[Sentinel program: Example of suicide prevention for an agricultural population in Switzerland]. / Programme sentinelle : exemple de prévention du suicide auprès d'une population agricole en Suisse.

OBJECTIVES: In the field of suicide prevention, the identification of risk groups is important, as is the training of front-line workers, to raise awareness of suicide issues. Agricultural workers represent a group at high risk of suicidal behavior due to various factors (low income of farmers, work related to climatic conditions, social isolation, poor access to primary care). The main objective of this article is to present the implementation of prevention training in suicide prevention for a population of agricultural workers in two cantons of French-speaking Switzerland (Vaud and Neuchâtel) which represent a population of about 980,000 inhabitants. The second objective is to identify the experiences of the participants in this training and their expectations. METHODS: Suicide prevention training sessions are organized in collaboration with public health departments, agriculture departments and suicide prevention professionals. Each session is led by four trainers experienced in suicide prevention and belonging to the "Groupement Romand Prévention du Suicide" (GRPS) which manages the training and other training modules on this topic in French-speaking Switzerland. The GRPS guarantees the content of the training as well as the updating of scientific knowledge. The training model is based on a concept that alternates between brief theoretical contributions, exchanges between participants in plenary sessions and role playing in small groups. The training has two main objectives: on the one hand to work on the participants' representations of suicide and to modify their posture by training "sentinels", i.e. "peers" who can establish a link between suffering individuals and the available support resources. On the other hand, to give key messages: dare to talk about the suicidal question and to not remain alone with this. RESULTS: Between December 2016 and May 2018, nine sessions were held in the two cantons of Vaud and Neuchâtel with a total of 220 participants. The sessions took place in agricultural schools or buildings related to agriculture. Invited to express themselves on the theme of suicide as well as on the concept of training, agricultural workers all verbalized the importance of this issue and were often very moved when the subject was discussed. The topics addressed by the participants were the taboo aspect of the subject, the difficulty of talking about it and the need to be able to address the subject (breaking the isolation). Participants also highlighted the need for peers to act as relays for help. CONCLUSIONS: The sessions were highly appreciated by the organizers concerned, particularly by the public health and agricultural departments. Participants expressed their satisfaction at the opportunity to express their views on this subject, regretting that such initiatives are all too rare. Although studies highlight the difficulty of emotional expression in the agricultural field, we observed on the contrary a great facility of the participants to express their emotions in relation to the suicidal theme. We have highlighted that the issue of suicide in this population is linked to several causal factors, as is the suicidal issue more broadly. Factors specific to this population emerged from the sessions, including working conditions and difficulties related to the family environment of farmers. There is a need to strengthen suicide prevention with training programs among the agricultural population. We also note the major importance of improving access to mental health care which is often very deficient in rural areas.

To Treat or Not to Treat: The Effect of Hypothetical Patients' Suicidal Severity on Therapists' Willingness to Treat.

Therapists' intense negative emotional responses regarding suicidal patients raise questions about therapists' willingness to treat them; however, this issue has yet to be investigated. The aim of the current study is to examine to what extent the severity of suicidality of a hypothetical patient will influence therapists' willingness to treat and the likelihood of their referring out. Mental health professionals (N = 249) completed a questionnaire that presented a vignette of a hypothetical patient referred for psychological treatment. The vignette contained a manipulation of the severity of suicidality levels of the referred patient, with two randomly assigned conditions: suicidal or depressive symptoms. Participants were then asked about their willingness to treat the hypothetical patient. Our results showed that willingness to treat was significantly lower and the likelihood of referring out was significantly higher among therapists in the suicidal patient condition, relative to the depressive patient condition. Longer professional seniority and previous training in suicide prevention moderated these effects. Our findings highlighted therapists' reluctance, especially among young practitioners, to treat suicidal patients, an inclination that may have a critical impact on patient suicidal outcomes. Findings reinforced the need for specific training on suicide prevention in the mental health curriculum.

["VigilanSeu.r.se": A new profession?] / « VigilanSeu.r.se ¼ : un nouveau métier ?

In January 2015, in accordance with decades of scientific work based on maintaining contact, was born an innovative device for suicide prevention: VigilanS. To ensure this link, the choice was made to build a team with an equal number of nurses and psychologists, all located within the medical regulation. Nowadays, they are named "VigilanSeur": an original entity that highlights the emergence of this new profession, at the crossroads of several disciplines.

Pharmacist training in suicide prevention.

OBJECTIVE: Suicide in the United States is a major preventable public health problem. Pharmacists need to be educated on suicide prevention strategies so that they can increase their own awareness and identify patients at-risk. A training program for pharmacists was used to provide skills necessary to recognize a crisis and the warning signs of suicide. The program's effect on the participant's general perception, self-efficacy, and attitude towards suicide prevention was examined. SETTING: Various academic, health care, and professional meetings throughout San Diego County. PRACTICE INNOVATION: First Question, Persuade, and Refer training program targeting pharmacists. EVALUATION: A self-administered presurvey, postsurvey and, Program Outcome Evaluation were given to participants of the suicide training program. Items included demographics, general perception, self-efficacy, and attitude toward suicide prevention. Descriptive statistics were used to describe participants' demographics. t tests were used to compare general perception, attitudes, and self-efficacy scores between pretest and post-program evaluation survey responses. Nonparametric Wilcoxon signed rank analyses for matched pairs were used to compare survey responses that asked about attitudes before and after trainings. Regression analyses were conducted to assess factors associated with general perception, self-efficacy, and attitudes. RESULTS: Participants were more likely to update knowledge after training and reported more confidence to make an intervention for a patient at risk for suicide. CONCLUSION: Our findings suggest that a suicide prevention training program helped pharmacist respondents build confidence in several self-efficacy areas relating to detection of suicide signs, response to patients with suicidal thoughts, reassurance for patients, and provision of resources and referrals.

Reducing eating disorder risk factors: A pilot effectiveness trial of a train-the-trainer approach to dissemination and implementation.

OBJECTIVE: Impediments limit dissemination and implementation of evidence-based interventions (EBIs), including lack of sufficient training. One strategy to increase implementation of EBIs is the train-the-trainer (TTT) model. The Body Project is a peer-led body image program that reduces eating disorder (ED) risk factors. This study examined the effectiveness of a TTT model at reducing risk factors in Body Project participants. Specifically, this study examined whether a master trainer could train a novice trainer to train undergraduate peer leaders to administer the Body Project such that individuals who received the Body Project (i.e., participants) would evidence comparable outcomes to previous trials. We hypothesized that participants would evidence reductions in ED risk factors, with effect sizes similar to previous trials. METHOD: Utilizing a TTT model, a master trainer trained a novice trainer to train undergraduate peer leaders to administer the Body Project to undergraduate women. Undergraduate women aged 18 years or older who received the Body Project intervention participated in the trial and completed measures at baseline, post-treatment, and five-month follow-up. Primary outcomes included body dissatisfaction, thin ideal internalization, negative affect, and ED pathology. RESULTS: Participants demonstrated significant reductions in thin ideal internalization, ED pathology and body dissatisfaction at post-treatment and 5-month follow-up. At 5 months, using three different strategies for managing missing data, effect sizes were larger or comparable to earlier trials for 3 out of 4 variables. DISCUSSION: Results support a TTT model for Body Project implementation and the importance of utilizing sensitivity analyses for longitudinal datasets with missing data.

Making time for the children: self-temporalization and the cultivation of the antisuicidal subject in south India.

This article examines suicide prevention among children in India's "suicide capital" of Kerala to interrogate the ways temporalization practices inform the cultivation of ethical, life-avowing subjects in late capitalism. As economic liberalization and migration expand consumer aspiration in Kerala, mental health experts link the quickening of material gratification in middle-class parenting to the production of insatiable, maladjusted, and impulsively suicidal children. Experiences of accelerated time through consumption in "modern" Kerala parenting practice reflect ideas about the threats of globalization that are informed both by national economic shifts and by nostalgia for the state's communist and developmentalist histories, suggesting that late capitalism's time­space compression is not a universalist phenomenon so much as one that is unevenly experienced through regionally specific renderings of the past. I demonstrate how experts position the Malayali child as uniquely vulnerable to the fatal dangers of immediate gratification, and thus exhort parents to retemporalize children through didactic games built around the deferral of desires for everyday consumer items. Teaching children how to wait as a pleasurable and explicitly antisuicidal way of being reveals anxieties, contestations, and contradictions concerning what ought to constitute "quality" investment in children as temporal subjects of late capitalism. The article concludes by bringing efforts to save elite lives into conversation with suicide prevention among migrants to draw out the ways distinct vulnerabilities and conditions of precarity situate waiting subjects in radically different ways against the prospect of self-destruction.

Does a gatekeeper suicide prevention program work in a school setting? Evaluating training outcome and moderators of effectiveness.

The suicide prevention gatekeeper training program QPR (Question, Persuade, and Refer) was evaluated among school personnel using a nonequivalent control group design. Substantial gains were demonstrated from pre- to post-test for attitudes, knowledge, and beliefs regarding suicide and suicide prevention. Exploratory analyses revealed the possible moderating effects of age, professional role, prior training, and recent contact with suicidal youth on QPR participants' general knowledge, questioning, attitudes toward suicide and suicide prevention, QPR quiz scores, and self-efficacy. The need for replication using a more rigorous experimental design in the context of strong community collaboration is discussed.

The usefulness of distinguishing types of aggression by function.

Far from being a universally defined notion, aggression is a changing and multifaceted phenomenon encompassing various concepts. There is no consensus as to how different types of aggression should be classified: multiple ways of doing so using a variety of criteria exist in the scientific literature. Some scientists categorise aggressive acts according to how they are expressed, while others prefer to look at motive, function, purpose and objective. Despite the claim of some authors that distinguishing between different types of aggressive acts is not always productive, categorising these according to different purposes and objectives can be very useful, both for developing theory and because such an approach serves forensic practice as well as preventive and therapeutic interventions, as these focus on the propensities and personality of the individual. Furthermore, given that the main functional classifications analysed show a common tendency to dichotomise, it would seem appropriate for their terminology and some of their measurement instruments to be standardised.

Suicide prevention program in the Army of Serbia and Montenegro.

Suicide, as one of the greatest problems of maladjustment to the military environment, has been a subject of investigation in the Army of Serbia and Montenegro (former Yugoslav Army) for more than six decades. The Suicide Prevention Program was implemented in December 2003. The aim of the study was to follow-up the application of the Suicide Prevention Program in the Army of Serbia and Montenegro and its effect on the suicide rate and to compare its incidence in civilians. Results of the program application showed that the number of suicides in the Army of Serbia and Montenegro was constantly reducing over the period 2004 to 2005. For soldiers, it was even four times less than in the civilian male population, particularly in the period of adaptation to the military environment. Since the Suicide Prevention Program in the Army of Serbia and Montenegro proved to be successful in decreasing the suicide number, it should be further improved and routinely applied.

Organization of preventive psychiatry programs.

Primary prevention seeks to lower the rate of new cases of psychosocial disorder in a high risk population by reducing the impact of pathogenic life stressors, and by increasing psychosocial supports that enable people to master their adversity in healthy ways. The organization of such a program in Jerusalem is described. It seeks to prevent psychosocial disorders in children of divorced parents. The entire population at risk is contacted in order to reach out to the subpopulation who are unable to cope on their own, but who can be helped to master their difficulties by the coordinated efforts of community caregivers.