Assessing suicidality during the SARS-CoV-2 pandemic: Lessons learned from adaptation and implementation of a telephone-based suicide risk assessment and response protocol in Malawi.
Assessing suicidality during the SARS-CoV-2 pandemic: Lessons learned from adaptation and implementation of a telephone-based suicide risk assessment and response protocol in Malawi.
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DOI：
10.1371/journal.pone.0281711
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
SARS-CoV-2大流行导致许多研究从面对面研究迅速过渡到全球电话跟踪研究。对于低收入环境下的心理健康研究，远程跟踪提出了独特的安全问题，因为有可能确定无法立即转诊到面对面护理的参与者的自杀风险。我们开发并反复修改了一种电话传递方案，旨在进行积极的自杀风险评估(SRA)筛查。我们描述了这一SRA方案的制定和实施，该方案是在新冠肺炎时代对参加撒哈拉以南非洲精神卫生能力建设区域伙伴关系(SHARP)随机对照试验的马拉维成年抑郁症患者进行跟踪调查的。我们将评估协议的可行性和性能，描述协议开发过程中的挑战和经验教训，并讨论该协议如何作为其他环境中使用的模型。从面对面的SRAS过渡到电话SRAS是可行的，并发现参与者有自杀意念(SI)。随诊方案监测显示，在此期间，在SRA之后的病例中，SI的分辨率为100%，表明这是一种有效的虚拟监测SI的策略。在通过电话监测的参与者中，超过2%的人在协议实施的前六个月筛查出SI阳性。大多数是被动风险(73%)。在研究期间，没有自杀或自杀企图。实施障碍包括为没有个人电话的参与者使用联系人、断断续续的网络问题以及推迟后续行动的预付费电话计划。在未来的调整中，应考虑由于联系联系人的困难、间歇性网络问题和预付费电话计划而导致的后续延迟。未来的方向包括对该议定书在其现有背景下的使用进行验证研究。该方案成功地确定了自杀风险水平，并为研究助理和参与者提供了结构化的后续和转诊计划。该协议可以作为虚拟SRA开发的模型，目前正被改编用于其他环境。
The SARS-CoV-2 pandemic led to the rapid transition of many research studies from in-person to telephone follow-up globally. For mental health research in low-income settings, tele-follow-up raises unique safety concerns due to the potential of identifying suicide risk in participants who cannot be immediately referred to in-person care. We developed and iteratively adapted a telephone-delivered protocol designed to follow a positive suicide risk assessment (SRA) screening. We describe the development and implementation of this SRA protocol during follow-up of a cohort of adults with depression in Malawi enrolled in the Sub-Saharan Africa Regional Partnership for Mental Health Capacity Building (SHARP) randomized control trial during the COVID-19 era. We assess protocol feasibility and performance, describe challenges and lessons learned during protocol development, and discuss how this protocol may function as a model for use in other settings. Transition from in-person to telephone SRAs was feasible and identified participants with suicidal ideation (SI). Follow-up protocol monitoring indicated a 100% resolution rate of SI in cases following the SRA during this period, indicating that this was an effective strategy for monitoring SI virtually. Over 2% of participants monitored by phone screened positive for SI in the first six months of protocol implementation. Most were passive risk (73%). There were no suicides or suicide attempts during the study period. Barriers to implementation included use of a contact person for participants without personal phones, intermittent network problems, and pre-paid phone plans delaying follow-up. Delays in follow-up due to challenges with reaching contact persons, intermittent network problems, and pre-paid phone plans should be considered in future adaptations. Future directions include validation studies for use of this protocol in its existing context. This protocol was successful at identifying suicide risk levels and providing research assistants and participants with structured follow-up and referral plans. The protocol can serve as a model for virtual SRA development and is currently being adapted for use in other contexts.
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DOI：
10.1176/appi.ps.202000003
发表时间：
2021-07-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Gaynes BN;Akiba CF;Hosseinipour MC;Kulisewa K;Amberbir A;Udedi M;Zimba CC;Masiye JK;Crampin M;Amarreh I;Pence BW
通讯作者：
Pence BW
影响因子：
7.4
作者：
Alonso J;Liu Z;Evans-Lacko S;Sadikova E;Sampson N;Chatterji S;Abdulmalik J;Aguilar-Gaxiola S;Al-Hamzawi A;Andrade LH;Bruffaerts R;Cardoso G;Cia A;Florescu S;de Girolamo G;Gureje O;Haro JM;He Y;de Jonge P;Karam EG;Kawakami N;Kovess-Masfety V;Lee S;Levinson D;Medina-Mora ME;Navarro-Mateu F;Pennell BE;Piazza M;Posada-Villa J;Ten Have M;Zarkov Z;Kessler RC;Thornicroft G;WHO World Mental Health Survey Collaborators
通讯作者：
WHO World Mental Health Survey Collaborators
DOI：
10.1017/gmh.2016.27
发表时间：
2016
期刊：
Global mental health (Cambridge, England)
影响因子：
--
作者：
Bantjes J;Iemmi V;Coast E;Channer K;Leone T;McDaid D;Palfreyman A;Stephens B;Lund C
通讯作者：
Lund C
影响因子：
4
作者：
Cheung, Y. T.;Chau, P. H.;Yip, Paul S. F.
通讯作者：
Yip, Paul S. F.
影响因子：
4.7
作者：
Belnap, Bea Herbeck;Schulberg, Herbert C.;Rollman, Bruce L.
通讯作者：
Rollman, Bruce L.