social withdrawal. Pearson correlation, multiple linear regression analysis, and mediation analysis were employed to assess the contribution of social withdrawal to suicide ideation. ResultsMDD patients with a higher frequency of social withdrawal were prone to have a higher frequency of suicide ideation (p for trend <0.001) and history of suicide behavior (p for trend <0.001). Multiple linear regression analysis showed that there was a dose–response relationship between social withdrawal and suicide ideation in MDD patients, but this association became insignificant after adjusting for emotional symptoms. Mediation analysis suggested that all of the emotional symptoms had significant mediating effects on the association between social withdrawal and suicide ideation in MDD patients (p < 0.05). The magnitude of mediation varied between 4.3 % and 64.3 %, with the largest mediating effect in the feeling of despair (64.3 %), helplessness (41.2 %), and loneliness (40.0 %). ConclusionOur study provides evidence that social withdrawal was a common clinical presentation and it may increase the risk for suicide through emotional symptoms in MDD patients. LimitationsCausal conclusions could not be drawn between social withdrawal, emotional symptoms, and suicide ideation because of the cross-sectional design of the study.

Cognitive behavioral therapy for suicide prevention among Veterans receiving substance use disorder treatment: Results from a randomized trial

Veterans receiving substance use disorder (SUD) treatment are at a clear elevated risk for engaging in suicidal behaviors. Intervening to reduce suicide risk during an episode of SUD treatment could meaningfully target a key high-risk group of Veterans. Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP) was developed to reduce the frequency and duration of suicidal ideation, as well as decrease suicidal behaviors. The form of CBT-SP in this study progressed from building an understanding of the cognitive model to practicing new skills, and highlighted the links between substance use, craving, self-efficacy and suicidal ideation and attempts. CBT-SP was compared to an attention matched 8-session control condition (termed Supportive Psychoeducational Control [SPC]) during a multi-site randomized controlled trial for 299 Veterans receiving outpatient SUD treatment services within the Veterans Health Administration. The frequency of suicidal ideation remained relatively constant over 24-months of follow-up, however the duration of suicidal ideation decreased, and suicide attempts decreased relative to baseline in both conditions. Forty-two participants (14%) reported at least one suicide attempt during the 2-year follow-up period. No statisticallysignificant differences were found between CBT-SP and SPC on any of these outcomes. Analyses of secondary outcomes indicate that preparatory behaviors for suicide were less common among those in the CBT-SP condition than SPC across the 24-month follow-up (OR, 95%CI = 0.44 (0.25, 0.79); p = 0.02). Veterans in SUD treatment are a high-risk group and delivery of suicide-specific interventions is feasible during SUD care. However, results did not indicate that CBT-SP was superior to SPC on any primary outcomes, underscoring the importance of identifying and testing alternative approaches that support suicide reduction in this group.

Understanding the Broader Impact of Stuttering: Suicidal Ideation.

Suicide and suicidal ideation are topics that have a long but limited history in stuttering research. Clinicians and clinical researchers have discussed personal and therapeutic experiences with clients who have attempted suicide, died by suicide, or struggled with suicidal thoughts. This study sought to (a) explore the occurrence of suicidal ideation in a sample of adults who stutter; (b) evaluate the relationship between adverse impact related to stuttering and suicidal ideation; and (c) document respondents' thoughts related to suicide, stuttering, and their intersection. One hundred forty adults who stutter completed the Suicide Behavior Questionnaire-Revised (SBQ-R). Of these, 70 participants completed the Perseverative Thinking Questionnaire (PTQ), and 67 completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Participants who indicated at least some tendency for suicidal thoughts on the SBQ-R (n = 95) were then asked a set of follow-up questions to explore their experiences of suicidal ideation related to stuttering. Quantitative data indicated that the majority of adults who reported experiencing suicidal ideation associated these experiences with stuttering (61.2%, n = 59). Individuals with higher Total Scores on the PTQ and OASES were predicted to experience significantly higher rates of suicidal ideation and, in particular, a higher likelihood of having more frequent suicidal ideation in the past year. Qualitative analyses revealed that suicidal ideation intersects meaningfully with the experience of stuttering. Data from this study highlight the importance of considering broader life consequences of stuttering that some adults may experience, including suicidal ideation. By being cognizant that clients may develop such thoughts, speech-language pathologists can play a valuable role in identifying and providing necessary support for at-risk individuals. https://doi.org/10.23641/asha.23699688.

Risk Factors Associated With Suicidal Ideation in Individuals With Spinal Cord Injury

ObjectiveTo assess the frequency of suicidal ideation (SI) among individuals with chronic spinal cord injury (SCI) and to identify risk factors associated with SI. DesignCross-sectional. SettingCommunity setting. ParticipantsTwo hundred and forty-six individuals with chronic SCI participating in the Spinal Cord Injury Model Systems at a Level 1 Trauma center. InterventionsNot applicable. Main Outcome MeasureSI, as assessed by question 9 of the Patient Health Questionnaire-9. ResultsTwenty-seven (11.0%) participants endorsed SI; 6 (22.2%) of whom endorsed active SI with a plan of self-harm. Participants who endorsed SI had significantly higher depressive symptoms, lower resilience, and lower satisfaction with life (all Ps<.001). They also had lower perceived health (P<.001), Craig Handicap Assessment & Reporting Technique Short Form (CHART-SF) physical independence (P=.013), and Spinal Cord Injury – Functional Index with Assistive Technology domains of basic mobility (P=.003), self-care (P=.042), and fine motor skills (P=.035). However, participants who endorsed SI were not significantly different in re-hospitalization rates and in other domains of CHART-SF and SCI-AT. Logistic regression, with a forward selection procedure, was used to identify significant predictors of endorsing SI in the context of multiple associated variables. Depressive symptoms (odds ratio [OR]=1.18, P=.020), resilience (OR=0.85, P=.003), and physical independence (OR=0.98, P=.019) remained significant predictors of SI. ConclusionStudy findings suggest higher levels of SI among people with SCI, a substantial proportion of whom have active SI. Individuals with SCI who endorse SI have greater burden of poor physical and mental health, as well as poorer functional status and adaptation. Interventions targeting multiple dimensions of quality of life may help reduce risk of SI and suicide among individuals with SCI.

The Impact of Allied Health Brief Therapy Clinic Interventions in Consumers in Suicidal Crisis.

Brief interventions increase access to and engagement with care for people who are discharged presentation to emergency departments or inpatient care due to suicidal behavior. This study was to investigate the effectiveness of the Allied Health Brief Therapies (AHBT) clinic interventions on suicide ideation, health service utilization, negative emotional states, and functioning and well-being in consumers in suicidal crisis. This research was designed as pre-post study. Three AHBT clinics were established to provide brief interventions in Queensland Australia. Repeated measures ANOVA and McNemar's test were used to measure the impact of the interventions. Sensitivity analysis was conducted to ensure the robustness and appropriate interpretation of the results. Among the 141 consumers who accepted the referral, 106 (75.2%) attended the AHBT sessions, and 35 (24.8%) did not start the interventions. The AHBT clinic interventions reduced consumers' presence and frequency of suicide ideation, emergency department presentations, and negative emotional states (depression, anxiety, and stress), and increased their functioning and well-being with large effect sizes. Change in the frequency of inpatient admission after the AHBT clinic interventions was statistically non-significant. This study provides evidence that the AHBT clinics can reduce suicidal risk factors, decrease health service utilization, and increase functioning and well-being in consumers in suicidal crisis. Future research should consider the use of a control group to increase confidence in the findings.