Firearm Safe Storage in Rural Families: Community Perspectives About Ownership and Safety Messaging.

Firearm-related injuries are the leading cause of death among youth in the United States, and rates of firearm-related suicide in rural youth are more than double those in urban youth. Although safe firearm storage has been shown to reduce firearm injuries, little is known about how to culturally tailor such interventions for rural families in the United States. Informed by community-based participatory methods, focus groups and key informant interviews were conducted to design a safe storage prevention strategy for rural families. Participants included a broad array of community stakeholders (n = 40; 60% male, 40% female; age 15-72, M = 36.9, SD = 18.9) who were asked to identify acceptable messengers, message content, and delivery mechanisms that were perceived as respectful to the strengths of rural culture. Independent coders analyzed qualitative data using an open coding technique. Emerging themes included (1) community norms, values, and beliefs about firearms; (2) reasons for ownership; (3) firearm safety; (4) storage practices; (5) barriers to safe storage; and (6) suggested intervention components. Firearms were described as a "way of life" and family tradition in rural areas. Owning firearms for hunting and protection influenced family storage decisions. Intervention strategies that use respected firearm experts as messengers, refer to locally derived data, and that reflect community pride in firearm safety and responsible ownership may improve the acceptability of prevention messages in rural areas.

Worsening Symptoms of Anxiety, Depression, and Sleep Problems in Caregivers Following Youth's Suicide-Related Emergency Department Visit.

OBJECTIVE: Although families assume considerable responsibility in caring for their child after a suicidal crisis, little is known about caregiver well-being following a suicide-related pediatric Emergency Department (ED) visit. This study aimed to (1) describe the course of caregiver distress symptoms (e.g., anxiety, depression, and negative affect) and sleep problems following their child's suicide-related ED visit and to (2) identify factors (e.g., parents' mental health history, youth suicide risk chronicity, and perception of feeling supported by the mental health system) hypothesized to be related to caregiver distress symptoms and sleep problems at follow-up using a diathesis-stress model framework. METHOD: Participants included 118 caregiver/youth (ages 11-17) dyads presenting to a psychiatric ED due to youths' suicide-related concerns. Caregivers and youth were assessed during index ED visit and 2-weeks following discharge. RESULTS: Caregivers' anxiety and depressive symptoms and sleep problems increased significantly from the time of the ED visit to 2-week follow-up. There was no significant change in caregiver negative affect. Caregivers with their own history of mental illness and those whose children had a previous ED visit due to a psychiatric concern, suggestive of chronic suicide risk, reported higher anxiety and depressive symptoms at follow-up. CONCLUSION: In the 2 weeks following an ED visit for their child's suicidal crisis, caregivers reported significant increases in anxiety and depressive symptoms and sleep problems. Findings highlight the need to consider the mental health of caregivers whose children are at elevated risk for suicide.HighlightsCaregivers report increases in distress symptoms following youth's suicidal crisis.Caregiver mental health history and youth suicide chronicity impacted distress.Caregiver mental health should be considered when planning youth interventions.

A qualitative study of supporters of adults following a suicide-related psychiatric emergency.

INTRODUCTION: Family, friends, and romantic partners (i.e., supporters) play a key role in the implementation of safety and support measures for loved ones with elevated risk for suicide; yet despite the link between interpersonal factors and suicide risk, few supporter-focused interventions exist. METHOD: This qualitative study to inform intervention development was conducted from September 2021 to March 2022 and explored (a) the feasibility and acceptability of a single-session phone call to a support person (n = 30, 67% female, 88% White non-Hispanic, Mage = 40.3 [SD = 17.1]) nominated during an emergency department (ED) visit for suicide risk and (b) the needs of supporters during and after a loved one's suicide crisis. RESULTS: Of the 30 supporters nominated, 27 were eligible to participate and were contacted. Eighteen completed an interview (66%). Seven core themes with 26 subthemes were identified characterizing the supporter's experience prior to, during, and following their loved one's suicide crisis. We found moderate acceptability and feasibility of a single-session supportive phone call to a support person following an ED visit for suicide risk. DISCUSSION: Supporters reported a period of stress prior to and during the ED visit as well as adaptive coping with continued barriers and challenges. Brief interventions aimed at improving communication between the supporter, patient, and their care team; defining roles; and enhancing practical and emotional support are likely to be acceptable and feasible. Further study is needed to determine whether brief interventions to improve supporter self-efficacy can benefit both supporter and patient. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Predictors of suicide coping self-efficacy among youth presenting to a psychiatric emergency department.

INTRODUCTION: Low levels of youth-reported self-efficacy to cope with suicidal urges have been shown to prospectively predict repeat emergency department (ED) visits and suicide attempts, yet little is known about how self-efficacy may change following receipt of crisis services or about factors that may strengthen self-efficacy. Protective factors (e.g., parent-reported youth competence, parent-family connectedness, and receipt of mental health services) were examined in relation to self-efficacy at the time of a psychiatric ED visit and 2 weeks later. METHODS: Participants were 205 youth (ages 10-17), presenting to a psychiatric ED due to a suicide-related concern. Youth primarily identified as biological female (63%) and White (87%). Multivariate hierarchical linear regressions were used to examine candidate protective factors in relation to initial and follow-up suicide coping self-efficacy. RESULTS: Self-efficacy significantly improved in the 2 weeks following the ED visit. Parent-family connectedness was positively related to suicide coping self-efficacy at the time of the ED visit. Parent-family connectedness and receipt of inpatient psychiatric care following the ED visit were associated with higher follow-up suicide coping self-efficacy. CONCLUSIONS: During the adolescent developmental period when suicidal thoughts and behaviors notably increase, study findings highlight potential malleable intervention targets, including parent-family connectedness, that may strengthen suicide coping self-efficacy.

Assessing the Perception of Family and Caregivers' Experience with Mental Health and Substance Use Services.

Standardized client feedback surveys encourage a culture of continuous quality improvement, allow for comparison of results over time and across similar types of service providers, and encourage use of evidence-based practices. Recognizing the importance of family and other caregivers in supporting people accessing services for mental health and substance use challenges, a standardized perception-of-care tool (the Ontario Perception of Care Tool for Mental Health and Addictions, OPOC-MHA) was adapted to collect feedback specific to the caregiver experience with these services. A collaborative process engaged a broad range of mental health and/or addiction providers, family advisory networks, and family members and caregivers to identify themes, specific items, and implementation approaches. The final version of the tool evolved through an iterative process of pilot testing and stakeholder feedback. Family member and caregiver perceptions of care will identify service areas in need of improvement, contribute to quality improvement initiatives, and facilitate the comparison of findings over time.

Housing Instability and Concurrent Substance use and Mental Health Concerns: An Examination of Canadian Youth.

OBJECTIVE: Though previous research has identified the high burden of mental health and addiction (MHA) concerns among precariously housed youth, earlier studies have not examined differences in MHA concerns among housing insecure Canadian youth across sectors. This study examines this issue using the Global Appraisal of Individual Needs Short Screener (GAIN-SS) in a cross-sectoral sample of Canadian youth. METHOD: A total of 2605 youth ages 12 to 24 seeking services across sectors completed the GAIN-SS and a sociodemographic form. The analyses described demographic variables and sector of presentation, then evaluated internalizing, externalizing, substance use, and crime/violence concerns based on housing status. RESULTS: While many precariously housed youth presented through the housing/outreach/support sector, 33.6% presented to other sectors. Housing groups endorsed comparably high levels of internalizing and externalizing problems. However, precariously housed youth reported higher rates of problematic substance use (OR = 1.54; 95% CI 1.25, 1.88; p < 0.01) and crime/violence issues (OR = 1.95; 95% CI 1.54, 2.46; p < 0.01). Precariously housed youth were 48% more likely to endorse concurrent disorders (OR = 1.48; 95% CI 1.21, 1.82; p < 0.01), which was largely driven by the high rate of concurrent disorders among precariously housed females. CONCLUSIONS: Since precariously housed youth with multiple clinical needs presented across sectors, attention must be given to screening for both housing stability and MHA and building stronger cross-sectoral partnerships. The findings should encourage systematic screening, MHA training and capacity building within housing sectors as well as integrated services across all youth-serving organizations.

OBJECTIF: Bien que la recherche antérieure ait identifié le lourd fardeau des problèmes de santé mentale et de dépendance (SMD) chez les jeunes au logement précaire, les études précédentes n'ont pas examiné les différences des problèmes de SMD chez les jeunes canadiens au logement précaire de tous les secteurs. La présente étude se penche sur cette question à l'aide de la version abrégée de l'évaluation générale des besoins individuels (GAIN-SS) dans un échantillon intersectoriel de jeunes canadiens. MÉTHODE: Un total de 2605 jeunes de 12 à 24 ans demandant des services dans tous les secteurs ont rempli la GAIN-SS et un formulaire sociodémographique. Les analyses ont décrit les variables démographiques et le secteur de présentation, puis évalué l'internalisation, l'externalisation, l'utilisation de substances, et les problèmes de crime/violence basés sur la situation du logement. RÉSULTATS: Même si nombre de jeunes au logement précaire se sont présentés dans le secteur logement/entraide/soutien, 33,6% d'entre eux se sont présentés à d'autres secteurs. Les groupes de logement présentaient des niveaux comparativement élevés de problèmes d'internalisation et d'externalisation. Toutefois, les jeunes au logement précaire déclaraient des taux élevés d'utilisation de substances problématique (RC = 1,54; IC à 95% 1,25 à 1,88; p < 0,01) et des problèmes de crime/violence (RC = 1,95; IC à 95% 1,54 à 2,46; p < 0,01). Les jeunes au logement précaire étaient 48% plus susceptibles de présenter des troubles co-occurrents (RC = 1,48; IC à 95% 1,21 à 1,82; p < 0,01), ce qui était largement attribuable au taux élevé de troubles co-occurrents chez les jeunes femmes au logement précaire. CONCLUSIONS: Puisque les jeunes au logement précaire ayant de multiples besoins cliniques étaient présents dans tous les secteurs, il faut porter notre attention au dépistage de l'instabilité du logement et de la SMD, et former des partenariats intersectoriels plus solides. Les résultats devraient encourager un dépistage systématique, la formation en matière de SMD et de renforcement des capacités dans les secteurs de logement ainsi que les services intégrés dans tous les organismes qui desservent les jeunes.