Group intervention programs and their impact on well-being and quality-of-life for adults living with a rare or orphan disease - realist review of literature.

PURPOSE: Adults living with a rare or orphan diseases (ROD) experience common psychosocial difficulties that are often poorly addressed in usual care. This realist literature review aims to inform the development, evaluation and implementation of evidence based group therapy programs adapted to shared needs of patients living with various ROD. METHOD: The review is based on an analysis of Context-Mechanism-Outcome configurations. It included 21 primary studies published between 2010 and April 2022 and used a PRISMA process for study selection and inclusion. RESULTS: Our results show that group psychosocial interventions can help reduce perception of symptoms and psychological impacts of disease, improve social functioning and support and quality of life in patients. CONCLUSION: Group therapy programs seem promising for ROD-patients and should be considered within comprehensive treatment and support plans. However, more comprehensive studies of group therapies in context should aim to identify core active components of these interventions with ROD-patients. Implications for Rehabilitation:Rare or Orphan Diseases are varied, difficult to diagnose and have a major impact on all aspects of the patients' lives (physical, emotional, psychological, social, professional).Psychosocial support is a key but underdeveloped component to support the recovery trajectory for these patients.In this review of group interventions, we identified a few promising practices adaptable to patients living with Rare or Orphan Diseases (Acceptance and commitment therapy, cognitive behavioural therapies, psychoeducational programs).Patients who received psychosocial group interventions are likely to experience improvement in their quality of life.

[The Development Process of the New Quebec Digital Suicide Prevention Strategy: Suicide.ca]. / Processus d'élaboration de la nouvelle Stratégie québécoise numérique en prévention du suicide : Suicide.ca.

In Quebec, nearly 3 persons still take their own lives every day, even though this number has been declining since 2000. Several institutional and community actors are involved in suicide prevention and several initiatives have contributed to the reduction of suicide rates. Despite this hard work, additional efforts are needed to intensify service offers and resource access to better reach people at risk of suicide not reached by actual services. For many years, several countries have been implementing digital technologies to reach them. In Quebec, there were delays in adoption of digital technologies for suicide prevention. In this context, the Health and Social services Ministry mandated Association québécoise de prévention du suicide (AQPS) to develop a Digital Strategy for Suicide Prevention (DSPS). From the beginning, AQPS wanted to anchor DSPS's development in a decision-making process based on scientific, contextual and experiential evidence. A process, derived from implementation science, was therefore put in place to actualize this intent. Implementation science is defined as the science of implementing programs in real-world settings. It is recognized as contributing to the successful implementation of new programs while promoting a rigorous evaluation of their impacts and outcomes. Objectives This article aims to: 1) present the process that was put in place to facilitate DSPS design, implementation, and evaluation; and 2) describe the DSPS action model and the DSPS. Method The Knowledge to Action (KTA) framework is central to the design, implementation, and evaluation of DSPS. This framework proposes a cyclical process in 7 iterative phases, each with its own methodological aspects and data collections Results The results section illustrates the concrete actions taken at each phase of the KTA process and the highlights that emerge from the analysis of the data collected. This section also presents the DSPS. Conclusion Optimal conditions to promote the implementation of DSPS, its use and its sustainability have been put in place. The current implementation and evaluation of this implementation and its impacts will allow to assess the capacity of DSPS to achieve its main objectives: to provide information about suicide, to identify suicidal individuals, to increase the visibility of resources, and to offer help to suicidal individuals who respond less to traditional resources.

Psychometric validation of the French version of the Suicidal Ideation Attributes Scale (SIDAS-FR).

The purpose of this study was to validate in French the Suicidal Ideation Attributes Scale (SIDAS) using an online community survey that was completed by 2304 French-speaking Quebec participants (adolescents and adults). The SIDAS-FR demonstrated high internal consistency (α = .83), a unifactorial structure, and strong convergent validity with relevant constructs. Cutoff scores of ≥13 for moderate severity and ≥20 for high severity of suicidal ideations were optimal. The excellent psychometric properties of the French-Canadian version of the SIDAS support its use as an effective tool for online screening of suicidal ideations, for both adolescents and adults.

Impact of Railway Critical Incidents on Train Drivers and Effectiveness of Critical Incident Management and Support Protocols: A Recovery Trajectory Analysis.

OBJECTIVE: Train drivers are regularly involved in railway critical incidents (CI) and critical incident management and support protocols (CIMSPs) have been developed to support them. This study describes the impact of CIs and evaluates the effectiveness of CIMSPs. METHODS: We interviewed 74 train drivers 1 week, 1, 3, and 6 months after a CI. We performed Linear growth model analyses to describe recovery paths and the effect of CIMSPs, considering the effect of CI complexity, proximity to victims, social support, self-assessment of health, use of resources, and attribution of responsibility. RESULTS: CIs have a significant negative impact on train drivers. Recovery paths can be explained by the level of implementation of CIMSPs, and other contributing factors. CONCLUSIONS: CIMSPs are effective in reducing the negative impact of CIs and should be implemented rigorously by employers.

Reducing the impacts of exposure to potentially traumatic events on the mental health of public safety personnel: A rapid systematic scoping review.

Police, firefighters, and emergency medical technicians and paramedics are frequently exposed to potentially traumatic events (PTE) in their work as public safety personnel (PSP). PTE are a risk factor for posttraumatic stress disorder, depression, anxiety, substance abuse, and suicidal ideation. This systematic rapid scoping review summarizes evaluation research on psychosocial interventions to reduce the negative consequences of exposure to work-related PTE on the mental health of PSP. Articles were identified using PubMed and PsycInfo. Publications from January 1, 2013, to December 1, 2020, were retained because the research published before 2013 was covered by other reviews. We identified 601 unique documents; 30 met preliminary eligibility criteria; and 18 were retained. Most studies were limited to police officers and firefighters. Participants exposed to prevention measures reported improvements of symptoms of depression, burnout, anxiety, sleep problems, and well-being. Most articles identified factors that may hinder or facilitate the use of program components. Studies on ways to support PSP recently affected by a PTE are lacking. There are little data on the efficacy of prevention programs in reducing the prevalence of mental disorders associated with PTE. More studies should focus on identifying participant characteristics and intervention components that influence program use, adherence, and efficacy. Realistic evaluations combined with participatory research could help address important knowledge gaps. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Evaluation of the Implementation of a Railway Critical Incident Management and Support Protocol to Help Train Drivers Cope With Accidents and Suicides.

OBJECTIVE: Railway accidents and suicides can have severe psychological consequences for train drivers. This study evaluates the implementation of railway critical incident management and support protocols (CIMSP) by employers. It also identifies environmental factors, characteristics of critical incidents, and types of work relations affecting implementation. METHODS: A longitudinal study was conducted with 74 train drivers. Participants were interviewed 1 week, 1, 3, and 6 months after a critical incident. Correlational analyses were performed to identify factors associated with implementation and satisfaction. RESULTS: CIMSP are generally partially applied by employers when a railway incident occurs. Workers' satisfaction toward implementation of the protocol is moderate. Obstacles to implementation are: geographic isolation, severity of the incident, and poor quality of work relations. CONCLUSIONS: These obstacles should be addressed in CIMSP design and implementation strategies.

Information and Communication Technology Use in Suicide Prevention: Scoping Review.

BACKGROUND: The use of information and communication technology (ICT) in suicide prevention has progressed rapidly over the past decade. ICT plays a major role in suicide prevention, but research on best and promising practices has been slow. OBJECTIVE: This paper aims to explore the existing literature on ICT use in suicide prevention to answer the following question: what are the best and most promising ICT practices for suicide prevention? METHODS: A scoping search was conducted using the following databases: PubMed, PsycINFO, Sociological Abstracts, and IEEE Xplore. These databases were searched for articles published between January 1, 2013, and December 31, 2018. The five stages of the scoping review process were as follows: identifying research questions; targeting relevant studies; selecting studies; charting data; and collating, summarizing, and reporting the results. The World Health Organization suicide prevention model was used according to the continuum of universal, selective, and indicated prevention. RESULTS: Of the 3848 studies identified, 115 (2.99%) were selected. Of these, 10 regarded the use of ICT in universal suicide prevention, 53 referred to the use of ICT in selective suicide prevention, and 52 dealt with the use of ICT in indicated suicide prevention. CONCLUSIONS: The use of ICT plays a major role in suicide prevention, and many promising programs were identified through this scoping review. However, large-scale evaluation studies are needed to further examine the effectiveness of these programs and strategies. In addition, safety and ethics protocols for ICT-based interventions are recommended.

Can CCTV identify people in public transit stations who are at risk of attempting suicide? An analysis of CCTV video recordings of attempters and a comparative investigation.

BACKGROUND: Suicides incur in all public transit systems which do not completely impede access to tracks. We conducted two studies to determine if we can reliably identify in stations people at risk of suicide in order to intervene in a timely manner. The first study analysed all CCTV recordings of suicide attempters in Montreal underground stations over 2 years to identify behaviours indicating suicide risk. The second study verified the potential of using those behaviours to discriminate attempters from other passengers in real time. METHODS: First study: Trained observers watched CCTV video recordings of 60 attempters, with 2-3 independent observers coding seven easily observable behaviours and five behaviours requiring interpretation (e.g. "strange behaviours," "anxious behaviour"). Second study: We randomly mixed 63 five-minute CCTV recordings before an attempt with 56 recordings from the same cameras at the same time of day, and day of week, but when no suicide attempt was to occur. Thirty-three undergraduate students after only 10 min of instructions watched the recordings and indicated if they observed each of 13 behaviours identified in the First Study. RESULTS: First study: Fifty (83%) of attempters had easily observable behaviours potentially indicative of an impending attempt, and 37 (61%) had two or more of these behaviours. Forty-five (75%) had at least one behaviours requiring interpretation. Twenty-two witnesses attempted to intervene to stop the attempt, and 75% of attempters had behaviours indicating possible ambivalence (e.g. waiting for several trains to pass; trying to get out of the path of the train). Second study: Two behaviours, leaving an object on the platform and pacing back and forth from the yellow line (just before the edge of the platform), could identify 24% of attempters with no false positives. The other target behaviours were also present in non-attempters. However, having two or more of these behaviours indicated a likelihood of being at risk of attempting suicide. CONCLUSIONS: We conclude that real time observations of CCTV monitors, automated computer monitoring of CCTV signals, and/or training of drivers and transit personnel on behavioural indications of suicide risk, may identify attempters with few false positives, and potentially save lives.

Cluster Analysis of Characteristics of Persons Who Died by Suicide in the Montreal Metro Transit.

BACKGROUND: Suicides occur in metro systems worldwide and patterns vary in different urban transit networks. AIMS: This study presents an in-depth analysis of 117 suicides in the Montreal Metro from 2000 to 2008 based on data obtained from coroners' investigations. METHOD: Cluster analyses were performed to identify characteristics of groups of people who kill themselves in the Montreal Metro. We also compared changes in characteristics with data from 1986 to 1995. RESULTS: We identified five clusters of suicidal persons that describe patterns of characteristics of individuals who died by suicide in the metro that may be useful for prevention. Comparisons of suicides during 2000-2008 with data from a previous study of coroners' investigations of Montreal Metro suicides during 1986-1995 indicate changes in age, isolation, types of problems, and geographic patterns. CONCLUSION: Characteristics of metro suicides may be specific to localities and can change over time. Their understanding may facilitate the development of prevention strategies tailored to these different profiles.

Comparison of the Effects of Telephone Suicide Prevention Help by Volunteers and Professional Paid Staff: Results from Studies in the USA and Quebec, Canada.

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.

Systematic review of research on railway and urban transit system suicides.

INTRODUCTION: We critically review research on railway suicides to inform suicide prevention initiatives and future studies, including who is at risk and why, and behaviours at track locations. METHOD: Literature was identified from Scopus, Web of Science, Google Scholar and our documentation centre, and contacting 71 railway companies, resulting in 716 articles and eight unpublished reports, with 94 having empirical data on 55 unique studies. Research quality was critically assessed. RESULTS: The quality of studies varies greatly with frequent shortcomings: no justification of sample size, lacking information on the reliability and validity of measures, no explanation nor theoretical understanding of findings. Railway suicides resemble closely people who use other methods, although they tend to be younger. As with other suicide methods, mental health problems are likely to be present. Railway suicide attempters usually die, but most urban transportation systems attempters survive. Railway suicides are rarely impulsive; people usually go to the railway for the purpose of killing themselves. Hotspots have been the focus of some prevention measures. We know little about why people choose railway suicide, but studies of survivors suggest they often thought they would have an immediate, certain and painless death. Media reports on railway suicides can increase their incidence. CONCLUSIONS: Most research focuses on the incidence and characteristics of events and attempters. Research has not shown that railway suicides are different from suicides by other means. Better quality research is needed, particularly studies that investigate why people use railways to kill themselves and how railway suicides can be effectively prevented, as well as more evaluations of prevention programmes. Because of significant variations by country and region in characteristics of railway suicides, prevention programmes should conduct a local assessment of the characteristics of attempters and incidents. PRACTICAL IMPLICATIONS: We need more research on indicators of suicide risk in attempters on railway property, and studies of how suicidal people on railway property are prevented from suicide. Changing beliefs and attitudes about railway suicides, reducing media reports, offering help onsite, controlling access at hotspots and better staff training in mental health facilities near tracks are promising prevention strategies. However, local specificities must be considered in planning prevention strategies.

Systematic Review of the Impact of Suicides and Other Critical Incidents on Railway Personnel.

The review summarizes current scientific knowledge on the effects of railway critical incidents on railway workers and the associated risk and protective factors. Diagnosable traumatic reactions sometimes occur after a serious incident. However, the most frequent effects are long-term impairments that do not meet diagnostic criteria but can still profoundly affect people's lives. Risk factors that can increase the negative effects of incidents include characteristics of the employee, coping mechanisms, the type of incident, and the support and care received. Prevention and intervention programs should consider the diversity of reactions to develop relevant support programs.

Development of a Comprehensive Programme to Prevent and Reduce the Negative Impact of Railway Fatalities, Injuries and Close Calls on Railway Employees.

AIM: This article presents a strategy to prevent trauma, support and care for railway personnel who experience critical incidents (CI) on the job, usually fatalities by accident or suicide. METHOD: We reviewed all publications on CI management, support and care practices in the railway industry, as well as practices in place in Canada (unpublished protocols). Semi structured interviews were conducted with 40 train engineers and conductors involved in CIs and the content was coded and analysed quantitatively. RESULTS: Employees' satisfaction with the help received after the incident varies according to the behaviour of the local manager, company officers and police, the level of compliance with existing company protocols to help them, the presence of unmet expectations for support and care, their perceived competency of clinicians they consulted and the level of trust toward their employers. CONCLUSION: On the basis of the interview results, the review of existing railway practices and discussions with railway stakeholders, a model protocol was developed for a comprehensive workplace prevention, support and care protocol to reduce the negative impact of railway critical incidents on employees. This protocol includes preventive actions before traumatic events occur, immediate responses at the site of incident, interventions within the first few days after the incident and longer term support and interventions provided by the company and by outsourced experts.

Comparing models of helper behavior to actual practice in telephone crisis intervention: a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network.

Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.

Which helper behaviors and intervention styles are related to better short-term outcomes in telephone crisis intervention? Results from a Silent Monitoring Study of Calls to the U.S. 1-800-SUICIDE Network.

A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller characteristics and changes during the calls. The relationship between intervention characteristics and call outcomes are reported for 1,431 crisis calls. Empathy and respect, as well as factor-analytically derived scales of supportive approach and good contact and collaborative problem solving were significantly related to positive outcomes, but not active listening. We recommend recruitment of helpers with these characteristics, development of standardized training in those methods that are empirically shown to be effective, and the need for research relating short-term outcomes to long-term effects.