The purpose of this phenomenological study was to explore the experience of front-line practitioners working with suicidal children and youth. Five front-line practitioners who had experienced working with children or youth who were suicidal participated in the semi-structured interviews. Transcripts of the interviews were analyzed and summarized under the following three areas of experience: Participants' Descriptions of Working with Suicidal Children and Youth, Knowledge Valued by Participants' to Inform their Practice with Suicidal Children and Youth, and Participants' Physical and Emotional Responses to Suicidal Children and Youth. There were a total of sixteen emergent theme clusters. The themes related to the experience of practice with suicidal children and youth provided a rich context for understanding the nature of meaning of the suicidal behaviors for participants. The emergent themes relating to the knowledge valued by participants to guide their approach provided a specific understanding of the multiple sources of knowledge participants were drawing from in the encounters. The emergent themes relating to the physical and emotional responses participants experienced in relation to their encounters with a suicidal child or youth provided an awareness of the impact the encounters had on participants. The major findings included the participants' broad scope of knowledge they used to guide their approach, as well as that encounters with suicidal children and youth did evoke strong physical and emotional responses amongst participants. The study concludes by describing the implications of these findings for Child and Youth Care practice and for future directions in research.

Syftet med denna studie var att genom en enkät kartlägga socialsekreterares upplevelse av beredskap och förekomst av möten med självmordsnära klienter inom socialtjänsten. I Sverige dör cirka 1100 människor årligen genom suicid och det klassas idag som ett folkhälsoproblem. Enligt forskning, kommer socialsekreterare inom socialtjänsten ofta i kontakt med suicidala klienter men hur dessa möten hanteras har inte studerats i någon större utsträckning. Studiens urval har avgränsats till Stockholm samt tre andra län och enheterna försörjningsstöd och vuxen/beroende valdes ut för närmare granskning. Forskning pekar på olika riskfaktorer för självmord, som exempelvis psykisk ohälsa, socioekonomisk utsatthet eller missbruk, därav valet av dessa enheter. Empirin bearbetades med hjälp av programmet SPSS, genom vilket bi- och univariata analyser utfördes. Resultatet analyserades sedan med hjälp av tidigare forskning, samt med teori om suicidprevention. Ett av studiens huvudresultat var att många socialsekreterare stöter på självmordsnära klienter. En majoritet av dessa socialsekreterare har träffat en eller flera självmordsnära klienter det senaste året. Vidare visade resultatet att de medverkande i viss utsträckning upplever sig beredda i möten med dessa klienter. En femtedel av de medverkande uppgav att de genomgått utbildning i suicidprevention och resultatet visade att sådan utbildning har positiv påverkan på deras upplevelse av beredskap. / The purpose of this study was to map out social workers’ preparedness and the occurrence of encounters with suicidal clients within the social services, through a survey. Nearly 1100 people in Sweden dies because of suicide every year and suicide is classified as a public health problem. According to research social workers often encounter suicidal clients, but how these encounters are handled have not been studied in any greater degree. The study’s selection was defined to Stockholm and three other counties. The units within the social services that were chosen for further examination were income support and adult/addiction. Research revolving suicide indicate that socioeconomic vulnerability, addiction and mental illness are risk factors connected to suicide, hence the choice of these units. The collected data material was processed by means of SPSS, through which univariate and bivariate analyses have been executed. The results were interpreted by means of earlier scientific findings, as well as theories concerning suicide prevention. One of the main findings that could be extracted from this study was that many social workers encounter suicidal clients. Most of the social workers have met one or several suicidal clients during the past year. The results also implies that the participants believe that they have preparedness to some extent in encounters with these clients. One fifth of the participants state that they have passed training in suicide prevention and the results show that training of such has a positive impact on their experience of preparedness.

Cette recherche s’intéresse à la façon singulière dont l’adolescent ou le jeune adulte suicidant se représente ses liens familiaux et extra-familiaux. Elle explore la façon dont ces jeunes s’inscrivent dans leur histoire familiale, se repèrent dans leur généalogie, mais aussi la façon dont ils construisent, dans le monde qui les entoure, leur réseau d’appartenance. Comprenant l’accès aux transmissions familiales et la possibilité de tisser un réseau de lien extra-familiaux, comme un élément capital de la construction identitaire, ce travail envisage l’hypothèse selon laquelle l’acte suicidaire de l’adolescent traduirait une revendication de l’unicité et de l’authenticité de son existence. L’intention de se faire exister serait plus prégnante que l’intention de se donner la mort. De telles conduites, à valeur ordalique, témoigneraient d’un affrontement avec le monde, dont l’enjeu serait de vivre plus. Elles amèneraient l’adolescent à s’imposer, inconsciemment, de frôler la mort pour se transformer, renaître, revivre après le traumatisme, pour enfin exister. A l’aide d’entretiens cliniques et d’outils d’évaluation systémique comprenant la réalisation de génogrammes libres et imaginaires, seize études de cas ont été réalisées. Ces données ont permis d’effectuer une analyse qualitative individuelle et groupale et, plus particulièrement une exploration familiale tri-générationnelle. Sans confirmer la valeur ordalique de la conduite suicidaire, nos résultas suggèrent que les jeunes rencontrés tentent de se faire exister en cherchant une enveloppe généalogique mais aussi affiliative, contenante au sein de laquelle ils se sentent inscrits et reconnus. Le sentiment d'appartenance qui permet la différenciation et qui donne sens à l’existence fait défaut chez tous. Ces résultats ouvrent une piste de réflexion sur la signification du geste suicidaire à l’adolescence: il s’agit d’une quête de sens, mais aussi de reconnaissance, qui passe par l’épreuve personnelle et le fait d’y survivre. <p> / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

(1) Background. Defeat and entrapment have been highlighted as major risk factors of suicidal ideation and behavior. Nevertheless, little is known about their short-term variability and their longitudinal association in real-time. Therefore, this study aims to investigate whether defeat and entrapment change over time and whether defeat predicts entrapment as stated by the integrated motivational–volitional model of suicidal behavior. (2) Methods. Healthy participants (n = 61) underwent a 7-day smartphone-based ecological momentary assessment (EMA) on suicidal ideation/behavior and relevant risk factors, including defeat and entrapment and a comprehensive baseline (T0) and post (T2) assessment. (3) Results. Mean squared successive differences (MSSD) and intraclass correlations (ICC) support the temporal instability as well as within-person variability of defeat and entrapment. Multilevel analyses revealed that during EMA, defeat was positively associated with entrapment at the same measurement. However, defeat could not predict entrapment to the next measurement (approximately two hours later). (4) Conclusion. This study provides evidence on the short-term variability of defeat and entrapment highlighting that repeated measurement of defeat and entrapment—preferably in real time—is necessary in order to adequately capture the actual empirical relations of these variables and not to overlook significant within-person variability. Further research—especially within clinical samples—seems warranted.

SAMMANFATTNING  Bakgrund: Patienter med suicidalt beteende uttrycker att avsaknad av en god vårdrelation kan öka risken för suicidalt beteende. Sjuksköterskor beskriver det som komplext och utmanande att vårda och bemöta patientgruppen och upplever en avsaknad av kunskap. Inom intensivvården riskerar psykosociala behov att nedprioriteras då medicinska behov ofta har ett större fokus.  Syfte: Syftet var att beskriva hur specialistsjuksköterskor inom intensivvård bemöter patienter med ett suicidalt beteende samt hur de tillgodoser deras psykosociala behov.  Metod: Åtta semistrukturerade intervjuer hölls med specialistsjuksköterskor inom intensivvård. Intervjustudien hade en induktiv ansats och analyserades med kvalitativ innehållsanalys.  Resultat: Resultatet visar att specialistsjuksköterskan eftersträvade ett respektfullt, ickedömande och lugnt bemötande till patienter med suicidalt beteende. Kommunikation, delaktighet och förtroende beskrevs som viktiga aspekter för att skapa en god relation med patienten. Psykosociala behov tillgodosågs bland annat genom kommunikation, närvaro och tillgodoseende av fysiska behov. I resultatet framkommer även faktorer, som tidsbrist och synen på rollen, som påverkade bemötandet och hur psykosociala behov tillgodosågs.  Slutsats: Trots en strävan om ett bemötande som skapade en god vårdrelation och en positiv inställning till att tillgodose psykosociala behov förekommer faktorer som påverkar omvårdnaden av patienter med suicidalt beteende negativt. Att uppnå personcentrerad vård av patienter med suicidalt beteende inom intensivvården är idag en utmaning och att uppmärksamma detta är avgörande för att förbättra vården av patientgruppen. Studiens resultat kan ge ledare och personal inom intensivvård insikt i hur omvårdnaden bedrivs för denna sårbara patientgrupp med omfattande psykosociala behov. / ABSTRACT  Background: Patients with suicidal behavior express that the absence of a good caring relationship can increase the risk of suicidal behavior. Nurses describe it as complex to care and interact with the patient group and experience a lack of knowledge. In intensive care, psychosocial needs risk being deprioritized as medical needs often have a greater focus.  Aim: The aim was to describe how nurse specialists in intensive care interact with patients with suicidal behavior and how they meet their psychosocial needs.  Method: Eight semi-structured interviews with nurse specialists in intensive care were conducted. The interview study had an inductive approach and was analyzed with qualitative content analysis.  Results: The results show that nurse specialists strived for a respectful, non-judgmental and calm interaction with patients with suicidal behavior. Communication, participation and trust were important aspects to create a good relationship with the patient. Psychosocial needs were met by communication, being present and meeting physical needs. In the results, factors appeared such as time constraints and the perception of the role, that affected the interaction and how psychosocial needs were met.  Conclusion: Despite ambitions of interactions that create a good caring relationship and a positive attitude to meeting psychosocial needs, factors appeared that affect the care of patients with suicidal behavior negatively. Achieving person-centered care of patients with suicidal behavior in intensive care is challenging and this observation is crucial to improve care. The study can offer leaders and personnel in intensive care insights in how care is conducted for this vulnerable patient group with vast psychosocial needs.

В статье анализируется необходимость формирования осознанного отношения у молодежи к смерти. Было выяснено, что сегодня молодёжь живёт в благополучной среде и в основном довольна жизнью, но есть факторы, провоцирующие рост риска суицидального поведения. Результатом представляется проект «Развитие осознанного отношения к смерти у молодёжи». / The article analyzes the necessity of forming an informed attitude to death among young people. It was found out that today young people live in a prosperous environment and are mostly satisfied with life, but there are factors provoking the growth of risk of suicidal behavior. The result is the project "Development of conscious attitude to death in youth".

MPH / Department of Public Health / Over the past years, suicide and suicidal ideation are being increasingly recognised as important issues for public health policy, especially, among police officers. Suicidal ideation is one of the tragic issues among police officers, causing serious emotional, spiritual, medical, social and psychological distress for the individual, their families and friends, however, not much is known about it in the Vhembe District. The purpose of the study was to explore the factors contributing to suicidal ideation among police officers in Vhembe District. The study was conducted in the Thohoyandou cluster, which is situated in Limpopo Province, South Africa. A study had a qualitative phenomenological research design. The data saturation were reached at the number of 12 police officers, the target population were selected by means of convenience sampling and data was collected through a semi-structured interview. The data collected was analysed using the thematic analytical approach and conclusion were made based on the findings of the study. The study findings show the following as the factors contributing to suicidal ideation among the police officers - domestic violence, financial problems, divorce, extramarital affairs, lack of social support, health problems, contradicting the law and organisational factors that include organisational structure and working with guns. The study recommended that the South African Police Services should continue to provide support and counselling to police officers after they have attended to traumatic cases and that police officers need to be more open about their problems and avoid attempting to deal with them by themselves. / NRF

The purpose of this study is to provide descriptions of conversations with survivors of suicide, including their relationships with the persons who committed suicide, the relationships that followed these deaths, their experiences of suicide, and the way that they made sense of these deaths. The epistemological framework of this dissertation is ecosystemic and social constructionist. This study involved in-depth interviews with three suicide survivors, exploring personal and professional domains. Thematic analysis was the method used to generate patterns of meaning. The researcher recounted the research participants' stories and punctuated emergent themes and patterns according to what she deemed important. Each story was contextualised, and included reflections of the researcher. Themes both common and unique to each participant story were highlighted and discussed. The information yielded from this study could have value to survivors of suicide and psychotherapists whose clients commit suicide. / Psychology / M.A. (Clinical Psychology)

In this dissertation the literature on suicidal behaviour is reviewed, with particular emphasis on professional conceptualizations and understanding as informed by the psychiatric and sociological paradigms. Basic postulates of the Ecosystemic paradigm, as it is informed by Maturana's second-order cybernetic approach was discussed. The effect of such an approach on therapy with suicidal individuals was pointed out. It became clear that perceived methodological problems experienced when researching suicidal behaviour from a Newtonian/realist paradigm can be side-stepped when viewed from an Ecosystemic paradigm. It was finally proposed that an ethic of participation, as informed by a second-order cybernetic approach, be adopted when viewing the suicide situation. In the process ethics was reconceptualized as an awareness of the therapist's participation in whatever is created, and not in finding the ''right" way when working with suicidal individuals. / Psychology / M.A. (Clinical Psychology)

Plus de la moitié des adolescents suicidaires dont une large proportion présente un trouble de personnalité limite (TPL) abandonnent leur traitement. Les conséquences de leur défection sont préoccupantes considérant la récurrence de leurs conduites suicidaires et le fait que cette pathologie augmente le risque d’une évolution défavorable à l’âge adulte. À partir d’une méthode de théorisation ancrée constructiviste, cette étude visait à comprendre les processus associés à l’instabilité du mode de consultation des adolescents avec TPL. Elle a permis de spécifier les vulnérabilités à l’abandon des adolescents avec TPL et celles de leurs parents et mis au jour que l’atténuation des problèmes d’accessibilité, la préparation au traitement, l’adaptation des soins aux particularités du TPL et finalement la prise en compte de la disposition à traiter des soignants constituent des réponses déterminantes pour leur engagement. Les processus de désengagement ont également été spécifiés. Des perceptions négatives à l’égard du traitement, du soignant ou du fait d’être en traitement génèrent une activation émotionnelle. Celle-ci induit ensuite des attitudes contre-productives qui évoluent vers des comportements francs de désengagement. Dans ce contexte, des réponses du dispositif de soins telles une régulation insuffisante de l’engagement, des impairs thérapeutiques et des demandes paradoxales précipitent l’abandon de traitement. Finalement, les processus impliqués dans l’abandon de traitement ont été formalisés dans le Modèle de l’engagement et de l’abandon de traitement des adolescents avec TPL. Celui-ci illustre que des processus distincts caractériseraient les abandons précoces et les abandons tardifs des adolescents avec TPL. L’abandon précoce résulterait de l’échec du dispositif de soins à profiter de l’impulsion de la demande d’aide pour engager l’adolescent et le parent lors de ce premier moment critique de sa trajectoire de soins. En contrepartie, les abandons tardifs traduiraient les défaillances du dispositif de soins à adopter des mesures correctives pour les maintenir en traitement lors d’un deuxième moment critique marqué par leur désengagement. Les taux d’abandon de traitement de ces jeunes pourraient être diminués par un dispositif de soins qui reconnaît les périls inhérents au traitement de cette clientèle, se montre proactif pour résoudre les problèmes de désengagement, intègre des mécanismes de soutien aux soignants et favorise une pratique réflexive. / More than half of suicidal adolescents, a large proportion of which manifest borderline personality disorder (BPD), drop out from treatment. The consequences of their premature termination are cause for concern, given the recurrence of their suicidal attempts and that they present elevated risk for major mental disorders during adulthood. The current study sought to gain a broader appreciation of processes involved in treatment dropout among adolescents with BPD through a constructivist grounded theory. Various dropout vulnerabilities specific to adolescents with BPD and their parents, including psychological characteristics, help-seeking context and perception of mental illness and mental healthcare were identified. Care-setting response including management of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and consideration for the health professional's disposition to treat were also found to be determinant to their engagement to treatment. The processes of disengagement from treatment have also been specified. Negative perceptions regarding treatment, clinicians, and receiving treatment have been shown to generate emotional activation. The aforementioned lead to counter-productive attitudes that evolve into outright disengagement behaviours. In this context, responses from the care-setting, such as an insufficient regulation of the engagement, therapeutic faux pas and paradoxical demands, precipitate premature treatment termination. Finally, the processes involved in the abandonment of treatment were formalized in the Model of engagement and treatment dropout for Adolescent with BPD. This illustrates that distinct processes characterise the premature and late dropouts of adolescents with BPD. The early terminations result from the failure of the care-setting to take advantage of the impetus at help seeking to engage the adolescent and the parent at that first critical moment in the care trajectory. On the other hand, the late dropouts translate failures of the care-setting to adopt corrective measures to maintain the patient in treatment at a second critical moment indicated by their disengagement. The termination rate of those adolescent treatments could be diminished by a system of care-setting that recognizes the inherent difficulties related to the treatment of those specific patients, is proactive to solve problems of disengagement, integrates support systems for clinicians and promotes a reflexive practice.