Adolescents with suicidal behaviours: A qualitative study about the assessment of Inpatient Service and Transition to Community.

WHAT IS KNOWN ON THE SUBJECT?: Only a small number of adolescents with suicidal behaviour receives any follow-up treatment. The implementation of recurrent behaviour prevention strategies is crucial in the period following suicide attempts and should take into account adolescents' opinions to be effective and congruent. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This paper shows that the 33 adolescent participants in the study identified the following protective factors of recurrent suicidal behaviour: family, friends and other trusted persons, as well as the self and newly learned strategies. The adolescents described their family as a constant presence and reported wishing that their parents maintain their current family support. Psychological support, health professionals and occupational activities are what the adolescents value most about hospitalization, and some criticisms are related to the environment, activities and health professionals. The adolescents also emphasize the need to maintain contact with the nurses after hospital discharge and make suggestions for service improvement related to the environment and the interventions implemented. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Knowing the protective factors of recurrent suicidal behaviours, perception of the impact of the intervention, the expectation of future support and healthcare follow-up is crucial for adapting suicide prevention strategies to be put in place by health services for better quality care delivery. The results obtained allow us to define as specific implications the implementation of psychoeducational intervention directed at the adolescent's family with suicidal behaviour during hospitalization and the definition of strategies for maintaining contact and follow-up with the adolescent after discharge. This study emphasizes the need to reinforce training in suicidology for all health professionals for the improvement of clinical practice. ABSTRACT: INTRODUCTION: The prevention of recurrent suicidal behaviours in adolescents should consider their perceptions, needs and expectations. AIM/QUESTION: To identify the protective factors of recurrent suicidal behaviours in adolescents; To describe the family and the expectations for future involvement; To know the most important aspects of hospitalization and discuss expectations of nursing care follow-up after hospital discharge. METHOD: A descriptive, qualitative and exploratory study was carried out in a sample of 33 adolescents with suicidal behaviours. Data were collected through semi-structured interviews, and the data processing used the content analysis technique. RESULTS: Findings arising from data allowed identifying the protective factors: family, friends and other trusted persons. During the hospitalization, the adolescents reinforce the knowledge about themselves and the newly learnt coping strategies. Psychological support and health professionals are what they value most about hospitalization and emphasize the need to maintain contact with the nurses after discharge. DISCUSSION: Knowing the needs and expectations of adolescents with suicidal behaviour will make nursing psychotherapeutic interventions more effective and congruent in this vulnerable group. IMPLICATIONS FOR PRACTICE: Ensuring psychoeducational intervention to the families of adolescents with suicidal behaviour and continuity of care after discharge, and reinforcing the training in suicidology for all health professionals.

Characterization of adopted suicidal behavior and its main influencing factors: A qualitative study with adolescents.

INTRODUCTION: A better understanding of the meanings that adolescents associate with suicide, contributes to the development of psychotherapeutic intervention programs to be implemented by nurse specialists in mental health and psychiatric nursing. Therefore, adolescents need to characterize their adopted suicidal behaviors and identify the personal characteristics that contribute to this same behavior. METHODOLOGY: A descriptive, exploratory, and qualitative study was conducted with 33 adolescents with suicidal behavior, hospitalized in a child psychiatry unit. Data were collected through a structured interview, and data treatment used the content analysis technique. RESULTS: Suicidal behaviors are characterized according to causality, meaning, and intent. Causality is mostly related to psychological factors (sadness, desperation, mental suffering, internal pain, emptiness, and rejection). As to the meaning, suicidal behavior is understood as an escape but also as a personal choice, sometimes regarded as rational. In what concerns intent, the intent to die is the most frequently reported. The most-reported personal characteristics which contributed to the suicidal behavior are feelings of exclusion, rejection, and humiliation, and also introversion. CONCLUSIONS: The results point to the need to reflect on the perceptions of adolescents with suicidal behavior. The current intervention strategies should be adjusted especially through the identification of the signs associated with mental distress in adolescents and the training of gatekeepers, contributing to productive and congruent suicide prevention in this vulnerable group.

Mental health literacy about schizophrenia: a survey of Portuguese youth.

AIM: Mental health literacy about psychotic disorders, specifically schizophrenia, may assist in appropriate help seeking and early intervention, preventing the exacerbation of symptoms and improving health outcomes in the medium and long term. The aim of this study was to characterize the level of mental health literacy of Portuguese youth concerning schizophrenia. METHODS: A mental health literacy questionnaire was administered to a random sample of Portuguese youth aged 14-24 years. This questionnaire evaluated the following components: recognition of disorders, knowledge about professionals and treatments available, knowledge about the effectiveness of self-help strategies, knowledge and skills to support and provide first aid to others, and knowledge of how to prevent mental disorders. RESULTS: There were 4938 adolescents and young adults who participated in the study. Schizophrenia or psychosis was recognized by 42.17% and 22.21%, respectively. Most young people recognized the potential helpfulness of family doctors, psychologists, psychiatrists and mental health services. There was also widespread belief in the potential helpfulness of family and friends, and lifestyle changes. However, teachers were not generally seen as a source of help. Appropriate mental health first-aid strategies were commonly endorsed, but there was a reluctance to ask about suicidal feelings and many endorsed speaking to the person firmly. Lifestyle factors were also commonly believed to be preventative. CONCLUSIONS: Although many Portuguese youth have beliefs that may assist early intervention, there was a substantial minority who did not. Given the central role of teachers in the lives of young people, it is notable that they were not seen as a potential source of help. Mental health first-aid skills of young people also need improvement.