SAMS & Suicide – Self-appraisals may be important for buffering suicidal thoughts and behaviours, potentially providing a key source of resilience

Resilience as positive coping appraisals: Testing the schematic appraisals model of suicide (SAMS). Behaviour Research and Therapy, 2009

Johnson J, Gooding PA, Wood AM, Tarrier N.

School of Psychological Sciences, University of Manchester, UK.


AIMS: The Schematic Appraisals Model of Suicide (SAMS) suggests that positive self-appraisals may be important for buffering suicidal thoughts and behaviours, potentially providing a key source of resilience. The current study aimed to explore whether positive self-appraisals buffered individuals from suicidality in the face of stressful life events. METHOD: 78 participants who reported experiencing some degree of suicidality were recruited from a student population. They completed a battery of questionnaires including measures of suicidality, stressful life events and positive self-appraisals. RESULTS: Positive self-appraisals moderated the association between stressful life events and suicidality. For those reporting moderate or high levels of positive self-appraisals, raised incidence of stressful life events did not lead to increases in suicidality. DISCUSSION: These results support the SAMS framework, and suggest that positive self-appraisals may confer resilience to suicide. Positive self-appraisals may be a promising avenue for further resilience research, and an important area to target for suicide interventions.

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Self-harm in adolescents

Self-harm in adolescents, Advances in Psychiatric Treatment (2009) 15: 434-441

Alison Wood 

has worked as a consultant in child and adolescent mental health services (CAMHS) for 13 years, 7 of those in Tier 4 services providing in-patient and out-patient/outreach care in partnership with Tier 3 CAMHS for young people with severe mental health disorders. Dr Wood has been actively involved in research of both self-harm and depression.


Self-harm in adolescents is common and is increasing. It can present to professionals as a symptom of major mental health disturbance or it can form part of a cultural ‘norm’. This article reviews current knowledge about self-harm in 12- to 18-year-olds. Definitions of self-harming behaviour, epidemiological and aetiological factors, risk assessment and management of self-harming in various settings are discussed in terms of pragmatic clinical approaches and evidence-based practice.

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Family Intervention for Suicide Prevention: A specialized emergency department intervention for suicidal youths.

Family Intervention for Suicide Prevention: A specialized emergency department intervention for suicidal youths, Professional Psychology: Research and Practice. Vol 40(2), Apr 2009, 118-125

Asarnow, Joan Rosenbaum; Berk, Michele S.; Baraff, Larry J.


Suicide attempts and suicidal ideation are common problems among youths seen in clinical practice. Despite the high risk of repeated suicidal behavior in these patients, clinicians are faced with a lack of empirically supported treatments for these youths. This article describes the Family Intervention for Suicide Prevention (FISP), a second-generation adaptation of the Specialized Emergency Room Intervention, an evidence-based practice. Although designed for use in emergency settings, the FISP can be used by practitioners working in a wide range of settings where youths present with suicidal emergencies. Rooted in cognitive–behavioral and family systems theory, the FISP is designed to mobilize family support and problem solving, reframe the suicide attempt as a critical event that requires treatment, reinforce more adaptive coping, motivate patients and families to initiate and adhere to follow-up treatment, and promote linkage to follow-up care. This approach can be used with a wide range of patients and offers an evidence-informed tool for practicing clinicians

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Suicide & Prevention – Investigation into West London Mental Health NHS Trust

Investigation into West London Mental Health NHS Trust  Care Quality Commission, July 2009

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This reports on an investigation into West London Mental Health NHS Trust that was triggered by concerns about the trust’s response to suicides within the trust. The investigators carried out two unannounced visits to see the environment in which care was being delivered, how staff engaged with service users and interview staff and managers. The findings are discussed under the following headings: national context; the trust’s history and role; providing a safe environment and protecting people from harm; enabling good outcomes for people through high quality care. The report concludes that one of the things that a trust must do is to learn the lessons from serious incidents and take action to prevent the same things happening again; the system that the trust had in place to do this was seriously flawed. A number of recommendations are made.

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The National Suicide Prevention Strategy for England – Annual Report

The national suicide prevention annual report  of progress in 2008 was published on 10 July 2009, National Mental Health Development Unit

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The report highlights progress made on a number of specific initiatives during 2008 as well as outlining some key issues for 2009. The suicide rate continues to fall and is now the lowest rate on record.   In addition, there has bee a further fall in the rate of suicide amongst young men under the age of 35. There has also been a further reduction in suicides amongst mental health in-patients and in prisons.  We cannot afford to be complacent however. Previously periods of high unemployment or severe economic problems have had an adverse effect on the mental health of the population and have been associated with higher rates of suicide.  PCTs and other front-line agencies are aware of the situation and continue to identify and support vulnerable individuals who are at risk. …..

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Suicide Prevention – Understanding and strengthening

Public involvement in suicide prevention: understanding and strengthening lay responses to distress, BMC Public Health 2009, 9:308

Owens C, Owen G, Lambert H, Donovan J, Belam J, Rapport F, Lloyd K

1Peninsula Medical School (Universities of Exeter & Plymouth), Wonford House, Dryden Road, Exeter, Devon, EX2 5AF, UK

2Department of Social Medicine, University of Bristol, Canynge Hall, Whatley Road, Bristol BS8 2PS, UK

3PAPYRUS prevention of young suicide, Burnley, Lancashire, UK

4School of Medicine, University of Swansea, Grove Building, Singleton Park, Swansea SA2 8PP, UK



The slogan “Suicide prevention is everyone’s business” has been used in a number of campaigns worldwide in recent years, but most research into suicide prevention has focused on the role of medical professionals in identifying and managing risk. Little consideration has been given to the role that lay people can play in suicide prevention, or to the resources they need in order to do so.

The majority of people who take their own lives are not under the care of specialist mental health services, and around half have not had recent contact with their general practitioner. These individuals are not known to be ‘at risk’ and there is little or no opportunity for clinical intervention. Family members and friends may be the only ones to know that a person is troubled or distressed, and their capacity to recognise, assess and respond to that distress is therefore vitally important. This study aims to discover what the suicidal process looks like from the point of view of relatives and friends and to gain insight into the complex and difficult judgements that people have to make when trying to support a distressed individual.


The study uses qualitative methods to build up a detailed picture of 15–20 completed suicides, aged 18–34. Data are gathered by means of in-depth interviews with relatives, friends and others who knew the deceased well. In each case, as many informants as possible are sought using a purposive snowballing technique. Interviews focus on the family and social network of the deceased, the ways in which relatives and friends interpreted and responded to his/her distress, the potential for intervention that may have existed within the lay network and the knowledge, skills and other resources that would have helped members to support the distressed individual more effectively.


The study will inform interventions to promote public mental health awareness and will provide a basis on which to develop community-focussed suicide prevention strategies.

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Suicide Prevention Programs & Europe

Optimizing Suicide Prevention Programs and Their Implementation in Europe (OSPI-Europe): An evidence-based multi-level approach  BMC Public Health 2009, 9:428

Hegerl U, Wittenburg L et al..

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Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based programme for suicide prevention is presented.


The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts.


This multi-centre research seeks to overcome major challenges of field research in suicide prevention. It pools data from four European regions, considerably increasing the study sam-ple, which will be close to one million. In addition, the study will gather important information concerning the potential to transfer this multilevel program to other health care systems. The results of this research will provide a basis for developing an evidence-based, efficient con-cept for suicide prevention for EU-member states.

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