Mental and Social Health Commons^™

Managing Student Suicidality On Campus: Perspectives From Diverse Student Affairs Staff, Carla Chugani, Gabriel Kass, Elizabeth Miller

The Qualitative Report

Suicidal behavior is a substantial public health issue faced by college campuses. College counseling professionals often interact with a variety of other student affairs professionals who may be involved in the management of suicidality on campus. However, research on their experiences and perspectives on this topic is scarce. In this study, we build on literature related to management of suicidality on campus, which is predominantly focused on campus counseling professionals. Fifteen semi-structured qualitative interviews were conducted with student affairs professionals to explore how professionals on campuses might better work together to prevent crises and support students at elevated risk for …

Nine-Year Prospective Efficacy And Safety Of Brain-Responsive Neurostimulation For Focal Epilepsy, Dileep R Nair, Kenneth D Laxer, Peter B Weber, Anthony M Murro, Yong D Park, Gregory L Barkley, Brien J Smith, Ryder P Gwinn, Michael J Doherty, Katherine H Noe, Richard S Zimmerman, Gregory K Bergey, William S Anderson, Christianne Heck, Charles Y Liu, Ricky W Lee, Toni Sadler, Robert B Duckrow, Lawrence J Hirsch, Robert E Wharen, William Tatum, Shraddha Srinivasan, Guy M Mckhann, Mark A Agostini, Andreas V Alexopoulos, Barbara C Jobst, David W Roberts, Vicenta Salanova, Thomas C Witt, Sydney S Cash, Andrew J Cole, Gregory A Worrell, Brian N Lundstrom, Jonathan C Edwards, Jonathan J Halford, David C Spencer, Lia Ernst, Christopher T Skidmore, Michael R Sperling, Ian Miller, Eric B Geller, Michel J Berg, A James Fessler, Paul Rutecki, Alica M Goldman, Eli M Mizrahi, Robert E Gross, Donald C Shields, Theodore H Schwartz, Douglas R Labar, Nathan B Fountain, W Jeff Elias, Piotr W Olejniczak, Nicole R Villemarette-Pittman, Stephan Eisenschenk, Steven N Roper, Jane G Boggs, Tracy A Courtney, Felice T Sun, Cairn G Seale, Kathy L Miller, Tara L Skarpaas, Martha J Morrell, Rns System Ltt Study

Faculty, Staff and Students Publications

OBJECTIVE: To prospectively evaluate safety and efficacy of brain-responsive neurostimulation in adults with medically intractable focal onset seizures (FOS) over 9 years.

METHODS: Adults treated with brain-responsive neurostimulation in 2-year feasibility or randomized controlled trials were enrolled in a long-term prospective open label trial (LTT) to assess safety, efficacy, and quality of life (QOL) over an additional 7 years. Safety was assessed as adverse events (AEs), efficacy as median percent change in seizure frequency and responder rate, and QOL with the Quality of Life in Epilepsy (QOLIE-89) inventory.

RESULTS: Of 256 patients treated in the initial trials, 230 participated in …

Association Of Tph1 And Serotonin Transporter Genotypes With Treatment Response For Suicidal Ideation: A Preliminary Study, David A Nielsen, Huiqiong Deng, Michelle A Patriquin, Mark J Harding, John Oldham, Ramiro Salas, J Christopher Fowler, B Christopher Frueh

Staff and Researcher Publications

Variants in three genes coding for components of the serotonergic system, the tryptophan hydroxylase 1 (TPH1) rs1799913, serotonin transporter (SLC6A4) 5-HTTLPR, and serotonin receptor 2A (HTR2A) rs6311, were evaluated for association with suicidal ideation (SI) and with recovery from SI in a psychiatric inpatient population. Five hundred and eighty-two adult inpatients, including 390 patients who had SI, collected from December 2012 to April 2016 were assessed. SI recovery, calculated as change in SI between the first two-week period after admission and weeks 5 and 6, was appraised for association with the three variants. In this preliminary study, both TPH1 and …

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 …

Preferences In Information Processing, Marginalized Identity, And Non-Monogamy: Understanding Factors In Suicide-Related Behavior Among Members Of The Alternative Sexuality Community, Robert J. Cramer, Jennifer Langhinrichsen-Rohling, Andrea R. Kaniuka, Corrine N. Wilsey, Annelise Mennicke, Susan Wright, Erika Montanaro, Jessamyn Bowling, Kristin E. Heron

Psychology Faculty Publications

Suicide-related behavior (SRB) is a mental health disparity experienced by the alternative sexuality community. We assessed mental health, relationship orientation, marginalized identities (i.e., sexual orientation minority, gender minority, racial minority, ethnic minority, and lower education), and preferences in information processing (PIP) as factors differentiating lifetime SRB groups. An online cross-sectional survey study was conducted in 2018. Members of the National Coalition for Sexual Freedom (NCSF; n = 334) took part. Bivariate analyses identified the following SRB risk factors: female and transgender/gender non-binary identity, sexual orientation minority identity, lower education, suicide attempt/death exposure, Need for Affect (NFA) Avoidance, depression, and anxiety. …

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 …

A Hard Row To Hoe: Suicide Among Kentucky Farmers, Olivia Eiler

Mahurin Honors College Capstone Experience/Thesis Projects

According to the Centers for Disease Control and Prevention, male farmers die by suicide at nearly twice the rate of the general population. My research focuses on understanding the factors contributing to this trend and identifying potential solutions, with a specific focus on the Commonwealth of Kentucky. I have collected qualitative data through video interviews with political leaders, scholars, and youth who are active in the agriculture community. These individuals have identified several key stressors, including stigma, a lack of healthcare providers in rural areas, financial insecurity, a lack of appreciation from the public, and uncertainty due to decisions made …

Analysis Of Personality, Suicide, And Self‐Injury In Emerging Adulthood, Amanda C. La Guardia, Robert J. Cramer, Claire N. Bryson, Kelly Emelianchik-Key

Community & Environmental Health Faculty Publications

Nonsuicidal self‐injury (NSSI) is a maladaptive coping strategy that is of significant clinical concern for behavioral health professionals in college settings. Relationships between NSSI, acquired capability for suicide, interpersonal cognitions, and five‐factor model personality traits were assessed in a survey‐based study that included 192 young adults in a college setting. Results indicated that those with an affirmative suicide attempt history, greater acquired capability for suicide, and elevated neuroticism had an increased likelihood of lifetime NSSI.

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 …

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 …

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.

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 …

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

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 …

Subanesthetic Iv Ketamine Reduces Acute Suicidal Ideation In Patients With Mood Disorders, Kimberly Jenko, Jack Anzilotti

Physician Assistant Capstones, 2016 to 2019

Background. Depression and suicide are common in the United States and present a significant problem in the healthcare landscape. Currently, there are few options that can rapidly reduce suicidal ideation in patients with depression. Ketamine, a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to reduce acute suicidality in patients with depression. Previous studies have a reduction of suicidal ideation compared to saline placebo, but few studies have shown a significant effect compared to a similar psychoactive drug such as midazolam.

Method. A search of PubMed and PsychNET was performed in September 2018 using the terms “ketamine,” “suicide,” …

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 …

A Letter To My Departed Niece, * Anonymous *

Journal of Patient-Centered Research and Reviews

The following piece was written in the weeks following the death of the author’s niece. It is an attempt to explore how we as a society handle health crises differently for medical versus mental health diagnoses.

Trajectories Of Self-Reported Sleep Disturbance Across Inpatient Psychiatric Treatment Predict Clinical Outcome In Comorbid Major Depressive Disorder And Generalized Anxiety Disorder, Elizabeth M Hartwig, Katrina A Rufino, Cara A Palmer, Christopher Shepard, Candice A Alfano, Bella Schanzer, Sanjay J Mathew, Michelle A Patriquin

Staff and Researcher Publications

Background: As there has been a demonstrated link between sleep disturbance and suicide, the present study investigated the relationship between self-reported sleep disturbance during inpatient psychiatric treatment and clinical outcomes at discharge and six months post-discharge.

Methods: Participants were 2,970 adults receiving care in a long-term inpatient psychiatric hospital. Greater than 90% of inpatients reported at least mild sleep disturbance throughout treatment. Group-based trajectory modeling was used to determine patterns of sleep disturbance changes over time.

Results: Participants fit into distinct categories based on their trajectories of sleep problems across treatment: No Sleep Problems (10.3% of participants, no sleep problems …

The Relationship Between Non-Suicidal Self-Injury, Suicide-Attempts And Resilience, Life Satisfaction, And Subjective Happiness In Minority Groups, Anna Siewers

Mahurin Honors College Capstone Experience/Thesis Projects

Non-suicidal self-injury and suicide ideation are important issues and known predictors of suicide attempts for any demographic, but specifically for minority groups who are significantly understudied and underreported in comparison to their White and Heterosexual counterparts. It has been found that among adolescents and college students, minority students are disproportionately impacted and are at greater risk for suicidal ideation and behavior. The goal of the present study was to examine the role of both ethnic and sexual minority experience in NSSI and suicide attempts, as well as potential protective factors. A sample of 2,280 undergraduate students completed a survey assessing …

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 …

Effect Of A Motivational Interviewing–Based Intervention On Initiation Of Mental Health Treatment And Mental Health After An Emergency Department Visit Among Suicidal Adolescents, Jacqueline Grupp-Phelan, Jack Stevens, Stephanie Boyd, Daniel M. Cohen, Robert T. Ammerman, Stacey Liddy-Hicks, Kendra Heck, Steven C. Marcus, Lara Stone, John V. Campo, Jefferey A. Bridge

Faculty & Staff Scholarship

Abstract

IMPORTANCE Emergency department (ED) visits present opportunities to identify and refer suicidal youth for outpatient mental health care, although this practice is not routine.

OBJECTIVE To examine whether a motivational interviewing–based intervention increases linkage of adolescents to outpatient mental health services and reduces depression symptoms and suicidal ideation in adolescents seeking emergency care for non–mental health–related concerns who screen positive for suicide risk.

DESIGN, SETTING, AND PARTICIPANTS In this randomized clinical trial, adolescents aged 12 to 17 years who screened positive on the Ask Suicide Screening Questions (ASQ) during a nonpsychiatric ED visit at 2 academic pediatric EDs in …

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 …

"Free Indirect Suicide: An Unfinished Fugue In H Minor", Seo-Young J. Chu

Publications and Research

In this lyric essay/work of creative nonfiction (listed among “Notable Essays & Literary Nonfiction” in Best American Essays 2020), Seo-Young Chu uses poetry, autotheory, and creative nonfiction to explore the generational trauma/postmemory han she inherited from her parents and the importance of destigmatizing mental illness through dialogue.

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 …

Resting-State Functional Connectivity Of The Habenula In Mood Disorder Patients With And Without Suicide-Related Behaviors, Elisa Ambrosi, David B Arciniegas, Kaylah N Curtis, Michelle A Patriquin, Gianfranco Spalletta, Gabriele Sani, B Christopher Frueh, J Christopher Fowler, Alok Madan, Ramiro Salas

Staff and Researcher Publications

The habenula is a small midbrain structure that is important for brain signaling and learning from negative events. Thus, the habenula is strongly connected to both the reward system and motor regions. Increasing evidence suggests a role for the habenula in the etiology of psychiatric disorders, including mood and substance use disorders. However, no studies to date have investigated habenular resting-state functional connectivity (rsFC) in suicide-related behaviors (SB). The authors enrolled 123 individuals with major depressive disorder (MDD) or bipolar disorder and a history of suicide-related behaviors (SB+), 74 individuals with MDD or bipolar disorder and a history of suicidal …

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 …

The Tragedy Of Child And Adolescent Suicide, Brad Hinman

Faculty Publications

"In 2015, the Centers for Disease Control and U.S. Department of Education reported that 20 to 28 percent of U.S. students in grades 6 to 12 have experienced bullying, 30 percent admitted to bullying others, and 70 percent witnessed bullying in some form. According to the report, children and young adults are affected by bullying and cyberbullying during their school-age years, and some even into adulthood.³ “School violence and bullying occurs throughout the world and affects a significant proportion of children and adolescents. It is estimated that 246 million children and adolescents experience school violence and bullying in …

Body Dissatisfaction And Suicidal Ideation Among Psychiatric Inpatients With Eating Disorders, Katrina A Rufino, Humsini Viswanath, Rebecca Wagner, Michelle A Patriquin

Staff and Researcher Publications

The current study the relationship between eating disorders (EDs) and suicidal ideation and suicide attempt in adult inpatients. In particular, the present study investigated one potential mechanism, body dissatisfaction (BD), which may contribute to increased risk for suicide in adult ED patients. A sample of 432 psychiatric inpatients ranging from 18 to 65 years of age participated in the current study. Findings indicated that patients who have higher levels of BD also had higher levels of passive and active suicidal ideation and previous suicide attempts. Higher levels of BD were also related to increased suicidal ideation after controlling for depression …