Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team

Background: The most significant risk factor for suicide is a previous suicide attempt. For individuals who present to hospital, accessing aftercare is essential to ameliorate this risk, but frequently discharge occurs without adequate follow-up. To improve post-suicidal aftercare, a hybrid team (Al...

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Main Authors: Angela M. Wright, Stuart J. Lee, Daniel Rylatt, Kathryn Henderson, Han-Mari Cronje, Michelle Kehoe, Simon Stafrace
Format: Article
Language:English
Published: Elsevier 2021-04-01
Series:Journal of Affective Disorders Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666915321000603
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spelling doaj-18332ca2e06c4c108e2f807fb827a7c52021-04-22T13:42:42ZengElsevierJournal of Affective Disorders Reports2666-91532021-04-014100133Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach teamAngela M. Wright0Stuart J. Lee1Daniel Rylatt2Kathryn Henderson3Han-Mari Cronje4Michelle Kehoe5Simon Stafrace6Alfred Mental &amp; Addiction Health, Alfred Health, PO Box 315, Prahran, Victoria 3181, Australia; Corresponding author.Alfred Mental &amp; Addiction Health, Alfred Health, PO Box 315, Prahran, Victoria 3181, Australia; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia; Centre for Forensic Behavioural Science, Swinburne University of Technology and Victorian Institute for Forensic Mental Health (Forensicare), Alphington, Victoria, AustraliaAlfred Mental &amp; Addiction Health, Alfred Health, PO Box 315, Prahran, Victoria 3181, AustraliaAlfred Mental &amp; Addiction Health, Alfred Health, PO Box 315, Prahran, Victoria 3181, AustraliaCentre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, AustraliaAlfred Mental &amp; Addiction Health, Alfred Health, PO Box 315, Prahran, Victoria 3181, Australia; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, AustraliaAlfred Mental &amp; Addiction Health, Alfred Health, PO Box 315, Prahran, Victoria 3181, AustraliaBackground: The most significant risk factor for suicide is a previous suicide attempt. For individuals who present to hospital, accessing aftercare is essential to ameliorate this risk, but frequently discharge occurs without adequate follow-up. To improve post-suicidal aftercare, a hybrid team (Alfred Hope) was developed offering three-months of psychosocial and clinical assertive outreach support. This study aimed to measure change in distress, suicidal ideation and coping beliefs and experience of care. Methods: For 92 consumers, initial and end-of-contact measures were collected: Suicidal Ideation Attributes Scale (suicidal ideation), Patient Health Questionnaire-4 (distress), Outcome Rating Scale (wellbeing), State Hope Scale (current hopeful thinking) and Coping Self-Efficacy Scale (coping ability beliefs). Qualitative responses regarding experience of care were also collected. Results: At initial contact, 79% of consumers reported at least moderate distress, 78% suicidal ideation suggesting high risk of suicidal behaviour and 83% impaired wellbeing. Large effects were observed for reduced suicidal ideation and distress and improved wellbeing, coping self-efficacy and hopeful thinking (all p<.001) and emergency department presentations reduced significantly (p<.001). Qualities of staff, what was received, and outcome of engagement were themes summarising what consumers reported was helpful. Limitations: Uncontrolled longitudinal study and not all consumers completed end-of-contact measures. Conclusion: Operation of a clinical/non-clinical assertive post-suicidal outreach team is feasible, highly valued and supported improvement for most consumers. With some participants displaying persistent high suicide risk, clinical and psychosocial expertise is needed alongside being collaborative and respectfully persistent to address stressors and build coping ability to better overcome future adversity.http://www.sciencedirect.com/science/article/pii/S2666915321000603Post-suicidal aftercareAssertiveFollow-upOutreachCollaborationConsumer experience
collection DOAJ
language English
format Article
sources DOAJ
author Angela M. Wright
Stuart J. Lee
Daniel Rylatt
Kathryn Henderson
Han-Mari Cronje
Michelle Kehoe
Simon Stafrace
spellingShingle Angela M. Wright
Stuart J. Lee
Daniel Rylatt
Kathryn Henderson
Han-Mari Cronje
Michelle Kehoe
Simon Stafrace
Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
Journal of Affective Disorders Reports
Post-suicidal aftercare
Assertive
Follow-up
Outreach
Collaboration
Consumer experience
author_facet Angela M. Wright
Stuart J. Lee
Daniel Rylatt
Kathryn Henderson
Han-Mari Cronje
Michelle Kehoe
Simon Stafrace
author_sort Angela M. Wright
title Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
title_short Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
title_full Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
title_fullStr Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
title_full_unstemmed Coordinated assertive aftercare: Measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
title_sort coordinated assertive aftercare: measuring the experience and impact of a hybrid clinical/non-clinical post-suicidal assertive outreach team
publisher Elsevier
series Journal of Affective Disorders Reports
issn 2666-9153
publishDate 2021-04-01
description Background: The most significant risk factor for suicide is a previous suicide attempt. For individuals who present to hospital, accessing aftercare is essential to ameliorate this risk, but frequently discharge occurs without adequate follow-up. To improve post-suicidal aftercare, a hybrid team (Alfred Hope) was developed offering three-months of psychosocial and clinical assertive outreach support. This study aimed to measure change in distress, suicidal ideation and coping beliefs and experience of care. Methods: For 92 consumers, initial and end-of-contact measures were collected: Suicidal Ideation Attributes Scale (suicidal ideation), Patient Health Questionnaire-4 (distress), Outcome Rating Scale (wellbeing), State Hope Scale (current hopeful thinking) and Coping Self-Efficacy Scale (coping ability beliefs). Qualitative responses regarding experience of care were also collected. Results: At initial contact, 79% of consumers reported at least moderate distress, 78% suicidal ideation suggesting high risk of suicidal behaviour and 83% impaired wellbeing. Large effects were observed for reduced suicidal ideation and distress and improved wellbeing, coping self-efficacy and hopeful thinking (all p<.001) and emergency department presentations reduced significantly (p<.001). Qualities of staff, what was received, and outcome of engagement were themes summarising what consumers reported was helpful. Limitations: Uncontrolled longitudinal study and not all consumers completed end-of-contact measures. Conclusion: Operation of a clinical/non-clinical assertive post-suicidal outreach team is feasible, highly valued and supported improvement for most consumers. With some participants displaying persistent high suicide risk, clinical and psychosocial expertise is needed alongside being collaborative and respectfully persistent to address stressors and build coping ability to better overcome future adversity.
topic Post-suicidal aftercare
Assertive
Follow-up
Outreach
Collaboration
Consumer experience
url http://www.sciencedirect.com/science/article/pii/S2666915321000603
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