Prevention of suicidal behaviour: Results of a controlled community-based intervention study in four European countries


Autoři: Ulrich Hegerl aff001;  Margaret Maxwell aff002;  Fiona Harris aff002;  Nicole Koburger aff003;  Roland Mergl aff004;  András Székely aff005;  Ella Arensman aff006;  Chantal Van Audenhove aff007;  Celine Larkin aff006;  Mónika Ditta Toth aff005;  Sónia Quintão aff008;  Airi Värnik aff009;  Axel Genz aff010;  Marco Sarchiapone aff011;  David McDaid aff012;  Armin Schmidtke aff013;  György Purebl aff005;  James C. Coyne aff014;  Ricardo Gusmão aff008
Působiště autorů: Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe-Universität Frankfurt, Frankfurt, Germany aff001;  Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, Scotland, United Kingdom aff002;  Department of Research Services, University of Leipzig, Leipzig, Saxonia, Germany aff003;  Department of Psychology, Bundeswehr University Munich aff004;  Institute of Behavioral Sciences, Semmelweis University Budapest, Budapest, Hungary aff005;  National Suicide Research Foundation and School of Public Health, University College Cork, Cork, Ireland aff006;  Center for care research and consultancy at KU Leuven (LUCAS), University of Leuven, Leuven, Belgium aff007;  CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal aff008;  Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia & Tallinn University, Tallinn, Estonia aff009;  Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Otto-von-Guericke University, Magdeburg, Saxonia-Anhalt, Germany aff010;  Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy aff011;  London School of Economics and Political Science, London, United Kingdom aff012;  Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Bavaria, Germany aff013;  Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America aff014;  ISPUP, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal aff015
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224602

Souhrn

The ‘European Alliance Against Depression’ community-based intervention approach simultaneously targets depression and suicidal behaviour by a multifaceted community based intervention and has been implemented in more than 115 regions worldwide. The two main aims of the European Union funded project “Optimizing Suicide Prevention Programmes and Their Implementation in Europe” were to optimise this approach and to evaluate its implementation and impact. This paper reports on the primary outcome of the intervention (the number of completed and attempted suicides combined as ‘suicidal acts’) and on results concerning process evaluation analysis. Interventions were implemented in four European cities in Germany, Hungary, Portugal and Ireland, with matched control sites. The intervention comprised activities with predefined minimal intensity at four levels: training of primary care providers, a public awareness campaign, training of community facilitators, support for patients and their relatives. Changes in frequency of suicidal acts with respect to a one-year baseline in the four intervention regions were compared to those in the four control regions (chi-square tests). The decrease in suicidal acts compared to baseline in the intervention regions (-58 cases, -3.26%) did not differ significantly (χ2 = 0.13; p = 0.72) from the decrease in the control regions (-18 cases, -1.40%). However, intervention effects differed between countries (χ2 = 8.59; p = 0.04), with significant effects on suicidal acts in Portugal (χ2 = 4.82; p = 0.03). The interviews and observations explored local circumstances in each site throughout the study. Hypothesised mechanisms of action for successful implementation were observed and drivers for ‘added-value’ were identified: local partnership working and ‘in-kind’ contributions; an approach which valued existing partnership strengths; and synergies operating across intervention levels. It can be assumed that significant events during the implementation phase had a certain impact on the observed outcomes. However, this impact was, of course, not proven.

Klíčová slova:

Community based intervention – Depression – Germany – Hungary – Ireland – Mental health and psychiatry – Portugal – Suicide


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2019 Číslo 11