Pessimism around youth suicide prevention approaches is unfounded

A comprehensive Australian study examining the global impact of suicide prevention approaches in young people has found that youth-specific interventions conducted in clinical, educational and community settings can be effective in reducing suicide-related behaviour in young people at risk.

The review, by researchers at Orygen, the National Centre of Excellence in Youth Mental Health, has been published this week in the UK journal E Clinical Medicine.

The comprehensive review examined 99 individual studies of which 52 were conducted in clinical settings, 31 in educational or workplace settings, and 15 in community settings, and found interventions delivered in these settings appeared to reduce self-harm and suicidal thinking in young people.

Large school-based studies showed that the interventions with the most promise for suicide prevention were integrated approaches, in particular those that combined educational workshops about suicide prevention with case detection designed to identify young people at risk.

In community settings it was also large-scale studies that combined a number of components that showed the most promise. Again, these typically included universal educational programs, training those who come into contact with at risk young people, screening for risk, and linking people to services, where appropriate.

The study's lead researcher, Dr Jo Robinson, said the study findings challenged the pessimism that often pervades discussions around suicide prevention. "At a time when we're seeing suicide rates around the world growing, this study shows us that we should feel hopeful that interventions specifically designed to reduce suicide risk in young people do work and can impact on suicide ideation and self-harm," Dr Robinson said.

"In Australia, we've seen a lot of investment in suicide prevention, but It's very important that this investment is directed in a strategic way and is being invested in evidence-based interventions.

"That's why this study is important, it will guide not just clinical services and interventions and research, but policy makers as well to ensure that we're putting funds into evidence-based suicide prevention interventions that work."

Despite the encouraging findings of the study, Dr Robinson said the research had identified some clear gaps in suicide prevention approaches.

"Many studies simply tested interventions that had previously been designed for adults as opposed to young people specifically, there was also an absence of studies that included indigenous, same sex attracted and/or gender diverse young people and those who live in low to middle income countries," Dr Robinson said.

"These findings suggest that important opportunities for youth suicide prevention are currently being missed and need to be addressed by researchers, research funders, and by policy makers, if we are to successfully address the rising rates of suicide among young people worldwide."

The research was supported by the Future Global Generations Fund, William Buckland Foundation, National Health and Medical Research Council, Auckland Medical Research Foundation, a Victorian Health and Medical Research Fellowship and the American Foundation for Suicide Prevention.

Reference:

Orygen, the National Centre of Excellence in Youth Mental Health. "Pessimism around youth suicide prevention approaches is unfounded." ScienceDaily. ScienceDaily, 2 November 2018. .

Courtesy: ScienceDaily

Grandparents: Raising their children's children, they get the job done

Millions of children are being raised solely by their grandparents, with numbers continuing to climb as the opioid crisis and other factors disrupt families. New research being presented at the American Academy of Pediatrics (AAP) 2018 National Conference & Exhibition shows that caregivers who step up to raise their grandchildren are overcoming unique challenges to manage just as well as biological and adoptive parent caregivers.

The study abstract, "Grandparents Raising Grandchildren: Are They Up to the Job?" will be presented on Monday, Nov. 5, at the Orange County Convention Center in Orlando, Fla. The study is the first to examine a nationally representative sample of children and directly compare households where children are being raised by their grandparents with those being raised by their parents.

"A large and increasing number of mothers and fathers aren't able to meet the responsibilities of parenthood, prompting their own parents to take on the primary caregiver role for their grandchildren," said senior author Andrew Adesman, MD, FAAP, Chief of Developmental and Behavioral Pediatrics for Cohen Children's Medical Center of New York. "Although these children are more likely to have endured one or more adverse childhood experiences and the grandparents themselves often face extra health and socioeconomic hurdles, our findings suggest they appear to be coping well."

The researchers analyzed and compared 2016 National Survey of Children's Health data from 44,807 parent-led households and 1,250 grandparent households. They determined that caregivers raising their grandchildren were more likely to have a greater number of physical and mental health problems, have household incomes at or below the federal poverty line, have lower levels of education, and be single.

In addition, the grandchildren they were raising were more likely to become angry/anxious with transitions, lose their temper and have other behavioral issues.

"This was not surprising, since we know that children in non-parental care are likely to have experienced more adverse childhood experiences and have an increased risk of behavioral problems as a result," said abstract co-author Sarah Keim, PhD, Principal Investigator at Nationwide Children's Hospital.

However, Keim said, grandparents and parents showed no difference when asked if the child "does things that really bother" them, is "harder to care for" than peers, or if they "felt angry with this child." In fact, grandparents and parents did not differ on most measures of parent coping, parenting stress, or caregiver-child interactions when stratified by child health and child age.

The study also found that a substantial proportion of both grandparent caregivers (31 percent) and parent caregivers (24 percent), reported that they did not have anyone "to turn to for day-to-day emotional support with parenting."

"Given that children being raised by their grandparents may pose greater behavioral challenges, and that nearly a third of the parenting grandparents reported they had no one to turn to for day-to-day emotional support with parenting, pediatricians and other health professionals caring for 'grandfamilies' must be mindful of these issues and be ready to refer families to counseling when needed, as well as refer them to supports groups locally and online," Dr. Adesman said.

 Reference: 

American Academy of Pediatrics. "Grandparents: Raising their children's children, they get the job done." ScienceDaily. ScienceDaily, 2 November 2018. .

Courtesy: ScienceDaily