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      Re-imagining crisis care: experiences of delivering and receiving the Assured brief psychological intervention for people presenting to Emergency Departments with self-harm

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          Abstract

          Background

          Risk of suicide is increased immediately following emergency department (ED) attendance for self-harm. Evidence suggests that brief psychological interventions delivered in EDs are effective for self-harm. The Assured intervention comprises an enhanced biopsychosocial assessment in the ED, collaborative safety planning and three rapid solution focused follow-up sessions.

          Aim

          We addressed the following research questions: What were ED mental health liaison practitioners’ and patients’ experiences of the Assured intervention? What were the barriers and facilitators? What might the mechanisms be for improving experiences and outcomes?

          Methods

          We conducted a feasibility study of the Assured intervention in four EDs in Southeast England. Semi-structured interviews were conducted with 13 practitioners and 27 patients. Interviews were transcribed, coded line-by-line in Nvivo and thematically analysed using an inductive approach. Inter-rater reliability was calculated with a kappa coefficient of 0.744.

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          Most cited references46

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            Suicide, Suicide Attempts, and Suicidal Ideation

            Suicidal behavior is a leading cause of death and disability worldwide. Fortunately, recent developments in suicide theory and research promise to meaningfully advance knowledge and prevention. One key development is the ideation-to-action framework, which stipulates that (a) the development of suicidal ideation and (b) the progression from ideation to suicide attempts are distinct phenomena with distinct explanations and predictors. A second key development is a growing body of research distinguishing factors that predict ideation from those that predict suicide attempts. For example, it is becoming clear that depression, hopelessness, most mental disorders, and even impulsivity predict ideation, but these factors struggle to distinguish those who have attempted suicide from those who have only considered suicide. Means restriction is also emerging as a highly effective way to block progression from ideation to attempt. A third key development is the proliferation of theories of suicide that are positioned within the ideation-to-action framework. These include the interpersonal theory, the integrated motivational-volitional model, and the three-step theory. These perspectives can and should inform the next generation of suicide research and prevention.
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              Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk

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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2364687Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2397639Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2599632Role: Role:
                URI : https://loop.frontiersin.org/people/2563266Role: Role: Role:
                URI : https://loop.frontiersin.org/people/906218Role: Role: Role: Role: Role: Role:
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                26 March 2024
                2024
                : 15
                : 1271674
                Affiliations
                [1] 1 School of Health and Psychological Science, City, University of London , London, United Kingdom
                [2] 2 Population Health Sciences Institute, Newcastle University , Newcastle-Upon-Tyne, United Kingdom
                Author notes

                Edited by: Tilman Steinert, ZfP Südwürttemberg, Germany

                Reviewed by: Carlos Schönfeldt-Lecuona, University of Ulm, Germany

                Johannes Hamann, Technical University of Munich, Germany

                *Correspondence: Neha Shah, neha.shah@ 123456lbbd.gov.uk
                Article
                10.3389/fpsyt.2024.1271674
                11004764
                38600980
                62d47848-8619-4b5c-aa4d-f9853ebd4c53
                Copyright © 2024 Shah, O’Keeffe, Hayward, Suzuki and McCabe

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 02 August 2023
                : 12 February 2024
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 47, Pages: 14, Words: 11386
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Reference number RP-PG-0617- 20004). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
                Categories
                Psychiatry
                Original Research
                Custom metadata
                Public Mental Health

                Clinical Psychology & Psychiatry
                emergency department,liaison psychiatry,self-harm,suicide,qualitative research,solution-focused,psychological intervention

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