Facilitators and barriers to implementation of suicide prevention interventions: Scoping review.

We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed.

Suicide Risk in Individuals With and Without Mental Disorders Before and During the COVID-19 Pandemic: An Analysis of Three Nationwide Cross-Sectional Surveys in Czechia.

OBJECTIVE: The impact of the coronavirus disease 2019 (COVID-19) pandemic on suicidal thoughts and behavior has been widely hypothesized but remains largely unexplored at the population-level. We aimed to assess changes in suicide risk (SR) in people with and without mental disorders, before and during the COVID-19 pandemic in Czechia. METHODS: We analyzed data from three nationwide cross-sectional surveys of Czech adults (November 2017, May and November 2020). For the 2017 data collection, we employed paper and pencil interviewing, while for the two 2020 data collections, we used a mixed computer-assisted web interviewing and computer-assisted telephone interviewing approach. All samples were representative in terms of age, gender, education, and area of residence for the Czech adult population (18+). We used the Mini International Neuropsychiatric Interview to screen for mental disorders and SR. We calculated weighted prevalence rates with 95% confidence intervals (95% CI). RESULTS: When compared to baseline, we found a 4% and 6% increase in SR in individuals without mental disorders in pandemic surveys (1.95% (1.45%; 2.44%) vs. 6.29% (5.28%; 7.30%) and 8.42% (7.19%; 9.65%)). Relative to baseline, SR in people with major depressive episode or anxiety disorders was elevated in May and November 2020 (22.35% (17.64%; 27.06%) vs. 36.68% (32.45%; 40.91%) and 38.88% (34.51%; 43.25%)). CONCLUSIONS: We found substantially increased SR in both people with and without mental disorders, however, these changes could be partially related to differing data collection methods used in the baseline and subsequent surveys. Ongoing prevention, monitoring and evaluation of nationwide suicidality is warranted.HIGHLIGHTSWe found that suicide risk substantially increased during the pandemicSuicide risk was elevated in both individuals with and without mental disordersOur findings support increased suicide monitoring and prevention.

Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries.

Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation. Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries' COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries' income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well. Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue. Funding: None.

Correction to: Meta-Review on the Effectiveness of Classroom-Based Psychological Interventions Aimed at Improving Student Mental Health and Well-Being, and Preventing Mental Illness.

The original version of the article, unfortunately, missing the funding information. Funding note is given below.

Meta-Review on the Effectiveness of Classroom-Based Psychological Interventions Aimed at Improving Student Mental Health and Well-Being, and Preventing Mental Illness.

This meta-review summarizes existing evidence from systematic reviews and meta-analyses on the effectiveness of school-based psychological interventions aimed at improving student mental health and well-being, and preventing mental illness. Systematic reviews and meta-analyses were identified via the electronic databases PsycINFO, Web of Knowledge, Medline, Embase, and HMIC (Health Management Information Consortium). Ten systematic reviews and meta-analysis were eligible for inclusion in the final analyses. These systematic reviews and meta-analyses evaluated the effects of five types of school-based psychological interventions: Mindfulness, Social Emotional Learning, Cognitive Behavioral Therapy, Yoga, and Body-Image. Overall effectiveness reported in the included studies was significant for the most part, and ranging from small to large with respect to the effect size. The authors of all of the studies emphasized the need for additional high-quality trials to further examine the effectiveness of school-based psychological interventions aimed at improving student mental health and well-being, and preventing mental illness.