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Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19... / JAMES KNOWLES

Swansea University Author: JAMES KNOWLES

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DOI (Published version): 10.23889/SUthesis.63616

Abstract

Part 1: Early identification of individuals at risk of suicide represents a crucial component of effective suicide prevention. However, many of the current suicide risk assessment procedures are limited in their ability to identify and prevent future suicide attempts. This thesis aimed to investigat...

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Published: Swansea, Wales, UK 2023
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Gray, Nicola., John, Ann. and Snowden, Robert.
URI: https://cronfa.swan.ac.uk/Record/cronfa63616
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first_indexed 2023-06-09T10:54:29Z
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However, many of the current suicide risk assessment procedures are limited in their ability to identify and prevent future suicide attempts. This thesis aimed to investigate whether the structured professional judgement approach was an effective method of suicide risk assessment within an accident and emergency department. Chapter 1 outlined the major challenges facing the field of suicide risk assessment and introduced the structured professional judgement approach to risk assessment. Chapter 2 reviewed the various methods used to assess the risk of suicide within accident and emergency services, evaluated the efficacy of the structured professional judgement approach and outlined the new structured professional judgement scheme, the Risk of Suicide Protocol, that was investigated in this thesis. Chapter 3 compared the Risk of Suicide Protocol and assessment as usual in their ability to identify future suicide attempts in 107 participants referred for a suicide risk assessment with the accident and emergency-based Psychiatric Liaison Team. Chapter 3 also evaluated the inter-rater reliability of the Risk of Suicide Protocol, with two independent assessors completing assessments on the same 12 patients. Chapter 7 reviewed the research relating to the RoSP and discussed the wider meaning and clinical implications of the findings. The findings demonstrated that risk judgements made using the Risk of Suicide Protocol were significantly better at identifying future suicide attempts compared to assessment as usual. Additionally, the risk judgements made using the Risk of Suicide Protocol demonstrated excellent inter-rater reliability. These results indicate that the Risk of Suicide Protocol is a valid and reliable assessment for the structured clinical evaluation of suicide risk within an accident and emergency department. Overall, this thesis demonstrates that the Risk of Suicide Protocol represents a valuable method for the evaluation of suicide risk and may offer an important solution to some of the challenges facing the field of suicide risk assessment. Part 2: The COVID-19 pandemic resulted in a wide range of difficulties for populations across the world, with research indicating that the pandemic had negatively impacted population mental health. This thesis aimed to identify and understand the factors influencing suicidal thoughts and attempts during the COVID-19 pandemic. Chapters 1 and 4 reviewed how the COVID-19 pandemic affected population mental health and suicidality and explored the rationale for this research. Chapters 5 and 6 reported the results of an online survey administered to a large sample of adults (N &gt; 13,000) living in Wales between the 18th of January 2021 to the 7th of March 2021. Chapter 5 aimed firstly, to identify the demographic groups most vulnerable to suicidal thoughts and attempts and secondly, to examine whether various pandemic related stressors (e.g., social isolation, food insecurity) were associated with suicidal thoughts and attempts. Chapter 6 investigated whether hope, social connectedness, resilience or pandemic acceptance could protect against the presence of suicidal thoughts during the COVID-19 pandemic. Chapter 7 reviewed the research and considered the wider implications of the findings. The findings from chapter 5 revealed that men, younger adults and socioeconomically deprived individuals were more likely to experience suicidal thoughts during the pandemic, with younger adults also more likely to attempt suicide. Chapter 5 also found that domestic abuse, food insecurity, difficulty accessing healthcare, social isolation, relationship problems, financial problems and being made redundant were the pandemic related stressors most strongly related to suicidal thoughts and attempts. Chapter 6 found that hope, resilience and pandemic acceptance all protected against suicidal thoughts during the pandemic, with higher levels of hope, resilience and pandemic acceptance weakening the relationship between pandemic stress and suicidal thoughts. Overall, this thesis has enhanced our understanding of the factors influencing suicidal thoughts and attempts during the COVID-19 pandemic. 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spelling v2 63616 2023-06-09 Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic. 84ea1e3de3ce0de43d1e6cc3387ecafc JAMES KNOWLES JAMES KNOWLES true false 2023-06-09 Part 1: Early identification of individuals at risk of suicide represents a crucial component of effective suicide prevention. However, many of the current suicide risk assessment procedures are limited in their ability to identify and prevent future suicide attempts. This thesis aimed to investigate whether the structured professional judgement approach was an effective method of suicide risk assessment within an accident and emergency department. Chapter 1 outlined the major challenges facing the field of suicide risk assessment and introduced the structured professional judgement approach to risk assessment. Chapter 2 reviewed the various methods used to assess the risk of suicide within accident and emergency services, evaluated the efficacy of the structured professional judgement approach and outlined the new structured professional judgement scheme, the Risk of Suicide Protocol, that was investigated in this thesis. Chapter 3 compared the Risk of Suicide Protocol and assessment as usual in their ability to identify future suicide attempts in 107 participants referred for a suicide risk assessment with the accident and emergency-based Psychiatric Liaison Team. Chapter 3 also evaluated the inter-rater reliability of the Risk of Suicide Protocol, with two independent assessors completing assessments on the same 12 patients. Chapter 7 reviewed the research relating to the RoSP and discussed the wider meaning and clinical implications of the findings. The findings demonstrated that risk judgements made using the Risk of Suicide Protocol were significantly better at identifying future suicide attempts compared to assessment as usual. Additionally, the risk judgements made using the Risk of Suicide Protocol demonstrated excellent inter-rater reliability. These results indicate that the Risk of Suicide Protocol is a valid and reliable assessment for the structured clinical evaluation of suicide risk within an accident and emergency department. Overall, this thesis demonstrates that the Risk of Suicide Protocol represents a valuable method for the evaluation of suicide risk and may offer an important solution to some of the challenges facing the field of suicide risk assessment. Part 2: The COVID-19 pandemic resulted in a wide range of difficulties for populations across the world, with research indicating that the pandemic had negatively impacted population mental health. This thesis aimed to identify and understand the factors influencing suicidal thoughts and attempts during the COVID-19 pandemic. Chapters 1 and 4 reviewed how the COVID-19 pandemic affected population mental health and suicidality and explored the rationale for this research. Chapters 5 and 6 reported the results of an online survey administered to a large sample of adults (N > 13,000) living in Wales between the 18th of January 2021 to the 7th of March 2021. Chapter 5 aimed firstly, to identify the demographic groups most vulnerable to suicidal thoughts and attempts and secondly, to examine whether various pandemic related stressors (e.g., social isolation, food insecurity) were associated with suicidal thoughts and attempts. Chapter 6 investigated whether hope, social connectedness, resilience or pandemic acceptance could protect against the presence of suicidal thoughts during the COVID-19 pandemic. Chapter 7 reviewed the research and considered the wider implications of the findings. The findings from chapter 5 revealed that men, younger adults and socioeconomically deprived individuals were more likely to experience suicidal thoughts during the pandemic, with younger adults also more likely to attempt suicide. Chapter 5 also found that domestic abuse, food insecurity, difficulty accessing healthcare, social isolation, relationship problems, financial problems and being made redundant were the pandemic related stressors most strongly related to suicidal thoughts and attempts. Chapter 6 found that hope, resilience and pandemic acceptance all protected against suicidal thoughts during the pandemic, with higher levels of hope, resilience and pandemic acceptance weakening the relationship between pandemic stress and suicidal thoughts. Overall, this thesis has enhanced our understanding of the factors influencing suicidal thoughts and attempts during the COVID-19 pandemic. The findings provide valuable insights that can be used to inform outreach and support structures in their efforts to prevent suicide. E-Thesis Swansea, Wales, UK Suicide, prevention, risk assessment, COVID-19, protective factors, risk factors 18 5 2023 2023-05-18 10.23889/SUthesis.63616 COLLEGE NANME COLLEGE CODE Swansea University Gray, Nicola., John, Ann. and Snowden, Robert. Doctoral Ph.D ESRC doctoral training grant and Swansea University 2023-09-29T10:32:29.6177053 2023-06-09T11:50:53.2975427 Faculty of Medicine, Health and Life Sciences School of Psychology JAMES KNOWLES 1 63616__27780__d5eeda28f6df4c80b7fd0a45fcae0b2f.pdf 2023_Knowles_JRP.final.63616.pdf 2023-06-09T12:07:33.2825621 Output 2299751 application/pdf E-Thesis – open access true Copyright: The Author, James R. P. Knowles, 2023. true eng
title Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
spellingShingle Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
JAMES KNOWLES
title_short Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
title_full Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
title_fullStr Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
title_full_unstemmed Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
title_sort Part 1: Supporting the Reduction of Suicide in the General Population of Wales via the use of Structured Professional Judgement; Part 2: Identifying the Factors Moderating Suicidal Thoughts and Suicide Attempts During the COVID-19 Pandemic.
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description Part 1: Early identification of individuals at risk of suicide represents a crucial component of effective suicide prevention. However, many of the current suicide risk assessment procedures are limited in their ability to identify and prevent future suicide attempts. This thesis aimed to investigate whether the structured professional judgement approach was an effective method of suicide risk assessment within an accident and emergency department. Chapter 1 outlined the major challenges facing the field of suicide risk assessment and introduced the structured professional judgement approach to risk assessment. Chapter 2 reviewed the various methods used to assess the risk of suicide within accident and emergency services, evaluated the efficacy of the structured professional judgement approach and outlined the new structured professional judgement scheme, the Risk of Suicide Protocol, that was investigated in this thesis. Chapter 3 compared the Risk of Suicide Protocol and assessment as usual in their ability to identify future suicide attempts in 107 participants referred for a suicide risk assessment with the accident and emergency-based Psychiatric Liaison Team. Chapter 3 also evaluated the inter-rater reliability of the Risk of Suicide Protocol, with two independent assessors completing assessments on the same 12 patients. Chapter 7 reviewed the research relating to the RoSP and discussed the wider meaning and clinical implications of the findings. The findings demonstrated that risk judgements made using the Risk of Suicide Protocol were significantly better at identifying future suicide attempts compared to assessment as usual. Additionally, the risk judgements made using the Risk of Suicide Protocol demonstrated excellent inter-rater reliability. These results indicate that the Risk of Suicide Protocol is a valid and reliable assessment for the structured clinical evaluation of suicide risk within an accident and emergency department. Overall, this thesis demonstrates that the Risk of Suicide Protocol represents a valuable method for the evaluation of suicide risk and may offer an important solution to some of the challenges facing the field of suicide risk assessment. Part 2: The COVID-19 pandemic resulted in a wide range of difficulties for populations across the world, with research indicating that the pandemic had negatively impacted population mental health. This thesis aimed to identify and understand the factors influencing suicidal thoughts and attempts during the COVID-19 pandemic. Chapters 1 and 4 reviewed how the COVID-19 pandemic affected population mental health and suicidality and explored the rationale for this research. Chapters 5 and 6 reported the results of an online survey administered to a large sample of adults (N > 13,000) living in Wales between the 18th of January 2021 to the 7th of March 2021. Chapter 5 aimed firstly, to identify the demographic groups most vulnerable to suicidal thoughts and attempts and secondly, to examine whether various pandemic related stressors (e.g., social isolation, food insecurity) were associated with suicidal thoughts and attempts. Chapter 6 investigated whether hope, social connectedness, resilience or pandemic acceptance could protect against the presence of suicidal thoughts during the COVID-19 pandemic. Chapter 7 reviewed the research and considered the wider implications of the findings. The findings from chapter 5 revealed that men, younger adults and socioeconomically deprived individuals were more likely to experience suicidal thoughts during the pandemic, with younger adults also more likely to attempt suicide. Chapter 5 also found that domestic abuse, food insecurity, difficulty accessing healthcare, social isolation, relationship problems, financial problems and being made redundant were the pandemic related stressors most strongly related to suicidal thoughts and attempts. Chapter 6 found that hope, resilience and pandemic acceptance all protected against suicidal thoughts during the pandemic, with higher levels of hope, resilience and pandemic acceptance weakening the relationship between pandemic stress and suicidal thoughts. Overall, this thesis has enhanced our understanding of the factors influencing suicidal thoughts and attempts during the COVID-19 pandemic. The findings provide valuable insights that can be used to inform outreach and support structures in their efforts to prevent suicide.
published_date 2023-05-18T10:32:30Z
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