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 …

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 …

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 …

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; …

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 …

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 …

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 …

Understanding The Role That The Internet And Social Media Plays In Suicide Survivor Bereavement, Catherine Merle Perusse

Walden Dissertations and Doctoral Studies

Every year more than 47,000 individuals die by suicide in the United States, leaving behind numerous family and friends who become suicide survivors. While there are prodigious amounts of research on suicidal behavior, little research has focused on what the surviving family members, friends, and community members need after the loss. Many suicide survivors use social media to address their grief and pain in a very public manner. A constructionist social theory of grief and existential phenomenology provided the framework for this qualitative study to examine the use of the Internet and social media as a forum for those grieving …

The Effects Of Therapist Expertise And Concerns Of Involuntary Hospitalization On The Disclosure Of Suicidal Ideations And Behavior, Zane Hensel

All Graduate Theses, Dissertations, and Other Capstone Projects

Suicide continues to grow as a complex and multi-faceted problem in prevention and treatment, particularly for college students with an increased predictor of risk of suicidal behaviors. Previous research has indicated that one of the largest concerns for suicide disclosure is a fear of involuntary hospitalization. Over 200 college students participated in examining therapist expertise and understanding information on involuntary hospitalization on their rate of suicide disclosure. A 2x2 MANOVA, a 2x2x2 MANOVA that included gender, and a factor analysis were performed on an ad-hoc 11-question survey assessing suicidal ideation and suicidal behavior disclosure. The results indicated that there was …

The Critical Need For A Culturally Sensitive Suicide Risk Assessment Instrument For American Indian And Alaska Native Youth, Courtney E. Shaw

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: This systematic literature review was conducted to better understand why there has been a significant increase in America Indian/Alaska Native (AI/AN) youth suicides in tribes across the United States today. The intent of this review is to understand key issues surrounding the increasing numbers of AI/AN youth with suicide ideation, plans, and attempt in order to be able to answer the following clinical question: Is there a valid and reliable culturally sensitive assessment tool designed to recognize at-risk AI/AN youth presenting for primary care? If not, what are key aspects to consider for developing an instrument that could …

Trends And Factors Associated With Suicide Deaths In Older Adults, Eada Novilla-Surette

Electronic Thesis and Dissertation Repository

Suicide in older adults is a significant overlooked problem worldwide; particularly in Canada where a national suicide prevention strategy has not yet been established. This population-level study utilized and analyzed linked administrative health care databases (from 2011-2015) that were available at ICES (provincial health care administrative data steward), to build a better understanding of suicide (rate; trends; risks/preventive factors) in older adults living in Ontario, Canada. The findings suggest that suicide remains a persistent cause of death in older adults (with an average annual suicide rate of 0.1 per 1000 people over 5 years; the risks include being male, living …

Analysis On Suicidal Ideation Among Adolescents (12-17 Years) In The Usa, Himani Raturi

Electronic Theses, Projects, and Dissertations

Suicide is one of the leading health concerns in United States among adolescents and the presence of suicidal ideation (SI) is quite high, with ~20-30% of adolescents reporting it at some point. Though we have seen growth and development in the prevention of suicide, there is limited research on the ability to identify the adolescents which might be at risk for SI. The objective behind the project is to identify adolescents with SI using machine learning.

The project shows statistics from different articles on adolescents in the U.S. For this study, adolescent data was taken from NSDUH 2018. Moreover, detailed …

Suicidal Ideation Among United States Veterans: A Systematic Review, Champagne D. Moore

Electronic Theses, Projects, and Dissertations

Objective: The goal of this study was to conduct a systematic review of suicidal ideation and associated factors among US veterans.

Methods: PRISMA guidelines for identifying and collecting published peer-reviewed articles were employed. Article characteristics were assessed, and trends were analyzed.

Results: Study results show that US veterans have higher rates of suicide as compared to non-US veterans. Among US veterans, the most common means of suicide was firearms, especially among males. Factors such as gun legislation was related to suicide rate among the population.

Conclusion: Veteran suicide prevention must be a public health priority. Prevention measures should further address …

Assessing The Need For Mental Health Interventions Within The Law Enforcement Community, Lizzi Varga Reinard

Art Therapy Counseling Final Research Projects

This research explored mental health interventions within the police. There is a need for mental health in law enforcement (O’Hara, 2018; Blue Help, 2019; Waters & Ussery, 2007; Mohandie & Hatchert, 1999; Miller, 1999; Violanti, 2010). Having been a law enforcement officer myself, I have experienced the stigma and the need of mental health care. I used a cross-sectional survey design to obtain further information on police officers in a Midwest county in the United States to assess the need for mental health interventions. I created response artwork prior to obtaining the survey results (to help assess and sort through …

Human Genetics, Psychotropic Drugs, And Acts Of Violence, Selma Jolanda Eikelenboom-Schieveld

Electronic Theses and Dissertations

From the start of the use of psychoactive prescription medications in the 1950s, physicians reported paradoxical adverse reactions, ranging from newly developing depressions to an increase in existing mood disorders, and extremely violent and bizarre acts of suicide and homicide. In this research, it is hypothesized that the pharmacological properties of the prescribed drugs or the interaction between the drugs and the enzymes that are primarily responsible for their metabolism (cytochrome P450s) could cause these reactions. Given that acts of violence could be medication-induced, the role of the rate of drug metabolism is discussed. Genetic testing of certain CYP450s could …

Breaking The Chain: Evaluating The Links Between Opioid Use Disorder, Overdose, And Suicide, Amanda Nicole Stover Mph

Graduate Theses, Dissertations, and Problem Reports

Previous research has estimated that 20–30% of individuals with opioid use disorder (OUD) have a history of both suicide attempt and unintentional opioid overdose. In 2018, more than 1.9 million adults 18 years and older had an OUD; while 1.4 million adults attempted suicide that same year (SAMHSA, 2019). The key to understanding this relationship is examining behaviors that precede these potentially fatal behaviors. One such precursory behavior is self-injury. Self-injurious behaviors (SIB) are one of the most important risk factors for future suicide (Cavanagh et al.,2003). This study has three primary objectives. The first is to conduct a systematic …

Qualitative Inquiry Of Resilience In Veterans Transitioning To Civilian Life, Brenda D. Nicholson

Walden Dissertations and Doctoral Studies

This qualitative phenomenological research focused on the resilience of 10 veterans transitioning back to civilian life. An increase in suicide rates among veterans over the last 10 years has become a major concern for the U.S. Congress and Department of Defense (DoD). The theoretical frameworks guiding the study are Durkheim’s suicide theory, Lindenberg and Frey’s social production function theory, and Diener’s deindividuation theory. Many veterans have no self-awareness of their need for psychological and transitional assistance, leaving them vulnerable during a time of potentially increased and unfamiliar stress. Understanding the need for effective psychological adjustment and resilience in military members …

Effect Of Educational Training On Nurse Leaders’ Knowledge, Attitude, And Behavior Toward Suicide Prevention, Ruth Odochi Idediora

Walden Dissertations and Doctoral Studies

Suicide is the 10th leading cause of death among adults in the United States and one of the top 10 most commonly occurring events that lead to serious injury or death in the hospital. Nurse leaders who are not working in psychiatric facility are instrumental in promoting culture of safety to mitigate adverse outcomes like suicide. The purpose of this single group pre-and post-test study, guided by the theory of planned behavior, was to determine the effect of the American Psychiatric Nurses Association Competency-Based Training for Suicide Prevention (Acute Care Setting Course) on the knowledge, attitude, and behavior (KAB) of …

Epidemiology Of Marijuana Use And Mental Health In The Context Of Changing Policies, David G. Harvey Ii

Walden Dissertations and Doctoral Studies

There is a growing body of evidence supporting the association between cannabis use and the development of mental health disorders, but few studies have addressed this association following the recent increase in marijuana legalization laws. Therefore, using the social ecological model and the self-medication theory of addiction as theoretical frameworks, the purpose of this retrospective database study was to assess the relationship between marijuana use and major depression and suicidal ideation in both adults and adolescents in 2008 and 2017. Data from the National Survey on Drug Use and Health were analyzed using logistic regression at the p < .05 threshold for statistical significance. Results demonstrated positive, statistically significant relationships between marijuana use and both major depression and suicidal ideation for both adults and adolescents in both 2008 and 2017. Further, the strengths of these relationships generally increased between 2008 and 2017, coincident with the increase in marijuana legalization laws. These findings provide empirical support to the association between cannabis use and the development of mental health disorders, and that the strength of these associations is increasing following the increase in marijuana legalization laws. This study has important implication for positive social change by identifying significant relationships between cannabis use and the development of mental health disorders and revealing that these relationships are strengthening over time, coincident with the increase in marijuana legalization laws.

National Guard Members With Suicide Ideation: The Impact Of Stigma, Mental Health, And Trauma History On Treatment-Seeking Outcomes, Amy Brown

Theses and Dissertations--Social Work

Background. Veterans are overrepresented among suicide deaths in the United States, representing 20% of annual suicide deaths but only about 1% of the U.S. population (Department of Veteran Affairs, 2010). Of all military suicide deaths in 2016, one-third (33.4%) were in the National Guard or Reserves (Department of Defense, 2018). Previous suicidal ideation or behavior (SIB) has been shown to increase risk of subsequent ideation or behavior in both active duty and veteran samples (Bryan, Rudd, & Wertenberger, 2016; Hazlett et al., 2016) but studies of SIB specific to National Guard service members were not found.

Access and Barriers to …

Preliminary Outcomes, Acceptability, And Feasibility Of A Brief Crisis Response Planning Intervention For Reducing Suicide Risk In Primary Care Behavioral Health Patients, Aubrey R. Dueweke

Graduate Theses and Dissertations

Primary care is an important setting for improving identification and treatment of people at risk for suicide. However, there are few developed protocols for management of suicide risk in this setting. This study aimed to evaluate the preliminary outcomes, acceptability, and feasibility of a brief crisis response planning intervention for patients at a moderate risk for suicide in a primary care behavioral health (PCBH) setting. The outcomes examined included change in suicidal cognitions, suicidal intent, hope, and coping efficacy. Twenty-two adult primary care patients at moderate risk for suicide participated in this study, which involved filling out self-report measures before …

Non-Psychiatric Nurse Self-Efficacy With Suicidality After An Educational Intervention, Nadin E. Knippschild

Nursing Theses and Capstone Projects

Lack of acute-care hospital non-psychiatric nurses’ confidence and competence with suicidality has been reported in the literature. Evidence supports multi-modal education to increase recall and improve outcomes. The theory of self-efficacy included concepts of confidence as well as competence and served as the project’s theoretical underpinning. A descriptive design was utilized to examine the effects of an education intervention using various methodologies addressing suicide risk factors, prevention, management, and safe care on nurses’ perceived level of self-efficacy. Methods included a pre-test survey, an education module intervention, and a non-matched post-test survey. The survey used consisted of 11 of the original …

Evaluating The Frequencies Of Self-Reported Mental Health Conditions In Affluent Youth, Philip Bondurant

Walden Dissertations and Doctoral Studies

American youth are facing a mental health crisis. Rates of depression and suicide continue to rise among all children ages 12-17. While there is considerable research on the mental health of underserved children, much less is known about the mental health status of youth from affluent communities. The purpose of this study was to evaluate the effectiveness of community health assessment (CHA)-driven mental health interventions on the youth of affluent communities. Using a pre and post evaluation model, this study compared the frequencies of self-reported depression and suicide ideation for students in Grades 8, 10, and 12, and geographic location …

Psychiatric Nurses' Knowledge Of Suicide Prevention, Wanda F. France

Walden Dissertations and Doctoral Studies

Suicide is a major health concern worldwide. Nurse practitioners must possess suicide assessment skills and treatment knowledge to ensure appropriate identification of persons with suicidal ideation. The purpose of this project was to assess psychiatric nurse practitioners' knowledge of suicide prevention in rural Kentucky. The conceptual framework was Orlando's nursing process theory, which emphasizes the importance of nurse-patient interaction. A 13-item survey of suicide-related knowledge and skills was administered to 10 psychiatric nurse practitioners in rural Kentucky. Only 3 participants responded correctly to a question related to suicidality in persons with borderline personality disorder. Regarding competency and support for assessing …

Best Practice Suicide Screening/Assessment Tools For The Emergency Department, Katheryn M. Spirito

Walden Dissertations and Doctoral Studies

Patients presenting to the emergency department (ED) often suffer from more than physical ailments when seeking care and treatment. Some of these patients have emotional ailments and suicidal ideation when they come to the local ED. The lack of recognition of at-risk patients by health care providers can lead to poor patient outcomes and death. The focus of this project was to understand which valid and reliable suicide assessment tools described in the literature were considered the best evidence-based instruments to identify ED patients who were at risk for suicide. Peplau's theory of interpersonal relations guided this project. A systematic …

Qualitative Analogue Study On Student Therapist’S Reactions To Client Suicidality, Cynthia A. Beevers

Dissertations

Suicidal clients are a reality for both professional and student therapists providing counseling (Chemtob et al., 1988; Dexter-Mazza & Freeman, 2003; Goodman, 1995; Howard, 2000; Jacobson, Ting, Sanders, & Harrington, 2004; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990; Mackelprang, Karle, & Cash, 2014; McAdams & Foster, 2000). Previous research has investigated the experiences of professional therapists working with suicidal clients, but little is known about student therapists’ experiences with suicidal clients. Only two studies were found investigating the experiences of student therapists working with suicidal clients (Kleespies et al., 1993; Kleespies et al., 1990). However, in the …

An Analysis Of Self-Reported Suicide Attempts And Ideation In A National Sample Of Incarcerated Sex Offenders, Kseniya Katsman

Student Theses

Suicide is the leading cause of preventable death in US jails and prisons, with rates three to nine times higher than those of the general population. Although suicide in correctional settings has been recognized as a serious problem, the research on suicide among incarcerated individuals remains limited. While the majority of suicide risk factors may be common across all offender types, sex offenders may be at a particularly elevated risk. Specifically, sex offenders have been found to report high rates of hopelessness and depressive mood, which are known predictors of suicidal behavior, and approximately 14% of incarcerated sex offenders have …

The Rise And Fall Of The Stock Market: A Look At Financial Professionals Suicide Ideation, Jefferson Mcclain

Undergraduate Honors Theses

On October 24, 1929, the United States stock market crashed. Will Rogers, a local newspaper writer, said of that experience, “When Wall Street took that tail spin, you had to stand in line to get a window to jump out of, and spectators were selling space for bodies in the East River” (Lowenthal 1987). Tales of ruined stockbrokers jumping from the windows of tall buildings ran across the country. These stories have prompted interest in the interaction between workplace environment and mental health. In this study, we looked at the relationship between stock market performance and suicide ideation for working …

Cultural Adaptation To Suicide Prevention Interventions On College Campuses, Leisha Marie Chiles

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Suicide is the second leading cause of death for adolescents and young adults ages 15 to 34. Given that college students are within that age range, it is believed they are at a similar risk. As college campuses try to address the suicide risk among their diverse student body, many have developed a public health approach, including the use of gatekeeper trainings. Many of these population-based interventions take a one-size fits all approach to suicide prevention, but with an increasingly diverse student population represented on college campuses this type of approach may fall short and fail to meet the cultural …