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The Evaluation of Interventions to Prevent Suicide
Purpose
The purpose of this cooperative agreement is to evaluate specific interventions that may
influence one or more of the factors that lead to suicidal behavior among high risk
populations.
New York, NY–Research Foundation for Mental Hygiene, Inc. at New York
State Psychiatric Institute - An Evaluation of Telephone Crisis Services for Adolescents
Partners
Boys Town, USA, Hastings High School (Westchester County, NY), and Sayville High School
(Suffolk County, NY)
Target Group
High school students, grades 9 through 12
Setting
Two high schools in the greater New York area
Description
Two New York area high schools, one each in Suffolk and Westchester counties, have been
selected for participation. In the first year of the study, 500 9th and 11th
grade students in each school will be recruited and serve as the comparison group, and in
the second year, 500 new 9th and 11th graders in each school will be
recruited for the treatment sample. The program is designed to enhance awareness,
utilization, and efficacy of telephone crisis intervention services for teenagers.
Students in both the comparison and intervention groups will complete a baseline
questionnaire assessing their use and perceptions of various kinds of treatment services.
These include both formal (e.g., alcohol/drug abuse centers, teenage drop-in centers,
mental health professionals, school counselors, clergy, crisis hotlines) and informal
(e.g., parents, friends, siblings, teachers, coaches) services. Students will also be
asked about their reasons for seeking help. The intervention will augment an existing
in-school mandatory health curriculum. It will include a discussion of help-seeking
alternatives for emotional problems and coping as well as a specific introduction to the
Boys Town crisis line. Cards with the crisis line number will be handed out to students in
class and the phone number will remain posted in the classroom. To track calls from these
students, a special call-in number will be created.
Evaluation
The evaluation has two components. The first uses a pre- and post-test design, one year
apart, to compare baseline and follow-up assessments of help-seeking attitudes and
behaviors. The follow-up interview will also include questions about students’ use of
the Boys Town crisis line and other hotlines, their compliance with any information or
advice they were given, and their assessment of the effectiveness of the help they
received. In addition, the interview will be used to assess the presence of psychiatric
difficulties (using the DISC-IV and Columbia Impairment Scale) and suicidal thoughts and
behaviors. The second component of the evaluation relies on information gathered from
calls made to the special Boys Town crisis line phone number as well as calls made by
teenagers to the general Boys Town crisis line that originate in the communities where the
schools are located (obtained by matching area codes and 3-digit exchanges). This
information will be used to understand which students actually utilize the crisis line and
the specific types of problems for which they call.
Contact
Madelyn Gould
Professor
Research Foundation for Mental Hygiene,
Inc. at New York State Psychiatric Institute
722 West 168th Street
New York, New York 10032
Telephone: 212-543-5329
FAX : 212-543-5966
Email: gouldm@childpsych.columbia.edu
Charleston, South Carolina - Life Review: Preventing Suicide in Older Adults
Purpose
The purpose of this cooperative agreement is to evaluate specific interventions that may
influence one or more of the factors that lead to suicidal behavior among high risk
populations.
Partners
Dr. Barbara Haight will collaborate with the Institute of Psychiatry, State Office on
Aging, Area Agency on Aging, South Carolina Center for the Study of Suicide, and
Charleston County Redevelopment Authority.
Target Group
Adults aged 65 and older who are experiencing minor depression.
Setting
The intervention will take place in participant’s home. The home offers pictures,
cues, and reminders that will facilitate the life review. If the home is not private, an
alternate setting will be established, such as a counseling office at the nursing clinic
or the College of Nursing.
Description
Adults over the age of 65 years have the highest suicide rate of all age groups.
However, since older people attach a stigma to mental illness and suicide, many do not
seek help even if they suspect a problem. Accordingly, an intervention must be perceived
as acceptable to older people in order to be effective. The life review is an intervention
that is empirically based and conceptually grounded. The life review is a structured
process of reminiscence, instigated by a therapeutic listener that helps the individual to
organize and synthesize his/her life until the individual accepts life as it has been
lived. Because the life review is a seemingly natural storytelling process with no stigma
attached, it engages older people with minor depression who often, otherwise, refuse
mental health services.
The life reviews are conducted on a one-to-one basis with a skill interviewer who acts
as a therapeutic listener. The therapeutic listener helps the aged individual reframe
periods and events in the lived life so that they are more acceptable to the individual.
The life review process is completed during 6 weekly visits. The first two visits are used
to address childhood and home. The next two visits focus on adolescence and adulthood and
the last two visits consist of an evaluation of one’s life. This evaluation period
assist the reviewer to come to terms with mistakes made, to place a value on the life that
has been lived and to integrate life events. Three key concepts have been identified for a
successful life review and they are included in this evaluation. The concepts are that the
life review is structured (birth to present), evaluative, and conducted on a one-to-one
basis. The process is directed by the use of a life review and experiencing form.
Evaluation
A sample of older adults will be selected from the community and screened for
depression. Eligible participants will be randomized to a life review intervention group
or a control group. A randomized trail with pretest/posttest design will compare treated
and control individuals at baseline and examine changes within and between groups.
Repeated post-treatment measures will be analyzed using multivariate techniques to test
whether those receiving the life review show a reduction in minor depression, risk of
developing major clinical depression, and risk of suicidal ideation at 8 weeks, 1 year,
and 2 years following the life review intervention when compared to older people receiving
no life review intervention.
Contact
Dr. Barbara Haight
Professor
Medical University of South Carolina
College of Nursing
99 Jonathan Lucas Street
Charleston, South Carolina 29401
Telephone: 843-792-4607
Fax: 843-792-1741
Email : HAIGHTB@MUSC.EDU
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