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A description of a psychosocial/psychoeducational intervention for persons with recurrent suicide attempts.

https://arctichealth.org/en/permalink/ahliterature186407
Source
Crisis. 2002;23(4):156-60
Publication Type
Article
Date
2002
Author
Yvonne Bergmans
Paul S Links
Author Affiliation
St. Michael's Hospital-University of Toronto, Toronto, Ontario, Canada. bergmansy@smh.toronto.on.ca
Source
Crisis. 2002;23(4):156-60
Date
2002
Language
English
Publication Type
Article
Keywords
Adult
Canada
Emotions
Female
Humans
Interpersonal Relations
Male
Patient Education as Topic
Poverty
Psychotherapy - methods
Psychotherapy, Group - methods
Recurrence
Suicide, Attempted - prevention & control - psychology
Vulnerable Populations
Abstract
This paper gives a description of a psychosocial/psychoeducational group intervention for individuals with a history of recurrent suicide attempts. The intervention was conceived to reduce the risk of future suicidal behavior and to modify the client's psychopathology. Three features are felt to make the intervention unique from others described in the literature. First, the intervention is targeted at both men and women from an inner-city population who are often underhoused, underemployed, and undereducated. 24 of 48 clients (50%) lived alone, and 24 of those (92%) were living in subsidized housing; 33% lived in supportive housing, and one lived on the street at the time of assessment. 48% had a high-school education or less. Second, the principles of our approach stressed client validation and participation in the development and delivery of the therapy. Our frame of reference was to name ourselves as professionals with a set of skills and access to some kinds of information and clients as the experts on the experience in their lives. Third, the group content incorporated a multimodal approach to meet the varied needs of the clients. Future reports will discuss the empirical evaluation of this intervention; however, the development of specific, targeted approaches for unique individuals with recurrent suicide attempts is clearly needed.
PubMed ID
12617479 View in PubMed
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Experiences of substance-using suicidal males who present frequently to the emergency department.

https://arctichealth.org/en/permalink/ahliterature155974
Source
CJEM. 2008 Jul;10(4):339-46
Publication Type
Article
Date
Jul-2008
Author
Julia M Spence
Yvonne Bergmans
Carol Strike
Paul S Links
Jeffrey S Ball
Anne E Rhodes
William J Watson
Rahel Eynan
Claire Rufo
Author Affiliation
Emergency Department, St. Michael's Hospital, University of Toronto, Toronto, Ontario. spencej@smh.toronto.on.ca
Source
CJEM. 2008 Jul;10(4):339-46
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Adult
Algorithms
Crisis Intervention
Emergency Service, Hospital
Humans
Male
Needs Assessment
Ontario
Recurrence
Self-Injurious Behavior - therapy
Substance-Related Disorders - psychology
Suicide - prevention & control
Abstract
This qualitative study investigated the repeated use of the emergency department (ED) by men with a history of suicidal behaviour and substance abuse to understand the needs and barriers to care for this high-risk group. Identification of common themes from interviews with patients and health care workers can serve as a basis for improved ED-based interventions.
Using semistructured interviews, patients, ED staff and family physicians were asked about needs of the aformentioned group. Twenty-five patients were interviewed and completed questionnaires regarding their substance use, aggression, parasuicidal behaviour, alexithymia and childhood trauma. In addition, 27 staff members were interviewed. Interviews were tape-recorded, transcribed and qualitatively analyzed using an iterative coding process.
Of the 25 patients, 23 (96%) had a mood or anxiety disorder and 18 (75%) had borderline personality disorder. One-half of the patients scored high and another quarter scored moderate on alexithymia testing. The ED was viewed as a last resort despite seeking help. Frustration was felt by both patients and staff regarding difficult communication, especially during an acute crisis.
The ED plays an important role in the provision of care for men with recurrent suicidal behaviour and substance abuse. Some of the diagnoses and problems faced by these patients are beyond the purview of the ED; however, staff can identify mutual goals for crisis interventions, allow for frequent communication and seek to de-escalate situations through the validation of the stress patients are experiencing.
PubMed ID
18652726 View in PubMed
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Fragmented pathways to care: the experiences of suicidal men.

https://arctichealth.org/en/permalink/ahliterature169557
Source
Crisis. 2006;27(1):31-8
Publication Type
Article
Date
2006
Author
Carol Strike
Anne E Rhodes
Yvonne Bergmans
Paul Links
Author Affiliation
Centre for Addiction and Mental Health, University of Toronto, ON, Canada. carol_strike@camh.net
Source
Crisis. 2006;27(1):31-8
Date
2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada
Humans
Male
Mental Disorders - psychology - therapy
Mental Health Services - standards - utilization
Physician-Patient Relations
Suicide, Attempted - psychology
Abstract
Using qualitative methods, this study examined how, and under what circumstances, suicidal men used mental health services. In particular, the analyses focused on fragmented pathways to care. Fifteen men with a history of suicidal and aggressive behaviors and a diagnosis of borderline personality disorder and/or antisocial personality disorder participated in semistructured interviews that consisted of questions about their mental health status and experiences with mental health and addiction services. Interviews were taped and transcribed. An iterative, inductive qualitative analytic process was used. Men followed a cyclical pattern wherein negative experiences with health care providers were said to be followed by avoidance of health care settings, crisis, and then by involuntary service utilization. Men identified five health care provider and three personal practices, and two types of episodes they believed to contribute to their fragmented pathways to care. Implementation of specialized interventions, and providing patients with more information and more opportunity to participate in decisions, may improve interactions between patients and providers and improve patients' mental health status.
PubMed ID
16642913 View in PubMed
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Moving from full-time healing work to paid employment: challenges and celebrations.

https://arctichealth.org/en/permalink/ahliterature147295
Source
Work. 2009;33(4):389-94
Publication Type
Article
Date
2009
Author
Yvonne Bergmans
Anne Carruthers
Elizabeth Ewanchuk
Judy James
Kate Wren
Christina Yager
Author Affiliation
Suicide Studies Unit, Toronto, Ontario M5B 1W8, Canada. bergmansy@smh.toronto.on.ca
Source
Work. 2009;33(4):389-94
Date
2009
Language
English
Publication Type
Article
Keywords
Employment
Female
Humans
Interviews as Topic
Mental Disorders - rehabilitation
Ontario
Social Adjustment
Stereotyping
Suicide, Attempted
Abstract
The experiences and barriers associated with the return to paid employment following healing from recurrent suicide attempts related to mental illness have not been addressed in the literature to date.
This paper is a collaborative case study between graduates (experts by experience) and facilitators of a psychosocial/psychoeducational group for people with recurrent suicide attempts. The journeys taken by the experts by experience are explored through thematic narrative analysis.
Issues of stigma, disclosure, accommodations, maintaining wellness and coming to re-define a sense of self were consistent themes found throughout all narratives.
The paper identified key areas of challenge and celebration, suggesting the need for enhanced support from health care providers, workplace managers, supervisors and colleagues for successful transitions into the workplace.
PubMed ID
19923661 View in PubMed
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