[Practice variation in the field of suicide prevention in Dutch mental healthcare]. / Praktijkvariatie op het gebied van suïcidepreventie in de Nederlandse ggz.

BACKGROUND: Previous studies found that the implementation of service guideline recommendations can significantly reduce the number of suicides in mental healthcare. Important barriers to suicide prevention guideline implementation are a lack of professionals' knowledge and competence towards the suicide prevention guideline.
AIM: To assess professionals' knowledge of, competence in, and adherence to the suicide prevention guideline in twelve Dutch specialist mental healthcare institutions.
METHOD: In this study, professionals working at crisis teams and outpatient care teams from each of the 12 participating mental healthcare institutions in the network of supranet Care were invited to fill in a questionnaire examining professionals' knowledge of, competence in, and adherence to the suicide prevention guideline (N = 400). Results were analyzed with multilevel regression analysis and adjusted for confounding.
RESULTS: Although professionals scored high on knowledge, competence, and adherence towards the guideline, they did not know to what extent the guideline was implemented within their own team. Outpatient care teams scored significantly lower on professionals' knowledge and reported lower levels of competence. Furthermore, we found significantly higher scores on adherence to the guideline for professionals in crisis teams compared to outpatient care teams. Healthcare professionals also reported practice variation within and across Dutch mental healthcare institutions. CONCLUSIONS Practice variation within and across teams and mental healthcare institutions is undesirable. To reduce this variation, professionals and mental healthcare institutions should share best-practices and learn from each other how the quality of care for suicidal patients can be optimized.

[Suicide prevention via the internet and the telephone: 113Online]. / Suïcidepreventie via internet en telefoon: 113Online.

BACKGROUND: 113Online is a combination of a website and a telephone help-line for suicidal persons, their relatives and bereaved next of kin. The services it provides include crisis intervention, self-tests and brief psychotherapy. aim: To discover whether 113Online can in fact prevent suicidal behaviour ­ since it has now been in operation for more than a year. METHOD: We were able to obtain information about the visitors of the website, check on the usage of services provided by 113Online and study the results of the self-tests. RESULTS: The results for the first year indicated that there was a great need for anonymous online help for persons contemplating suicide. Scores for the self-tests showed that the website was visited by severely suicidal persons. It is surprising that so few of the users thereafter sought assistance from the conventional mental health care services. CONCLUSION: The 113Online seems to be a promising approach to suicide prevention. The online assistance reaches its target population and seems to fulfil needs that are not being met by the regular health care services.