Medicine and Health Sciences Commons^™

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Implementation Of The Columbia-Suicide Severity Rating Scale At An Outpatient Mental Health Practice To Increase Provider Confidence In Identifying Suicide Risk, Lauren Reed

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based Doctor of Nursing Practice project was to implement the Columbia-Suicide Severity Rating Scale (C-SSRS) as part of routine patient assessment at an outpatient mental health practice to increase the likelihood of identifying clients at risk for suicidal behavior and increase provider confidence in screening for suicidal behavior. The study site is a Southern California-based outpatient mental health practice that employs a variety of clinicians, including psychiatric-mental health nurse practitioners, to provide mental health care to clients across the lifespan.

Background: Approximately 57% of individuals who die by suicide had at least one contact with …

The Mental Health Epidemic In Veterinary Medicine: An Analysis Of Burnout In The Veterinary Field, Hannah Eckstein

Undergraduate Theses

The Mayo Clinic describes burnout as a specific type of stress that involves a state of physical or emotional exhaustion. This exhaustion can lead to a lowered sense of accomplishment and negative personal identity. Despite burnout not being an actual diagnosis, many researchers believe there are several mental health components that contribute to burnout, such as depression and anxiety. Several factors are known to contribute to specifically work-related burnout, including lack of control, work-life imbalance, lack of social support, and extremes of the activity. All of the above factors relate to the veterinary field. In one study, 6.8% of male …

The Effect Of Community Health Linkages On Suicide Rates In Veterans, Erica Anderson

Walden Dissertations and Doctoral Studies

Suicide risk is a public health issue. It is a complex and poorly understood mental health and societal threat. This study examined veteran suicide rates and their relationship to family and social support, as measured by the social association rate, mental health funding per capita, and the lethality of the method rate. The interpersonal-psychological theory of suicide and the social-ecological model are the theoretical frameworks that guided the study. Both theories emphasize the complexity surrounding suicide at the state level as it is related to the individual, social, environmental, and political landscape related to veteran suicide. The quantitative bivariate correlation …

Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles

Master's Projects and Capstones

The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.

After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …

Understanding Deaths Of Despair In Us Counties Through Bourdieu's Theory Of Capital, Seulki Kim

Legacy Theses & Dissertations (2009 - 2024)

The overarching goal of this dissertation is to examine a recent rise in rates of deaths from suicide, alcohol, and drugs, labeled together as “deaths of despair” in the United States using Bourdieu’s theory of capital. Although the deaths of despair phenomenon is a product of a complex process related to various material and non-material factors, there is no theoretical framework that is able to account for different domains of predictors. Thus, this dissertation aims to fill this gap by drawing on Bourdieu’s theory of capital and systematically investigating the relationships of mortality rates attributed to suicide, alcohol, and opioid …

Screening For Suicide Risk In The Outpatient Electroconvulsive Therapy Population, Cerah Nagata

Doctor of Nursing Practice Final Manuscripts

TITLE: Screening for suicide risk in the outpatient electroconvulsive therapy population

BACKGROUND: Reducing risk for suicide continues to be a national hospital patient safety goal. Suicide is the 10th leading cause of death in the United States and suicide rates have increased 33% in the last decade. It has been found that 83% of those who die by suicide received healthcare services in their last year of life, thus healthcare providers are uniquely suited to play a role in identifying suicidality. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a validated tool developed by Columbia University, University of Pennsylvania, and the …

Helping Our Heroes: An Evaluation Of Mental Health And Organizational Policies Surrounding Suicide Prevention And Postvention Strategies For Nebraska First Responders, Maria S. Mickles

Capstone Experience

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and 25-34 years of age (Centers for Disease Control and Prevention, 2022). These statistics disproportionately reflect first responders (i.e., firefighters, dispatchers, law enforcement, EMS, paramedics, etc.), as they die by suicide more than the general public (National EMS Management Association, 2016). Within their line of work …

Impact Of Cognitive Behavioral Therapy On Military Suicide Rates, Madison Lett, Jamia Bird

Theses, Dissertations and Capstones

Introduction: Suicide has been labeled a serious public health dilemma in the United States. Military personnel have suicide rates greater than non-military individuals. Cognitive Behavioral Therapy has been used as a means to help military personnel to overcome suicidal thoughts and feelings.

Purpose of the Study: The purpose of this study was to analyze the effect of Cognitive Behavioral Therapy on military patients’ mental health and how it affects the rate of suicidal ideation, suicide attempts, and deaths by suicide in military patients.

Methodology: This study utilized a literature review and a semi-structured interview with a Veteran Affairs social worker. …

Decreasing Anxiety, Depression, And Suicidal Ideation Through The Implementation Of Education And Screening At Chandler Medical Center, Ashley Gillstrap

DNP Projects

PURPOSE: To provide education on high suicide rates within the healthcare community, screen providers for suicide risk factors, and disseminate mental health resources at the University of Kentucky Chandler Medical Center (UKCMC). The goal of this intervention is to increase awareness and provide resources to providers to essentially decrease these suicide rates.

METHODS: A randomized controlled trial was used with a non-equivalent group pretest-posttest survey design to examine the effect of an education module about suicide risk factors. Along with a rating of how COVID-19 affected mental health, a Patient Health Questionnaire 9 (PHQ-9) was implemented, and mental health resources …

Staff Education To Improve Knowledge About Suicide Screening, Cidia Alysia Awyie

Walden Dissertations and Doctoral Studies

AbstractHealthcare workers play an essential role in healthcare facilities to help patients with mental health challenges and those at risk of committing suicide. The practice gap that the healthcare facility was experiencing was a knowledge deficit among healthcare staff on the importance of suicide screening. The importance of equipping staff with suicide screening knowledge is to help decrease suicide attempts, suicide thoughts, and completed suicide in patients. The practice-focused question for this staff education project asked if staff education for nursing staff and psychiatrists would increase their knowledge about suicide prevention methods and suicide screening techniques. The purpose of the …

Clinical Practice Guideline On Suicide Prevention Among Adolescents, Beltta Gangwab Tachi

Walden Dissertations and Doctoral Studies

AbstractIncreasing rates of suicide among adolescents in the United States is an unsettling problem whereby suicide is the second leading cause of mortality among adolescents. Although interventions exist to address this problem, there is a lack of clinical practice guidelines (CPGs) to assist healthcare providers to identify and prevent adolescent suicide. Guided by the zero-suicide model, the purpose of this project was to develop a CPG to address this gap in practice. A literature review on adolescent suicide prevention resulted in 24 peer-reviewed articles published in the past 5 years that were graded and arranged in a literature matrix. These …

Educational Level As A Moderator Between Stress And Suicidal Ideation Among Law Enforcement Officers, Sittipong Permsookjit

Walden Dissertations and Doctoral Studies

Law enforcement officers are exposed to occupation-related stress at a level greater than any other occupation, save war combatants, such stress can lead to suicidal ideation. There is a growing trend of suicidal ideation among law enforcement officers. This trend will threaten the stability of society if it is allowed to continue. Educational level has been shown to improve quality of life and is considered a quantitative resource. Using the theoretical framework of appraisal theory, this study’s purpose was to examine the moderating effects of educational level on stress and suicidal ideation among law enforcement officers. A total of 72 …

The Effect Of A Web-Based Training On Suicide Knowledge, Attitudes, And Health Access Behaviors Of Behavioral Health Nurses Regarding Suicide Prevention, Marc Woods

DNP Projects

Background: Nurses, critical to the health care delivery system, experience a variety of psychological stressors that predispose them to suicide risk. Recent studies have verified elevated suicide risks in nurses when compared to the general population. There is limited understanding regarding the effectiveness of various strategies to reduce risk factors and increase protective factors for suicide among nurses.

Purpose: The purpose of this study was to evaluate if a web-based education module can improve the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in behavioral health nurses.

Conceptual Framework: Ajzen’s theory of …

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …

The Syndemic Landscape: A New Paradigm For Montana Suicide Prevention Grounded In Agricultural Renewal, Emory Chandler Padgett

Graduate Student Theses, Dissertations, & Professional Papers

Montana has had one of the highest suicide rates in the nation for half a century, and since 2000, it has risen almost 50%. Despite suicide’s alarming persistence in the state, there has been minimal academic study of suicide or mental health specifically in Montana, so this thesis attempts to answer a few questions: Why does Montana have such a high suicide rate? Is there something culturally, historically, or socially unique about Montana that contributes to suicide? Are current prevention efforts helpful, harmful, or lacking? Could a consideration of culture and land benefit an understanding of suicide in Montana? What …

Education And Awareness Of Workplace Hazards: An Educational Intervention For First Responder Trainees, Emily Portune

All Master's Theses

First responder paramedics, emergency medical technicians (EMTs), and firefighters provide emergency services to communities everywhere, often in life-threatening circumstances. At the same time, these first responders face high-stress life and death situations and may also endure unique workplace hazards like racism, sexual harassment and discrimination, verbal and physical patient assault, and extreme sleep deprivation. These hazards make prehospital providers vulnerable to mental illness, a fact proven by preexisting research that found more than 85% of first responders reported negative mental health symptoms and outcomes directly related to their career. Not only are prehospital providers at high risk of mental illness; …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

Increasing Referrals To School Counselors By Integrating An Evidence-Based Program For Educators Identifying Adolescents At Risk For Suicide In A Rural High School, Wendy Holloway

Doctor of Nursing Practice Projects

Background: Addressing suicide in America's youth is imperative. Teachers play an essential role in identifying and intervening with adolescents experiencing psychological distress leading to suicide. Teachers and staff lack professional development addressing the identification of students in psychological distress.

Purpose: This project aimed to increase referrals to school counselors by integrating an evidence-based program for educators identifying adolescents at risk for suicide in a rural high school.

Design Method: This was a quantitative quality improvement project with a pre-/post-test design. Additionally, referrals to the school guidance counselors before implementing the program and after the completion of the program were …

Positive Symptoms Of Schizophrenia And Suicide: A Systematic Review Of Gender, Race/Ethnicity, And Premorbid Iq Variables, Susan Diann Paschall

Dissertations

Schizophrenia is an exceptionally debilitating mental disorder. Its effects permeate all facets of psychosocial functioning and it is associated with premature mortality. As such, suicide is of clinical concern. Positive symptoms such as hallucinations and delusions may influence the risk of suicide among individuals diagnosed with schizophrenia, but additional research is necessary, as the limited literature on this topic is dated and includes heterogeneous results. Early recognition of and intervention for suicide risk factors, such as the presence of positive symptoms of psychosis, may reduce mortality rates for individuals with schizophrenia. The present literature review examined the role of gender, …

Decreasing Suicidal Risks Among Military Veterans With Posttraumatic Stress Disorder Or Major Depression, Manpreet K. Sheabat

Physician Assistant Scholarly Project Papers

Suicide is a major cause of death in the United States. Some populations, such as the veterans and active duty military personnel are at a higher risk of committing suicide compared to the general population. The risk is exacerbated by mental health conditions such as Posttraumatic Stress Disorder (PTSD) and major depression. Few reviews have explored the effects of the recommended psychotherapeutic interventions on suicidal ideations and suicide rates for these two disorders, focusing on the veteran population. To address this, a literature search was performed using a comprehensive search through electronic databases, applying the search criteria and keywords aimed …

Suicide Risk And School Related Stressors In Veterinary Students, Deanna Nicole Arnold

Honors College Theses

Compared to the general population of the United States, veterinarians are at an increasingly higher risk for suicide. This is commonly associated with stressful work environments, long work hours, poor work-life balance, client demands and complaints, and large amounts of euthanasia procedures. While many studies have been performed to confirm the above statements, few to no studies have been done on students currently enrolled in veterinary school to assess their mental health. This study will survey graduate school students in this field and will evaluate their mental health state and risk factors towards suicide. Through comparing the results of this …

Reducing Patient Risk For Suicidal Behaviors With A Safety Bundle Of Best Practices With Non-Psychiatric Patients, Olayemi Akindele

Student Scholarly Projects

Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients.

PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks?

Evidence: Ten studies served as evidence …

Suicide And Non-Suicidal Self-Injury Among Vermont High School Students: An Analysis Of Associated Health-Behavior Variables, Douglas Michael Lebo, Catherine Markesich, Ida Sargent, Mika Smith, Mariana Wingood, Heidi Hales

Master of Public Health Culminating Projects

Objectives: To determine the prevalence of suicidal ideation (SI) and non-suicidal self-injury (NSSI) among Vermont high schoolers and examine their relationship with health-behavior and demographic variables.

Methods: We used responses to the 2019 Centers for Disease Control and Prevention Youth Risk Behavior Surveillance survey from Vermont high schoolers (n = 18 613) to perform bivariate logistic regression analyses of variables thought to predict SI and NSSI.

Results: In 2019, 14.8% of Vermont high schoolers reported SI in the past year, and 18.9% reported NSSI. Lower grade level, LGBT identity, self-perception as over- or underweight, being bullied, alcohol use, smoking, and …

Associations Between Demographic Factors And Suicide Deaths In Vermont: 2015-2019, Isabelle Tomanelli, Lucy Lincoln, Stephanie Stead, Mary Ryan-Eldred, Nick Martin, Sarah Vose

Master of Public Health Culminating Projects

Objectives. To quantify the complex relationships shared between numerous risk factors associated with suicide among Vermont decedents.

Methods. Vermont Electronic Death Registration System (EDRS) data from 2015-2019 were examined through binary logistic regression analyses to examine demographic variables’ ability to predict death by suicide.

Results. In the analysis of 26,738 deaths, significant predictors of suicide among the 535 suicide decedents included rurality (odds ratio [OR] = 1.043; 95% CI = 1.016, 1.071; P = 0.002), divorce (OR = 1.785; 95% CI = 1,396, 2.281; P < 0.001), and higher educational attainment including associate degree (OR = 1.472; 95% CI = 1.033, 2.098; P = 0.032), bachelor’s degree (OR = 1.686; 95% CI = 1.266, 2.247; P < 0.001), master’s degree (OR = 1.812; 95% CI = 1.162, 2.826; P …