Suicide Prevention in the Dot Com Era: Technological Aspects of a University Suicide Prevention Program

Abstract

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest–posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

Developing a Brief Suicide Prevention Intervention and Mobile Phone Application: A Qualitative Report

Suicide is the second leading cause of death among youth and has become a serious public health problem. There has been limited research on strategies to decrease the likelihood of reattempt in adolescents. As phase one of a treatment development study, clinicians, parents, and adolescents participated in qualitative interviews in order to gain new perspectives on developing a targeted intervention and a safety plan phone application for suicide prevention. Participants indicated that transition of care, specific treatment targets, and safety planning were important parts of treatment. In addition, all participants endorsed the use of a smartphone application for these purposes.     

Implementing an Early Intervention Program for Residential Students Who Present With Suicide Risk: A Case Study

Abstract

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for suicide between Fall 2004 and Spring 2011. Methods: Data were collected from archival records to examine quality of early intervention services, student retention, and grade point average (GPA) during the semesters prior to, during, and subsequent to the referral incident. Results: Program implementation was timely and responsive to student needs; students successfully completing the early intervention program remained in school and demonstrated small but significant rebounds in GPA the semester subsequent to the incident. Conclusions: There are benefits associated with the implementation of early intervention programs designed to respond to students manifesting risk for suicide, such as connecting the student to vital services and support networks.     

The Impact of Experiential Exercises on Communication and Relational Skills in a Suicide Prevention Gatekeeper-Training Program for College Resident Advisors

Abstract

Objective: In an effort to identify students at risk for suicide, many colleges are implementing suicide prevention training for campus gatekeepers. This study evaluated the efficacy of a 3-hour, experiential-based gatekeeper training that included an emphasis on enhancing communication skills and relational connection in addition to the didactic foci of standard gatekeeper training. Participants: Sixty-five college student resident advisors (RAs) were trained with Campus Connect. Methods: The training was dismantled to examine the specific contribution of experiential exercises on training outcomes. Results: Compared to didactic training alone, following participation in experiential exercises RAs’ training outcome scores exhibited additional improvement on the Suicide Intervention Response Inventory–2 and a 14-item self-report measure of self-efficacy for specific suicide- and crisis-related knowledge and skills. Conclusions: In gatekeeper training, experiential exercises emphasizing awareness and empathic responding and practice of these skills contribute to an improvement in crisis response skills above and beyond that of didactic training alone.     

Personal and Professional Knowledge of and Experience With Suicide and Suicide Prevention Among Stakeholders in Clinical and Community Practice

Community-dwelling veterans at risk for suicide may be in contact with a variety of providers in agency-based settings that offer health and human services. The study aim is to describe the perspective of agency-based clinical and community providers who may come into contact with veterans in need of suicide prevention services and to examine the nature of their personal and professional relationships to individuals at risk for suicide among this sample.

This study reports on qualitative data from a sample of Veterans’ Affairs (VA) and community providers serving veterans and military families in one Midwestern state (N = 70). Providers completed a survey assessing exposure to suicide, including contact with and relationship to someone suicidal, and organizational characteristics of the providers’ employing agencies. Semi-structured interview questions probed for the nature of how they would react with suicidal individuals. Most providers (94%) had some prior contact with someone who was suicidal, and nearly three quarters (77%) knew someone who had died by suicide. Providers reported powerful emotional responses of sadness and remorse to suicidal experiences. While these providers interact with veterans and military families as part of their jobs, they may have their own history of being exposed to suicide, both professionally and personally.     

Sexual Abuse Prevention Mobile Application (SAP_MobAPP) for Primary School Children in Korea

ABSTRACT

This study aimed to develop and evaluate the effects of a sexual abuse prevention mobile application, SAP_MobAPP, for primary school children. Forty-five subjects were trained for 40 minutes once a week. The experimental group received education that utilized the SAP_MobAPP. Control group A received Web based sexual abuse prevention education, while control group B received textbook based sexual abuse prevention education. Effectiveness was verified through a survey on child sexual abuse recognition and avoidance skills administered before and after training. The SAP_MobAPP program improved recognition (awareness) and the child’s skills to avoid child sexual abuse situations, and the effects were long-lasting. However, differences between groups were not statistically significant. This study developed a sexual abuse prevention application and verified its effectiveness. Awareness and skills to avoid child sexual abuse after app education increased immediately after training and four weeks later. The SAP_MobAPP could be used for sexual abuse prevention education in schools.     

Evaluation of an avatar-based training program to promote suicide prevention awareness in a college setting

Objective: Training programs exist that prepare college students, faculty, and staff to identify and support students potentially at risk for suicide. Kognito is an online program that trains users through simulated interactions with virtual humans. This study evaluated Kognito's effectiveness in preparing users to intervene with at-risk students. Participants: Training was completed by 2,727 university students, faculty, and staff from April, 2014 through September, 2015. Methods: Voluntary and mandatory participants at a land-grant university completed Kognito modules designed for higher education, along with pre- and post-assessments. Results: All modules produced significant gains in reported Preparedness, Likelihood, and Self-Efficacy in intervening with troubled students. Despite initial disparities in reported abilities, after training participants reported being similarly capable of assisting at-risk students, including LGBTQ and veteran students. Conclusions: Kognito training appears to be effective, on a large scale, in educating users to act in a facilitative role for at-risk college students.     

Grounding Online Prevention Interventions in Theory: Guidelines from a Review of Selected Theories and Research

ABSTRACT

Literature suggests that grounding online interventions in theory improves their success. This article reviews 10 theories selected from the fields of psychotherapy, social work, health promotion, gaming, and innovation dissemination that can be used for grounding the design, development, implementation, and evaluation of online interventions. Selected studies are reviewed to illustrate how these theories have been used in online human service interventions. After this review, an integrated theoretical approach for grounding online interventions is proposed along with guidelines suggested by the review.     

Understanding Client Communities Spatially for Developing Effective Interventions: Application of Geographic Information Systems (GIS) Technology for Program Planning in Health and Human Services Agencies

Social workers are better equipped to understand the need to incorporate geographical aspects pertaining to their clients’ lives as part of their practice, given the significant influence these factors have on client well-being. Geographic Information Systems (GIS) technology is a useful tool for administrators and planners to make informed decisions regarding human service programs including examining program outcomes and impact as well as streamlining program implementation. This article synthesizes the literature to date on GIS in health and human services with examples of real world applications.     

Financial Abuse of Elders and Dependent Adults: The FAST (Financial Abuse Specialist Team) Approach

ABSTRACT

The Financial Abuse Specialist Team, a partnership of professionals from diverse disciplines, volunteer their time to review cases of financial elder abuse and facilitate comprehensive service delivery. The team also advocates for legislative reform, educates the community about the problem, and trains professionals in how to recognize, prevent, and resolve financial elder abuse.     

The Evolution of Worker Connect: A Case Study of a System of Systems

We discuss the rationale, development, deployment, and evolution of Worker Connect, a federation of agency systems that is used by authorized health and human services workers in New York City. We show how Worker Connect evolved with HHS-Connect, the organization that enables the integration and synergy of interagency health and human services systems. We show how the system of systems framework provides a way to understand issues encountered and lessons learned in developing and deploying Worker Connect and similar interagency human services systems. The first part of this article provides a history of the Worker Connect project in the context of a case study on achieving interoperability. The second part of this article introduces the framework of system of systems, and describes Worker Connect and HHS-Connect within this framework. The third part of the article describes future work, and offers some lessons for others wanting to implement a system of systems project for human services.     

Functional Neurological Symptom Disorder (Conversion Disorder) from an Interactional Approach: A Composite Case Study

Functional neurological symptom disorder, alternatively termed conversion disorder (FNSD-CD) (Although the DSM-5 utilises the term 'conversion disorder', practitioners and consumers consider this to be an outdated, unsubstantiated and often stigmatising term. In accordance with this, the current terminology used in the field is 'functional neurological symptom disorder'), involves symptoms of altered voluntary motor or sensory functions without identifiable nervous system disease or pathology. It is considered a psychiatric disorder and is, thus, listed in the Diagnostic and Statistical Manual of Mental Disorders (5th Ed.; DSM-5). As per the nosology of the DSM-5, the discrete behavioural or psychological syndrome or pattern observed in FNSD-CD is assumed to be a function of a problem of, or a disorder within, the individual. Accordingly, the psychiatric approach to FNSD-CD, as set out in the DSM-5, invokes an assumption common to the medical model which is that of lineal (i.e., straight-line) causality, namely, causal events are arranged in a lineal sequence. The interactional approach, however, which is a development of general system theory in the field of family therapy, offers an alternative approach to understanding psychiatric disorders. Specifically, this approach places the emphasis on the relationships between individuals and their reciprocal influences on – including their psychological and emotional wellbeing with – one another. It draws on the assumption of nonlineal (i.e., circular) causality, namely, causal events are arranged in a circular sequence. From an interactional approach, therefore, FNSD-CD is thought to be a function of a problem of, or a deficit within, the individuals’ relationship/s, rather than within an individual, per se. This article utilises a composite case study to investigate FNSD-CD from an interactional approach.     

Screening for Sexually Transmitted Infections (STIs) Among a Heterogeneous Group of WSW(M)

ABSTRACT

Objectives: This study explored predictors of STI screening among a heterogeneous group of women who have sex with women and men. Methods: Following bivariate analyses, a multivariate logistic regression model was conducted to assess the relationship between testing and sociodemographic, relationship characteristics. Results: The majority of participants reported not receiving STI screening in the past year. Gender expression, and not sexual orientation, was a significant predictor of screening. For each increase in masculinity, participants had lower odds of receiving an STI test. Conclusions: More research is needed to understand how gender expression of WSW(M) relates to preventative health behaviors.     

Teaching and incorporating practice models in a human behavior in the social environment (HBSE) course

ABSTRACT

Human behavior and the social environment (HBSE) instructors do not systematically or routinely teach and incorporate practice models in their course. In this article, social work educators describe an approach to teaching and incorporating practice models in a HBSE course using a five-step adapted, modified version of Mosey’s extrapolation method for teaching master level social work students to evaluate and apply practice models. The authors use the Balanced and Restorative Justice (BARJ) model as an illustration to help social work students develop critically reflective approaches to evaluating and applying practice models. The techniques and guidelines outlined in this article could be applied to other practice models and used by social work educators and students interested in other fields of practice.     

The Relationship Between Sexual Minority Verbal Harassment and Utilization of Health Services: Results from Countywide Risk Assessment Survey (CRAS) 2004

In this article we examine the prevalence of and associations between sexual orientation–based verbal harassment and reported utilization of health services across levels of sexual orientation in a diverse sample of adult recipients of Los Angeles County–funded HIV-related health and social services. Thirty-two percent reported they had experienced verbal harassment, the majority (80.3%) of whom identified as lesbian, gay, or bisexual (LGB). Those who reported being verbally harassed received significantly more services overall than those who were not verbally harassed, and service utilization varied by sexual orientation. These findings inform future efforts to identify and assess social discrimination in health and social service settings.     

The Impact of HIV Pre-exposure Prophylaxis (PrEP) Use on the Sexual Health of Men Who Have Sex with Men: A Qualitative Study in Seattle,WA

This study explores the impacts of HIV pre-exposure prophylaxis (PrEP) use on the sexual health of men who have sex with men (MSM). The authors conducted in-depth interviews with MSM who use PrEP (n = 14). Data was analyzed using interpretative phenomenological analysis. PrEP use reduced fear and shame associated with sex and facilitated greater sexual satisfaction and intimacy. Although participants generally viewed PrEP as empowering and beneficial, they also experienced PrEP-related stigma. The authors’ analysis emphasizes the importance of understanding the reasons MSM use PrEP and highlights opportunities for reducing harm and fostering sexual health among MSM who are using or considering PrEP.     

Moving On From Supportive Housing (MOSH): Development and evaluation of a transitional skill-building curriculum for providers helping residents exit homeless services

This article describes the development and evaluation of MOSH (Moving On From Supportive Housing), a transitional skill-building curriculum for providers helping residents exit homeless services to mainstream housing without embedded supports. In this evaluation, we assess the feasibility, acceptability, fit, and potential efficacy of the MOSH curriculum to improve proximal provider-level outcomes, including self-efficacy to provide MOSH-related independent living skills and supports. Homeless-services providers (N = 49) from a range of programs and settings participated in the training. Findings from focus groups and pre- and posttest surveys indicate high levels of overall satisfaction with the training. The majority of trainees perceived the training to be useful to their work and potentially useful for service recipients, felt the training would fit well within their existing day-to-day work, and said they were very likely to use MOSH skills in such work. Statistically significant improvements in self-efficacy regarding all skills but one were also found. MOSH holds promise as an intervention that can enhance provider practice and promotion of independent living skills in homeless services. Although these initial findings on MOSH are encouraging, further research will be needed to evaluate provider knowledge gains and effective use of these skills in practice.     

Working on Womanhood (WOW): A participatory formative evaluation of a community-developed intervention

The well-documented disparities in availability, accessibility, and quality of behavioral health services suggest the need for innovative programs to address the needs of ethnic minority youth. The current study aimed to conduct a participatory, formative evaluation of “Working on Womanhood” (WOW), a community-developed, multifaceted, school-based intervention serving primarily ethnic minority girls living in underserved urban communities. Specifically, the current study aimed to examine the feasibility, acceptability, and initial promise of WOW using community-based participatory research (CBPR) and represented the third phase of a community-academic partnership. Qualitative and quantitative data were collected from 960 WOW participants in 21 urban public schools, as well as WOW counselors, parents, and school staff over the course of one academic year. Results demonstrated evidence of acceptability of WOW and noteworthy improvements for WOW participants in targeted outcomes, including mental health, emotion regulation, and academic engagement. Findings also indicated several challenges to implementation feasibility and acceptability, including screening and enrollment processes and curriculum length. Additionally, we discuss how, consistent with participatory and formative research, findings were used by program implementers to inform program improvements, including modifications to screening processes, timelines, curriculum, and trainings – all in preparation for a rigorous effectiveness evaluation.     

Investigating Preexposure Prophylaxis (PrEP) Uptake Among Black African Communities in East London and Hertfordshire: A Brief Report of a Mixed Methods Study

Abstract

Objective: This study investigated the factors influencing preexposure prophylaxis (PrEP) uptake among Black African heterosexuals in the United Kingdom, while using a 2-phase sequential mixed-methods design. Methods: Surveys from 247 mixed-gender participants were followed by focus groups involving 18 women. Results: Despite the general lack of HIV and PrEP awareness, the study found significant associations between HIV testing, HIV awareness, PrEP awareness, and uptake interest. Stigma was also seen as key barrier: PrEP being connected with HIV positivity, promiscuity, and risky behaviors. Conclusion: This study underlines the need for service providers to develop HIV-prevention interventions that take into account the Black African sociocultural contexts in the United Kingdom.