Suicide Can’t Be Predicted by Asking About Suicidal Thoughts

Summary: Researchers report 60% of people who died by suicide denied having suicidal thoughts to medical professionals.

Source: University of New South Wales.

The majority of people who die by suicide deny having suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a ground-breaking UNSW Sydney study has found.

Catherine M. McHugh, Amy Corderoy, Christopher James Ryan, Ian B. Hickie, and Matthew Michael Large in BJPsych Open. Published January 30 2019.

The research questions a widely held belief that suicide can be accurately predicted by psychiatrists and clinicians by assessing a patient’s risk, especially in the short-term.

The meta-analysis, co-authored by clinical psychiatrist and Conjoint Professor Matthew Large from UNSW’s School of Psychiatry, is published today in the journal BJPsych Open.

The review of data from 70 major studies of suicidal thoughts shows that, as a stand-alone test, only 1.7% of people with suicidal ideas died by suicide. About 60% of people who died by suicide had denied having suicidal thoughts when asked by a psychiatrist or GP.

“We know that suicide ideas are pretty common and that suicide is actually a rare event, even among people with severe mental illness,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.

“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he said.

The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by a GP.

“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. Hospital and community care teams in Australia are extremely under-resourced, and this needs to change. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts.”

“Doctors sometimes rely on what is known as suicidal ideation – being preoccupied with thoughts and planning suicide – as a crucial test for short-term suicide risk, and it has been argued it could form part of a screening test for suicide,” said the study’s lead author, Dr Catherine McHugh, a registrar psychiatrist. “Our results show that this is not in the best interests of patients.

Professor Large said that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide. Asking about suicidal thoughts was a central skill for health professionals, he said, but clinicians should be not be persuaded into false confidence generated by a lack of ideation. NeuroscienceNews.com image is in the public domain.

“Some people will try to hide their suicidal feelings from their doctor, either out of shame or because they don’t want to be stopped. We also know that suicidal feelings can fluctuate rapidly, and people may suicide very impulsively after only a short period of suicidal thoughts.”

The main message, said Professor Large, was that clinicians should give less weight to suicidal ideation than had been the case. “It means trying to better understand the patient’s distress and not making patients wait weeks for treatment or denying treatment in the absence of suicidal thoughts.”

There was also an important message for people bereaved of a loved one after a suicide, said Professor Large. “Even if they knew their relative was suicidal, the risk of death was low. And it was not their fault if they did not know someone was suicidal.”About this neuroscience research article

Source: Lucy Carroll – University of New South Wales
Publisher: Organized by NeuroscienceNews.com.
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Open access research for “Association between suicidal ideation and suicide: meta-analyses of odds ratios, sensitivity, specificity and positive predictive value” by Catherine M. McHugh, Amy Corderoy, Christopher James Ryan, Ian B. Hickie, and Matthew Michael Large in BJPsych Open. Published January 30 2019.
doi:10.1192/bjo.2018.88 Cite This NeuroscienceNews.com Article

University of New South Wales”Suicide Can’t Be Predicted by Asking About Suicidal Thoughts.” NeuroscienceNews. NeuroscienceNews, 32 February 2019.
<http://neurosciencenews.com/suicide-prediction-10677/&gt;.University of New South Wales(2019, February 32). Suicide Can’t Be Predicted by Asking About Suicidal Thoughts. NeuroscienceNews. Retrieved February 32, 2019 from http://neurosciencenews.com/suicide-prediction-10677/University of New South Wales”Suicide Can’t Be Predicted by Asking About Suicidal Thoughts.” http://neurosciencenews.com/suicide-prediction-10677/ (accessed February 32, 2019).

Abstract

Association between suicidal ideation and suicide: meta-analyses of odds ratios, sensitivity, specificity and positive predictive value.

Background
The expression of suicidal ideation is considered to be an important warning sign for suicide. However, the predictive properties of suicidal ideation as a test of later suicide are unclear.

Aims
To assess the strength of the association between suicidal ideation and later suicide measured by odds ratio (OR), sensitivity, specificity and positive predictive value (PPV).

Method
We located English-language studies indexed in PubMed that reported the expression or non-expression of suicidal ideation among people who later died by suicide or did not. A random effects meta-analysis was used to assess the pooled OR, sensitivity, specificity and positive predictive value (PPV) of suicidal ideation for later suicide among groups of people from psychiatric and non-psychiatric settings.

Conclusions
Estimates of the extent of the association between suicidal ideation and later suicide are limited by unexplained between-study heterogeneity. The utility of suicidal ideation as a test for later suicide is limited by a modest sensitivity and low PPV.

Declaration interest
M.M.L. and C.J.R. have provided expert evidence in civil, criminal and coronial matters. I.B.H. has been a Commissioner in Australia’s National Mental Health Commission since 2012. He is the Co-Director, Health and Policy at the Brain and Mind Centre (BMC) University of Sydney. The BMC operates an early-intervention youth services at Camperdown under contract to Headspace. I.B.H. has previously led community-based and pharmaceutical industry-supported (Wyeth, Eli Lily, Servier, Pfizer, AstraZeneca) projects focused on the identification and better management of anxiety and depression. He is a Board Member of Psychosis Australia Trust and a member of Veterans Mental Health Clinical Reference group. He was a member of the Medical Advisory Panel for Medibank Private until October 2017. He is the Chief Scientific Advisor to, and an equity shareholder in, InnoWell. InnoWell has been formed by the University of Sydney and PricewaterhouseCoopers to administer the $30 M Australian Government Funded Project Synergy. Project Synergy is a 3-year programme for the transformation of mental health services through the use of innovative technologies.

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 pm – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10 am-10 pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10 am-10 pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families



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Mental Health Practitioner Research Participants Wanted

Western Sydney University is seeking mental health practitioners to share their experiences related to the death of a client as a result of suicide.

The research team would like to invite you to make contact with us, if you are: a nurse, psychologist, social worker, doctor or occupational therapist currently working in mental health services and have experienced the death of client as a result of suicide.

If   you   would   like   further  information  or   like to participate in the study, please make contact with:

Dr. Gill Murphy, Lecturer, School of Nursing & Midwifery, Western Sydney University. Tel: (02) 4570 1280

Email: g.murphy@westernsydney.edu.au

All enquires are confidential

Human Research Ethics Committee approval number: H12485

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 pm – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10 am-10 pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10 am-10 pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

FREE Online Suicide Prevention Summit April 12-14, 2019

MHA_2019_Suicide_Prevention_Summit_Schedule-V4 (1)

Join the largest Suicide Prevention online conference for mental health professionals ever held in Australia

https://www.mentalhealthacademy.com.au/suicideprevention

PURPOSE

To equip every practicing mental health professional in Australia with global best-practice knowledge and skills on suicide prevention, thereby making a tangible reduction on suicide rates.

Dear Mental/Allied Health Professional,

Suicide remains the leading cause of death for Australians aged between 15 and 44.

As a mental health professional, you are the frontline of defence, and you will be required to work with suicidality.

You must be prepared.

The purpose of this Summit is to equip practicing mental health professionals in Australia with the most up-to-date, advanced knowledge and treatment options on suicide prevention.

To achieve that, we’ve assembled 15 of the most highly respected global experts on suicide into one online specialised Summit.

Over 3 days, April 12-14, you’ll have free access to all Summit sessions, live online. You will then have on-demand streaming access for an additional two weeks, from April 15 to April 28.

One of the most powerful resources we have to reduce suicide is our front-line mental health workforce. We believe that by providing every mental health practitioner in Australia with global best-practice know-how and skills, we can tangibly reduce suicide rates in Australia.

We see our role as bringing global best-practice education to Australian practitioners – for free. Your role is taking the time to learn and apply.

As we endeavour to save valuable lives, we look forward to seeing you at the online 2019 Suicide Prevention Summit.

An Unprecedented Body of Knowledge

The Summit brings together an unprecedented body of knowledge on suicidology and suicide prevention.

Australian mental health practitioners have this extraordinary opportunity to learn global best-practice strategies to treat and manage suicidal behaviour.

The 2019 Suicide Prevention Summit is streamed direct to your computer. All you need is an internet (preferably broadband) connected device with speakers to access the highest-quality CPD training available anywhere.

And if you can’t attend the event in real-time (we understand you have a busy schedule), you can access ALL the session content for a full 14 days (15-28 April) after the event, at your convenience.

Snapshot of the Summit

The 2019 Suicide Prevention Summit will be delivered via 15 live webinar sessions from Friday 12th April to Sunday 14th April and will continue as an on-demand event (i.e. you can watch recorded versions of the live
sessions) until Sunday 28th April.

Free Access

Registration for the Summit is entirely free

Live Webinars

Access live*, interactive webinars facilitated by global experts on suicide

Recorded Sessions

Recorded, on-demand sessions – so you don’t miss out on anything

Live Q&A

Interact with presenters through live Q&A sessions

Best Practices

Learn global best practice in suicide prevention

Specialised Areas

Including youth, Aboriginal health, technology, lived experience, and more

15 CPD Hours

Accrue CPD hours as a mental health professional

Proceeds Go to Charity

All funds raised will be donated to Lifeline Australia

*Each live webinar can hold a maximum of 2,000 concurrent participants.

There is no charge and there are some great speakers and topics. Please register at the the webpage (above) to be kept updated and reminded closer to the event.

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 pm – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10 am-10 pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10 am-10 pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

Reflections from the Brisbane North PHN LGBTI Suicide Prevention Trial

Mindout

MindOUT: LGBTI Health Alliance Webinar Invitation

Monday 18th March, 2019

NSW, Victoria, ACT & Tasmania: 1 pm to 2 pm
South Australia: 12.30 pm to 1.30 pm
Queensland: 12 pm to 1 pm
Northern Territory: 11.30 am to 12.30 pm
Western Australia: 10 am to 11 am

Description
This webinar will provide an overview of the work of the Brisbane North Primary Health Network (PHN) has been undertaking in the delivery of the National Suicide Prevention Trial. With 12 sites nationally, the National Suicide Prevention Trials are part of a regional approach to suicide prevention in Australia funded by the Commonwealth Department of Health. Brisbane North PHN is one of only two trial sites that are focusing on LGBTIQ+ people as a priority population.  Adopting the the Black Dog Institute’s LifeSpan Framework, this work has utilised a community driven collaborative co-design process with LGBTI people and communities who are central to this work.

Presenter
Ged Farmer is the Suicide Prevention Officer from the Brisbane North Primary Health Network working on the National Suicide Prevention Trial with the identified priority groups, Aboriginal and Torres Strait Islander, LGBTIQ+, and Young to Middle Aged Men. Ged has been working in the health arena for around 20 years and has a background in Community Development, Health Promotion and Mental Health. Ged has extensive experience working with Aboriginal and Torres Strait Islander communities and LGBTIQ+ communities embedding health promotion and community development philosophies. Ged has developed and delivered LGBTIQ+ training and has delivered system reform across the Brisbane North PiR Consortium creating the inclusion of gender, sex, and sexuality in data capturing.

Register for Webinar

For help in Australia

CAPS – Talk Suicide Support Service – Free telephone and face to face support      1800 008 255

Salvation Army Care Line     1300 36 36 22

Reach Out     http://au.reachout.com/tough-times

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 4636

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 pm – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  –  Talk to a mental health professional (weekdays, 10 am-10 pm AEST) 1800 18 72 63

Helpline chat – Chat online with a mental health professional (weekdays 10 am-10 pm AEST)

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families