Special Topic Paper:
The purpose of this paper is to investigate a specific problem, issue or process that is of special interest to the student. Please note that the does not need to be a DSM-5 diagnosis, but rather a specific psychological problem, issue, or concern affecting adults, adolescents, or children in contemporary society. A topic paper does not just inform the reader about the subject, but
critically evaluates the evidence that supports it.
It must include at least 3 research articles references, (published within the last 10 years), and your appraisal of these research articles (level of evidence, strength of the study, etc.).
Some examples: 1) gangs and violence, 2) trauma resiliency, 3) homelessness and the
Mentally ill, 4) the impact of co-occurring mental illness and substance use disorders,
5)Ketamine treatment for depression. 6) Assisted Outpatient Treatment 7) Telpsychiatry
And many other possibilities…start thinking.
The paper should include a cover page, introduction, and purpose, body of paper,
conclusion, implications, conclusion, and reference pages. The length, excluding cover page
and reference page, should be between 5-8 pages (not including cover and references pages).
The outline for the paper is as follows:
Grading Rubric
–Introduction: Brief introduction to the psychological problem of concern.
–Purpose: Explanation of the significance and importance of the topic.
–Body of Paper: The review of the literature of 3 research articles.
–Implications: How the topic influences and affects clinical practice.
–Conclusion: Final summary and evidence-based recommendations.
–References: Quality of references.
–Quality of writing: clarity, grammar, organization and APA format.
Survivors of Suicide Attempt
Student’s Name
Institutional Affiliations
Survivors of Suicide Attempt
Suicidal ideation is categorized as a mental disorder by the American Psychiatric Association. It falls among those psychological problems that mental health professionals are expected to learn to diagnose, treat, and manage (Lee et al., 2021). Suicidal ideation is a risk factor for suicide attempts and suicide-related deaths. Many countries around the world, especially the United States and Korea have been recording increasing incidences of suicide and suicide attempts attributed to mental health problems since 2016 (Lee et al., 2021; Ahn et al., 2020; Kim et al., 2020). The psychological problem of concern that will be the focus of this assignment is the increasing rates of suicide attempts survivors repeating the act due to lack of implementation of appropriate psychological interventions (Michaud et al., 2021). People who attempt suicide and fail to die usually suffer severe psychological problems that require the attention of mental health professionals (Brådvik, 2018). If not addressed, these survivors usually engage in repeated suicide attempts which eventually leads to their death. As they work with survivors of suicide attempts, mental health professionals must utilize evidence-based therapeutic interventions that have the capacity to improve the quality of life of their patients (Ahn et al., 2020). Therefore, nursing students in the mental health specialty must learn how to appraise published literature in order to locate the best available evidence that they can implement to improve the mental health and well-being of survivors of suicide attempts.
Purpose
Survivors of suicide attempts have expressed concerns regarding the nature of care that they are receiving from healthcare facilities to manage their psychological issues. For instance, in a study conducted by Michaud et al. (2021), survivors of suicide attempts indicated that they value individualized and patient-centered care which they rarely receive from hospitals. They view individualized or patient-centered care as that type of care that entails establishing close therapeutic relationships with their healthcare providers. They value follow-up calls and face-to-face meetings with their healthcare providers. The quality of nurse case-manager that was valued by most participants is the ability to form interpersonal relationships aimed at improving recovery factors. Practically, survivors of suicide attempts believe that they will express their concerns effectively to their healthcare providers when they receive individualized and patient-centered care. Besides, clinicians who are providing patient-centered and individualized care should walk with their patients towards the recovery path (Michaud et al., 2021). In another study performed by Hom et al. (2021), suicide attempt survivors reported that their mental health and well-being can improve greatly when they are cared for by healthcare professionals who work together as a team to deliver integrated continuity care with coordinated follow-ups. Integrated continuity care is long-term and continuous care provided beyond the hospital setting by a team of healthcare professionals (Hom et al., 2021). Therefore, the purpose of this assignment is to appraise published literature to locate evidence that supports the effectiveness of a crisis intervention team that utilizes suicide-targeted approaches in preventing repeated suicide attempts among survivors of suicide attempts. This appraisal is significant in that it will provide new knowledge that mental health professionals can utilize with survivors of suicide attempts to protect them from suicide-related deaths. The chosen topic is important in that it will help healthcare organizations and mental health practitioners to address gaps in clinical practice by implementing crisis intervention team-based care in the treatment and management of survivors of suicide attempts. It will help survivors of suicide attempts or at-risk individuals to know how best they can work with mental health professionals to avoid repeating suicide attempts.
Review of the Literature
Numerous studies have been conducted to evaluate the effects of a crisis intervention delivered by a team of healthcare professionals on the mental health and well-being of suicide attempt survivors. For example, one study by Ahn et al. (2020) examined the impacts of a crisis intervention team on the ability of suicide attempt survivors to complete counseling or suicide prevention programs. The researchers used a retrospective before-and-after analysis design. They used suicide attempt survivors who were receiving care at an emergency department of the Korea University Medical Center Ansan hospital in Ansan City, South Korea. Patients were divided into intervention and control groups. The pre-intervention team comprised 246 patients while the post-intervention group consisted of 296 suicide attempt survivors. This happened due to changes in the number of patients present in the hospital at the time of study considering the fact that some patients were being discharged, some died, and new ones were admitted. The researchers utilized a quantitative approach or methodology to complete the study. The statistical analysis procedures performed by the researchers include the chi-square test and Wilcoxon rank-sum test or Kruskal–Wallis test. The main advantage of prioritizing a quantitative approach was to test the statistical significance between the implementation of a crisis intervention team and the completion rate of suicide prevention programs. The researchers found that a crisis intervention team utilizing suicide-targeted approaches enhanced the counseling completion rates among suicide attempt survivors. The patients were able to complete 8 weeks’ follow-up suicide prevention counseling programs which improved their mental health and prevented them from engaging in repetitive suicide.
Healthcare providers who are working as a team find it easy to make referrals to specialists whenever their patients need specialized care. Being part of a team might make the referral process easy for providers. However, it is important to note that it might be quite difficult to make appropriate referrals when working as part of a team in situations where approval from every member of the healthcare team is required for a referral process to be completed (Give et al., 2019). Kim et al. (2020) conducted a study to investigate the effects of referral to mental health specialists on the suicide death risks of adolescent suicide attempt survivors. The researchers used suicide statistics from the Ministry of Education of Korea collected between 2016 and 2018. From the report, 878 cases of suicide met the inclusion criteria. The inclusion criteria used in the study include; suicide-deceased adolescents and survivors of suicide attempts aged between 7 and 19 years. These inclusion criteria enabled the researchers to effectively compare the impacts of referral to mental health specialists on suicide and suicide attempt rates (Kim et al., 2020). These cases included suicide attempt survivors who received care from a team of healthcare professionals and those who were not cared for by a team of healthcare professionals. Due to the nature of care received, some of the patients died while others recovered. The researchers collected data for the study by evaluating healthcare data of the 878 cases which included 236 suicide-related deaths and 642 suicide attempt survivors. They utilized a quantitative methodology in the study. Findings from the study indicate that team-based care that included referrals to a mental health specialist was associated with reduced suicide death risks among adolescent suicide attempt survivors. High rates of suicide-related deaths were recorded among survivors who were not referred for mental health services. The researchers concluded that there is a need to strengthen team-based care with enhanced referral to mental health services in order to improve mental health and reduce suicide death risk among adolescent suicide attempt survivors. However, it is important to note that the outcomes might differ for young adults which calls for the need to conduct similar research with young adults instead of adolescents.
Adequately trained mental health professionals have the capacity to utilize their knowledge and skills in an integrated setting to provide suicide targeted interventions to suicidal individuals and suicide attempt survivors. Lengvenyte et al. (2021) conducted a study to examine the best practice evidence addressing the effects of particular system-based interventions on the mental health outcomes of individuals considered to be at a high risk of engaging in suicide. The researchers conducted a systematic review of randomized controlled trials that used suicide attempt survivors and individuals with suicidal ideation as study participants. A total of 34 articles were reviewed. From the study, Lengvenyte et al. (2021) discovered that both pharmacological and non-pharmacological suicide-targeted interventions reduced the risk of suicide deaths among patients with suicidal ideation and survivors of suicide attempts. The pharmacological interventions that were found to improve the mental health and well-being of participants include buprenorphine, ketamine, and esketamine paroxetine. The non-pharmacological interventions include assertive case management and the use of a crisis response plan developed by a team of healthcare professionals. The study supported the effectiveness of team-based crisis intervention in improving the mental health and well-being of suicide attempt survivors as well as those with suicidal ideation.
When appraising literature for best practice evidence, nurses should focus on studies with findings that can easily be generalized to other clinical practice settings. Factors that determine generalizability include the study purpose, participants or subjects used, design, and appropriateness of findings. These factors influence the level and quality of evidence in a study. Strong and high-quality evidence has solid indication for a practice change (The Johns Hopkins University School of Nursing, 2017). The three reviewed studies have strong and high-quality evidence because they contain Level I evidence. According to the Johns Hopkins University School of Nursing (2017), level I evidence is contained in experimental studies, randomized controlled trials, systematic reviews of randomized controlled trials with or without meta-analyses, and explanatory mixed-methods designs that include only a level I quantitative study. Ahn et al (2020) conducted an experimental/intervention study, Kim et al. (2020) conducted an explanatory quantitative study, and a study by Lengvenyte et al. (2021) is a systematic review of randomized controlled trials. These are considered high-quality evidence because they have strong and consistent results. From the data analysis, the researchers of the reviewed studies generated almost similar findings linking the implementation of a crisis intervention team with reduced rates of suicide attempts. This evidence supports the effectiveness of a crisis intervention team that implements suicide-targeted approaches in reducing the risk of suicide deaths among survivors of suicide attempts.
Implications
The evidence contained in the reviewed literature has great implications for clinical practice. It affects how healthcare organizations and healthcare professionals, especially mental health settings and practitioners, should care for survivors of suicide attempts not only to improve their mental health and well-being but also to prevent them from engaging in repeated suicide. As supported by research evidence, survivors of suicide attempts should be cared for by a crisis intervention team that closely assesses their needs and implements suicide-targeted interventions aimed at reducing suicide risk and preventing repeated suicide (Ahn et al., 2020; Kim et al., 2020; Lengvenyte et al., 2021). Healthcare professionals should make speedy referrals of at-risk patients to mental health services for specialized care and treatment.
A crisis intervention team should provide care that meets the specific needs of patients in order to improve their mental health and prevent them from engaging in repeated suicide. Also, healthcare organizations should have clearly documented guidelines and policies indicating how to implement a crisis intervention team, including referrals to mental health services for specialized care. In a study conducted by Hom et al. (2021), suicide attempt survivors gave a number of recommendations of the type of care that they want from healthcare providers. Their proposals include; enhanced provider engagement, acceptance and appropriate treatment planning, trauma-informed individualized care, and improved access to hospital-based and continuity care. Michaud et al. (2021) reported patient perspectives regarding post-suicide interventions. Patients expressed the need for individualized patient-centered care that targets specific trauma-related needs. These needs have some implications for healthcare organizations, patients, and providers. For example, healthcare organizations should incorporate these needs into clinical practice guidelines. Additionally, addressing trauma-related needs through individualized patient-centered interventions will not only enable healthcare providers to provide quality care but will also help at-risk patients to avoid suicide attempts. It is important to center the needs and voices of patients themselves into healthcare delivery in order to effectively address patients’ needs and concerns (Lee et al., 2021). Such guidelines will guide the implementation of a crisis intervention team-based care in a manner that generates maximum health benefits for suicide attempt survivors. Health benefits will be determined by evaluating or measuring rates of suicide attempts among survivors. A reduction in suicide attempt rates or lack of it will signify maximum benefits. Living in the United States or Korea where suicide attempt rates are high might generate more clear outcomes when evaluating the successful implementation of team-based interventive care (Kim et al., 2020). The reason is that it will be easier to observe changes in suicide attempt rates before and after the implementation of team-based interventive interventions.
Conclusion
It is by reviewing published peer-reviewed studies related to a topic of interest that nurses can identify best practice evidence to address a clinical practice problem. Survivors of suicide attempts usually suffer numerous psychological problems that can best be addressed by implementing evidence-based interventions. It is anticipated that team-based care can improve the mental well-being of survivors of suicide and can help to prevent suicide deaths. In this assignment, the author has appraised published literature to locate evidence that supports the effectiveness of a crisis intervention team that utilizes suicide-targeted approaches in preventing repeated suicide among survivors of suicide attempts. From the appraisal, it is evident that a crisis intervention team that implements suicide-targeted approaches is effective in reducing the risk of suicide deaths among survivors of suicide attempts. Based on this evidence, healthcare organizations and healthcare providers, especially mental health settings and practitioners should utilize crisis intervention teams to care for survivors of suicide attempts not only to improve their mental health and well-being but also to prevent them from engaging in repeated suicide that can lead to death. In conducting this literature review, an evidence-based intervention that might inspire future research in this area is evaluating how outcomes might differ among patients of different age groups including adolescents, young adults, and older adults, as well as different gender including male and female patients.
References
Ahn, E., Kim, J., & Moon, S. (2020). Effect of a crisis intervention team for suicide attempt patients in an emergency department in Korea. Hong Kong Journal of Emergency Medicine, 27(2):92-98. doi:10.1177/1024907918822255.
Brådvik L. (2018). Suicide risk and mental disorders. International Journal of Environmental Research and Public Health, 15(9), 2028. https://doi.org/10.3390/ijerph15092028.
Give, C., Ndima, S., Steege, R., Ormel, H., McCollum, R., Theobald, S., Taegtmeyer, M., Kok, M., & Sidat, M. (2019). Strengthening referral systems in community health programs: a qualitative study in two rural districts of Maputo Province, Mozambique. BMC Health Services Research, 19(1), 263. https://doi.org/10.1186/s12913-019-4076-3.
Hom, M. A., Bauer, B. W., Stanley, I. H., Boffa, J. W., Stage, D. L., Capron, D. W., Schmidt ,N. B., & Joiner, T. E. (2021). Suicide attempt survivors’ recommendations for improving mental health treatment for attempt survivors. Psychological Services, 18(3):365-376. doi: 10.1037/ser0000415.
Kim, J., Hong, S. H., & Hong, H. J. (2020). The impact of referral to mental health services on suicide death risk in adolescent suicide survivors. Soa–ch’ongsonyon Chongsin Uihak = Journal of Child & Adolescent Psychiatry, 31(4), 177–184. https://doi.org/10.5765/jkacap.200028.
Lee, H., Lim, J., Lee, S. M., Kim, S. N., Lee, H., Lee, K. U., Lee, B. C., Lee, H. Y., & Paik, J. W. (2021). Hospital-Based Case Management for Suicide High-Risk Group Using Delphi Survey. Psychiatry Investigation, 18(10), 986–996. https://doi.org/10.30773/pi.2021.0079
Lengvenyte, A., Olié, E., Strumila, R., Navickas, A., Gonzalez Pinto, A., Courtet, P. (2021). Immediate and short-term efficacy of suicide-targeted interventions in suicidal individuals: A systematic review. The World Journal of Biological Psychiatry, 22(9):670-685. doi: 10.1080/15622975.2021.1907712.
Michaud, L., Dorogi, Y., Gilbert, S., & Bourquin, C. (2021). Patient perspectives on an intervention after suicide attempt: The need for patient centred and individualized care. PloS ONE, 16(2), e0247393. https://doi.org/10.1371/journal.pone.0247393.
The Johns Hopkins University School of Nursing. (2017). Evidence-based practice. Author.