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      Reasons to Love Life : Effects of a Suicide-Awareness Campaign on the Utilization of a Telephone Emergency Line in Austria

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          Abstract

          Background: A suicide awareness campaign was initiated in the Austrian federal state of Styria to increase help-seeking behavior in the population. Billboards were shown throughout Styria depicting joyful everyday-life situations with a focus on social and family connectedness, and promoting the Telephone Emergency Service, a crisis hotline. Aims: The present study investigated the impact of this campaign on the utilization of the crisis hotline and on suicide rates. Method: Phone calls and suicide rates in the study region 3 months before the campaign were compared with rates 3 months after the campaign. The changes were contrasted with the characteristics of phone calls and the suicide rate in a comparable control region. Results: There were significantly more phone calls in the study region after the awareness campaign compared to the control region, which was similar to seasonal trends in nonintervention years, and there was no increase of suicide-related phone calls. The proportion of suicide-related phone calls referring to family problems decreased after the initiation of the campaign. Suicide rates did not change. Conclusion: The campaign may have had some minor immediate impact on the utilization of the Telephone Emergency Service, but it did not seem to motivate suicidal individuals, especially those with family problems, to call.

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          Suicide prevention strategies: a systematic review.

          J John Mann, Alan Apter, José Bertolote … (2005)
          In 2002, an estimated 877,000 lives were lost worldwide through suicide. Some developed nations have implemented national suicide prevention plans. Although these plans generally propose multiple interventions, their effectiveness is rarely evaluated. To examine evidence for the effectiveness of specific suicide-preventive interventions and to make recommendations for future prevention programs and research. Relevant publications were identified via electronic searches of MEDLINE, the Cochrane Library, and PsychINFO databases using multiple search terms related to suicide prevention. Studies, published between 1966 and June 2005, included those that evaluated preventative interventions in major domains; education and awareness for the general public and for professionals; screening tools for at-risk individuals; treatment of psychiatric disorders; restricting access to lethal means; and responsible media reporting of suicide. Data were extracted on primary outcomes of interest: suicidal behavior (completion, attempt, ideation), intermediary or secondary outcomes (treatment seeking, identification of at-risk individuals, antidepressant prescription/use rates, referrals), or both. Experts from 15 countries reviewed all studies. Included articles were those that reported on completed and attempted suicide and suicidal ideation; or, where applicable, intermediate outcomes, including help-seeking behavior, identification of at-risk individuals, entry into treatment, and antidepressant prescription rates. We included 3 major types of studies for which the research question was clearly defined: systematic reviews and meta-analyses (n = 10); quantitative studies, either randomized controlled trials (n = 18) or cohort studies (n = 24); and ecological, or population- based studies (n = 41). Heterogeneity of study populations and methodology did not permit formal meta-analysis; thus, a narrative synthesis is presented. Education of physicians and restricting access to lethal means were found to prevent suicide. Other methods including public education, screening programs, and media education need more testing. Physician education in depression recognition and treatment and restricting access to lethal methods reduce suicide rates. Other interventions need more evidence of efficacy. Ascertaining which components of suicide prevention programs are effective in reducing rates of suicide and suicide attempt is essential in order to optimize use of limited resources.
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            The alliance against depression: 2-year evaluation of a community-based intervention to reduce suicidality.

            David Althaus, Ulrich Hegerl, Armin Schmidtke … (2006)
            The global burden and large diagnostic and therapeutic deficits associated with depressive disorders call for intervention programs. The aim of the Nuremberg Alliance against Depression (NAD) is to establish and to assess the effectiveness of a four-level intervention program for improving the care of patients with depression. A 2-year intervention program was performed in Nuremberg (480000 inhabitants) at four levels: training of family doctors and support through different methods; a public relations campaign informing about depression; cooperation with community facilitators (teachers, priests, local media, etc.); and support for self-help activities as well as for high-risk groups. The effects of the 2-year intervention on the number of suicidal acts (completed suicides plus suicide attempts, main outcome criterion) were evaluated with respect to a 1-year baseline and a control region (Wuerzburg, 270,000 inhabitants). Compared to the control region, a reduction in frequency of suicidal acts was observed in Nuremberg during the 2-year intervention (2001 v. 2000: -19.4%; p< or =0.082; 2002 v. 2000: -24%, p< or =0.004). Considering suicide attempts only (secondary outcome criterion), the same effect was found (2001 v. 2000: -18.3%, p< or =0.023; 2002 v. 2000: -26.5%, p<0.001). The reduction was most noticeable for high-risk methods (e.g. hanging, jumping, shooting). Concerning completed suicides, there were no significant differences compared to the control region. The NAD appeared to be effective in reducing suicidality. It provides a concept as well as many methods that are currently being implemented in several other intervention regions in Germany and in other countries.
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              Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy

              Annemarie Wright, Patrick D McGorry, Meredith G Harris … (2006)
              Background Early detection and treatment of mental disorders in adolescents and young adults can lead to better health outcomes. Mental health literacy is a key to early recognition and help seeking. Whilst a number of population health initiatives have attempted to improve mental health literacy, none to date have specifically targeted young people nor have they applied the rigorous standards of population health models now accepted as best practice in other health areas. This paper describes the outcomes from the application of a health promotion model to the development, implementation and evaluation of a community awareness campaign designed to improve mental health literacy and early help seeking amongst young people. Method The Compass Strategy was implemented in the western metropolitan Melbourne and Barwon regions of Victoria, Australia. The Precede-Proceed Model guided the population assessment, campaign strategy development and evaluation. The campaign included the use of multimedia, a website, and an information telephone service. Multiple levels of evaluation were conducted. This included a cross-sectional telephone survey of mental health literacy undertaken before and after 14 months of the campaign using a quasi-experimental design. Randomly selected independent samples of 600 young people aged 12–25 years from the experimental region and another 600 from a comparison region were interviewed at each time point. A series of binary logistic regression analyses were used to measure the association between a range of campaign outcome variables and the predictor variables of region and time. Results The program was judged to have an impact on the following variables, as indicated by significant region-by-time interaction effects (p < 0.05): awareness of mental health campaigns, self-identified depression, help for depression sought in the previous year, correct estimate of prevalence of mental health problems, increased awareness of suicide risk, and a reduction in perceived barriers to help seeking. These effects may be underestimated because media distribution error resulted in a small amount of print material "leaking" into the comparison region. Conclusion We believe this is the first study to apply the rigorous standards of a health promotion model including the use of a control region to a mental health population intervention. The program achieved many of its aims despite the relatively short duration and moderate intensity of the campaign.
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                Author and article information

                Journal
                Journal ID (publisher-id): cri
                Title: Crisis
                Subtitle: The Journal of Crisis Intervention and Suicide Prevention
                Publisher: Hogrefe Publishing
                ISSN (Print): 0227-5910
                ISSN (Electronic): 2151-2396
                Publication date (Print): August 27, 2013
                Publication date (Electronic): 2013
                Volume: 34
                Issue: 6
                Pages: 382-389
                Affiliations
                [ 1 ] Suicide Research Unit, Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Austria
                [ 2 ] Crisis Intervention Center and Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria
                [ 3 ] Telephone Emergency Service, Graz, Austria
                [ 4 ] Foundation WEIL (Weiter im Leben), Graz, Austria
                Author notes
                Benedikt Till, Suicide Research Unit, Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria +43 1 401 603-4615 +43 1 401 6093-4600 benedikt.till@ 123456meduniwien.ac.at
                Article
                Apa ID: cri_34_6_382
                DOI: 10.1027/0227-5910/a000212
                PubMed ID: 23942384
                SO-VID: 13ece993-2e7e-4ae2-9341-07e093dfd146
                Copyright statement: Copyright @ 2013
                History
                Date: September 20, 2012
                Date: February 25, 2013
                Date accepted : February 25, 2013
                Categories
                Subject: Research Trends

                ScienceOpen disciplines: Emergency medicine & Trauma,Psychology,Health & Social care,Clinical Psychology & Psychiatry,Public health
                Keywords: suicide,crisis hotline,telephonic utilization,Austria,awareness campaign
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma, Psychology, Health & Social care, Clinical Psychology & Psychiatry, Public health
                Keywords: suicide, crisis hotline, telephonic utilization, Austria, awareness campaign

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