Tagsuicide prevention

Reading of the Week: Suicidal? Get a Postcard. The New JCP Paper on Suicide Prevention. Also, Ketamine & Inpatients

From the Editor

Can we do better at suicide prevention?

In recent years, several studies have tried brief contact interventions – that is, interventions aimed at maintaining a post-discharge connection – reporting success. These interventions have been relatively simple, such as handwritten postcards or phone calls for people post-attempt.

In this week’s selection, we look at a new paper from The Journal of Clinical Psychiatry. Involving 23 emergency departments and crisis centres in France, the authors pulled together different interventions, coming up with an algorithm offering patients care informed by the best evidence. So some patients received calls, but others were given crisis cards.

It’s an ambitious project. Did it work? The results weren’t statistically significant.

p1110389Postcards: colourful and pretty – and life-saving?

We consider this paper, the negative result, and ask: what does this say about suicide prevention? And then, looking at the evolving literature on suicide, we briefly consider a paper written by Sunnybook’s Mark Sinyor that uses IV ketamine for suicidal thoughts.

Please note: there will be no Reading next week.

DG
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Reading of the Week: Do Suicide Barriers Work? Sinyor et al. on the Bloor Viaduct and Toronto Suicides

From the Editor

Do suicide barriers really work, or do they cost money that could have been better spent elsewhere?

This debate raged in Toronto about a decade and a half ago when some argued that a suicide barrier must be added to the Bloor Viaduct. That bridge, which connects downtown Toronto with its east end, was considered a “suicide magnet” – a place that proved popular for suicide attempts. In North America, only the Golden Gate Bridge in San Francisco had more suicides associated with it. Media coverage of the debate included an article in The New York Times; it ran with the dramatic headline: “A Veil of Deterrence for a Bridge With a Dark Side.”

And in 2003, the barrier went up.

So did the suicide rate go down?

This week, we look at a new paper just published by Sunnybrook’s Mark Sinyor et al. Drawing on years of data, they consider the utility of the Bloor Viaduct suicide barrier. They find that it has saved lives. The paper obviously has implications for other bridges and cities.

The Bloor Viaduct: big debate, big outcome?

The authors also looked at media reporting on suicide.

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Reading of the Week: Can We Reduce Suicide in the Emergency Department Population? Also, Drugs & Crime

From the Editor

He presents to the Emergency Department a few days after a suicide attempt. What can we do to help keep this man safe today – and moving forward?

Emergency Departments: noisy, busy, and an opportunity for suicide prevention?

It’s a scenario that repeats itself at EDs across the country with regularity. This week, in our first selection, we consider a new JAMA Psychiatry paper that has just been published looking at suicide prevention in the ED population. The authors claim “this study is the largest suicide intervention trial ever conducted in the United States,” and they show that, with an intervention, they can reduce suicides and suicide attempts.

And, in the other selection, we look at a short New York Times essay in which economist Austin Frakt argues that substance programs pay for themselves in crime reduction.

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Reading of the Week: Chains and the Mentally Ill, and More

From the Editor

How to free the mentally ill from their chains?

This week, I’ve selected three Readings. We open with a moving essay about a man who works to free the mentally ill from their chains – literally – in Africa. In an op ed, Mental Health Commission of Canada’s Michael Wilson argues that the federal budget must make suicide prevention a priority. Finally, we look at a new study considering an old problem: access to mental health services.

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