Adolescent Suicide Rare In Rural Flashcards
Adolescent suicide in rural
In this station candidates are asked to use their knowledge and experience to date to think more broadly. They should all be aware of issues associated with high adolescent and rural suicide rates; this station asks them to work within their team to plan and provide expertise in service implementation to improve outcomes.
Rural youth suicide is a serious mental health issue; with rates double that in the city. Males are more likely to succeed at a 6.25:1 ratio to women, with hanging the most frequent method in both groups (women have higher attempts at 2:1 but this is decreasing). Indigenous youth are particularly at risk.
Prevention can be viewed as universal, selective or indicated; this task heads the candidate towards the latter two.
Objectives are likely to include:
1. Mental Health Strategies eg increased access to mental health services; better follow up of self harm in ED departments, with identification of youth friendly services and local pathways of referral
2. Community Strategies to increase connectedness and decreasing risk factors
3. Training programs for those with the potential to respond – in this case, in particular, the teachers.
It is very difficult to do RCT evaluation of such interventions and the better candidates will be able to discuss this. However some basic goals of assessment of any program implemented can incorporate better uptake of mental health services and satisfaction with referral process. Crude measures like actual suicide rate is unlikely to be helpful in a small community. Evaluation should include a base line assessment – data would probably be available in the service of referral rates etc, and at initial meetings a brief feedback form could be given to key stakeholders as a base level of satisfaction and barriers against which to rate improvement. Identifies the underlying psychiatric illnesses associated with suicide including substance abuse; demonstrates solid knowledge of risk factors for both youth and rural suicides; including specific issues for Indigenous populations; includes improving access to youth and primary care services; teacher training in identification of those at risk and appropriate referral; to include strategies such as youth friendly areas with safe transport; reducing means eg by decreasing access to firearms in the community; involvement of media in ways to decrease “contagion”; deals simplistically with conflict of interest/confidentiality issue.
