Scoping review of 30 years of suicide prevention in university students around the world: efficacy, effectiveness, and cost-effectiveness

A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and costeffectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation. (AU)

Atendimento psicossocial a crianças e adolescentes em situação de violência: o psicólogo e a rede de atenção / Psychosocial care for children and adolescents in situation of violence: the psychologist and the attention network / Atención psicosocial para niños y adolescentes en situación de violencia: el psicólogo y la red de atención

Este estudo de caso discute o atendimento psicossocial oferecido a crianças e adolescentes em situação de violência, em um centro de extensão universitário voltado a essa clientela, no município de Goiânia (GO). Tratou-se de uma família que enfrentava situação de vulnerabilidade social e de violência física, encaminhada para instituição especializada no atendimento a situações de violação de direitos. Além do atendimento psicológico, foram necessárias ações para garantir os direitos desses sujeitos, o que exigiu da psicóloga um posicionamento estratégico para dialogar com outros profissionais e instituições. Entre os impasses para a eficácia dessas ações, destacaram-se a escassa e demorada articulação entre os profissionais da rede e a falta de capacitação no sentido de superar formas tradicionais de atendimento, correndo-se o risco de perpetuar práticas retrógradas e estigmatizantes em detrimento da doutrina da proteção integral.

This case study discusses the psychosocial care offered to children and adolescents in a situation of violence, in a university extension center addressed to this clientele, in the city of Goiânia (GO). It was a family that faced a situation of social vulnerability and physical violence, referred to an institution specialized in dealing with situations of violation of rights. In addition to psychological care, actions were required to guarantee the rights of these subjects, which required the Psychologist a strategic position to dialogue with other professionals and institutions. Among the impasses for the effectiveness of these actions were the scarce and time-consuming articulation between the network professionals and the lack of training in order to overcome traditional forms of care, running the risk of perpetuating retrograde and stigmatizing practices to the detriment of the doctrine of integral protection.

Este estudio de caso discute la atención psicosocial que se ofreció a niños y adolescentes en situación de violencia, en un centro de extensión universitario dirigido a esta clientela, en la ciudad de Goiânia (GO). Fue una familia que se enfrentó a una situación de vulnerabilidad social y violencia física, referida a una institución especializada en atender situaciones de violación de derechos. Además de la atención psicológica, se requerían acciones para garantizar los derechos de estos sujetos, lo que exigía de la psicóloga una posición estratégica para dialogar con otros profesionales e instituciones. Entre los impases para la efectividad de estas acciones estaban la escasa y demorada articulación entre los profesionales de la red y la falta de formación para superar las formas tradicionales de atención, corriendo el riesgo de perpetuar las prácticas retrógradas y estigmatizadoras en detrimento de la doctrina de protección integral.

Ações em grupo voltadas à promoção da saúde de adolescentes / Group actions to promote the adolescents health

O estudo analisou artigos brasileiros sobre pesquisas nas unidades básicas de saúde, que utilizaram como metodologia atividades educativas em grupo com adolescentes, para conhecer as características principais dessas atividades nos serviços de atenção primária à saúde. Foram acessadas as bases Lilacs, Scielo e Adolec. Os artigos foram categorizados segundo os critérios: (1) artigos publicados em periódicos brasileiros sobre (2) intervenções grupais com adolescentes para a promoção de saúde (3) nas unidades básicas de saúde, (4) entre 2000-2010. Os textos foram analisados de acordo com os itens: profissionais envolvidos, características metodológicas, temas abordados nos grupos, periodicidade, número de participantes, idade, sexo, concepção de adolescência presente nos estudos e resultados apresentados pelos autores. Os resultados mostraram um maior número de ações baseadas em pesquisas epidemiológicas e no enfoque biomédico da adolescência. As ações descritas nessas publicações focavam intervenções grupais para a prevenção de comportamentos de risco em saúde sexual e reprodutiva, em detrimento da diversidade de fatores relacionados à saúde integral dos adolescentes.

The study analyzed brazilian articles on research in basic health units, which used educative activities as methodology, in order to ascertain the main characteristics of those activities being conducted in primary health care services. The following units were accessed: Lilacs, Scielo and Adolec. The articles were categorized according to these criteria: (1) articles published in brazilian journals about (2) group interventions with adolescents for health promotion (3) in basic health units, (4) between 2000-2010. The texts were analyzed according to the following items: professionals involved, methodological features, topics covered in the groups, frequency, number of participants, age, sex, the conception of adolescence present in the studies as well as results presented by the authors. The results showed a larger number of actions based on epidemiological and biomedical research. The services described in these publications for focused on group interventions the prevention of risk behavior in sexual and reproductive health rather than considering the diversity of factors related to the adolescents' overall health concerns.