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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Suicidal Ideation. Show all posts
Showing posts with label Suicidal Ideation. Show all posts

Monday, June 12, 2023

Why some mental health professionals avoid self-care

Dattilio, F. M. (2023).
Journal of Consulting and Clinical Psychology, 
91(5), 251–253.
https://doi.org/10.1037/ccp0000818

Abstract

This article briefly discusses reasons why some mental health professionals are resistant to self-care. These reasons include the savior complex, avoidance, and lack of collegial assiduity. Several proposed solutions are offered.

Here is an excerpt:

Savior Complex

One hypothesis used to explain professionals’ resistance is what some refer to as a “savior complex.” Certain MHPs may be engaging in the cognitive distortion that it is their duty to save as many people from suffering and demise as they can and in turn need to sacrifice their own psychological welfare for those facing distress. MHPs may be skewed in their thinking that they are also invulnerable to psychological and other stressors. Inherent in this distortion is their fear of being viewed as weak or ineffective, and as a result, they overcompensate by attempting to be stronger than others. This type of thinking may also involve a defense mechanism that develops early in their professional lives and emerges during the course of their work in the field. This may stem from preexisting components of their personality dynamics. 

Another reason may be that the extreme rewards that professionals experience from helping others in such a desperate state of need serve as a euphoric experience for them that can be addictive. In essence, the “high” that they obtain from helping others often spurs them on.
Avoidance

Another less complicated explanation for MHPs’ blindness to their own vulnerabilities may be their strong desire to avoid admitting to their own weaknesses and sense of vulnerability. The defense mechanism of rationalization that they are stronger and healthier than everyone else may embolden them to push on even when there are visible signs to others of the stress in their lives that is compromising their functioning. 

Avoidance is also a way of sidestepping the obvious and putting it off until later. This may be coupled with the need that has increased, particularly with the recent pandemic that has intensified the demand for mental health services.

Denial

The dismissal of MHPs’ own needs or what some may term as, “denial” is a deeper aspect that goes hand-in-hand with cognitive distortions that develop with MHPs, but involve a more complex level of blindness to the obvious (Bearse et al., 2013). It may also serve as a way for professionals to devalue their own emotional and psychological challenges. 

Denial may also stem from an underlying fear of being determined as incapacitated or not up to the challenge by their colleagues and thus prohibited from returning to their work or having to face limitations or restrictions. It can sometimes emanate from the fear of being reported as having engaged in unethical behavior by not seeking assistance sooner. This is particularly so with cases of MHPs who have become involved with illicit drug or alcohol abuse or addiction. 

Most ethical principles mandate that MHPs strive to remain cognizant of the potential effects that their work has on their own physical and mental health status while they are in the process of treating others and to recognize when their ability to be effective has been compromised. 

Last, in some cases, MHPs’ denial can even be a response to genuine and accurately perceived expectations in a variety of work contexts where they do not have control over their schedules. This may occur more commonly with facilities or institutions that do not support the disclosure of vulnerability and stress. It is for the aforementioned reasons that the American and Canadian Psychological Associations as well as other mental health organizations have mandated special education on this topic in graduate training programs (American Psychiatric Association, 2013; Maranzan et al., 2018).

Lack of Collegial Assiduity

A final reason may involve a lack of collegial assiduity, where fellow MHPs observe their colleagues enduring signs of stress but fail to confront the individual of concern and alert them to the obvious. It is often very awkward and uncomfortable for a colleague to address this issue and risk rebuke or a negative outcome. As a result, they simply avoid it altogether, thus leaving the issue of concern unaddressed.

The article is paywalled here, which is a complete shame.  We need more access to self-care resources.

Friday, September 13, 2019

The dynamics of social support among suicide attempters: A smartphone-based daily diary study

Coppersmith, D.D.L.; Kleiman, E.M.; Glenn, C.R.; Millner, A.J.; Nock, M.K.
Behaviour Research and Therapy (2018)

Abstract

Decades of research suggest that social support is an important factor in predicting suicide risk and resilience. However, no studies have examined dynamic fluctuations in day-by-day levels of perceived social support. We examined such fluctuations over 28 days among a sample of 53 adults who attempted suicide in the past year (992 total observations). Variability in social support was analyzed with between-person intraclass correlations and root mean square of successive differences. Multi-level models were conducted to determine the association between social support and suicidal ideation. Results revealed that social support varies considerably from day to day with 45% of social support ratings differing by at least one standard deviation from the prior assessment. Social support is inversely associated with same-day and next-day suicidal ideation, but not with next-day suicidal ideation after adjusting for same-day suicidal ideation (i.e., not with daily changes in suicidal ideation). These results suggest that social support is a time-varying protective factor for suicidal ideation.

The research is here.

Friday, December 23, 2011

Greek woes drive up suicide rate to highest in Europe

By Helena Smith
The Guardian

Homeless man begs for money
The suicide rate in Greece has reached a pan-European record high, with experts attributing the rise to the country's economic crisis.

Painful austerity measures and a seemingly endless economic drama is exacting a deadly toll on the nation. Statistics released by the Greek ministry of health show a 40% rise in those taking their own lives between January and May this year compared to the same period in 2010.

Before the financial crisis first began to bite three years ago, Greece had the lowest suicide rate in Europe at 2.8 per 100,000 inhabitants. It now has almost double that number, the highest on the continent, despite the stigma in a nation where the Orthodox church refuses funeral rights for those who take their lives. Attempted suicides have also increased.

"It's never just one thing, but almost always debts, joblessness, the fear of being fired are cited when people phone in to say they are contemplating ending their lives," said Eleni Beikari, a psychiatrist at the non-governmental organisation, Klimaka, which runs a 24-hour suicide hotline.

Klimaka received around 10 calls a day before the crisis; it now gets more than 100 in any 24-hour period.

"Most come from women aged between 30 and 50 and men between 40 and 45 despairing over economic problems," said Beikari. "In my experience it's the men, suffering from hurt dignity and lost pride, who are most serious."

The entire story is here.

Tuesday, October 11, 2011

A third of troop suicides told someone of plans

By Dan Elliott
The Associated Press

DENVER — A third of military personnel who committed suicide last year had told at least one person they planned to take their own lives, a newly released Defense Department report says.

Nearly half went to see medical personnel, behavioral health specialists, chaplains or other service providers sometime in the 90 days before they died, according to the 2010 Department of Defense Suicide Event Report.
That doesn’t necessarily reflect a failure in the Defense Department suicide prevention program, said Richard McKeon, chief of the Suicide Prevention Branch at the federal Substance Abuse and Mental Health Services Administration.
“It’s not that some person blew it,” McKeon said Thursday. But physical and behavior health care personnel, counselors and other providers need to monitor their programs and look for improvements, he said.
“(Providers) need to be aware of what those opportunities are, and need to be regularly evaluating their efforts on what is working or what is not,” McKeon said.
The 250-page report released late Wednesday analyzes 295 confirmed or “strongly suspected” suicides that were reported last year, down from 309 the year before. Caucasian service members under age 25 and in the lower ranks were at the highest risk, the same as the year before.
The 2010 total includes active-duty, reserve and National Guard personnel. It reflects a slight downward revision from the 301 suicides the Defense Department reported in January, which included about 70 that were still under investigation.
The Defense Department has been coping with rising suicide numbers during its protracted wars in Afghanistan and Iraq. Individual service branches have tracked suicides for years, and in 2008, the Defense Department began using a standard form for collecting information called the Department of Defense Suicide Event Report or DoDSER.
The entire story can be found here.

Tuesday, August 2, 2011

Parental Military Deployment Has Detrimental Affect On Adolescent Boys

Mary Guiden
University of Washington
Medical News Today

In 2007, nearly two million children in the United States had at least one parent serving in the military. Military families and children, in particular, suffer from mental health problems related to long deployments. 

A new study from researchers at the University of Washington (UW) concludes that parental military deployment is associated with impaired well-being among adolescents, especially adolescent boys. The study, "Adolescent well-being in Washington state military families," was published online in the American Journal of Public Health.

Lead author Sarah C. Reed, who has a master's degree from the UW School of Public Health, said the findings show that it is time to focus more on the children that are left behind in times of war. "There is a lot of research about veterans and active-duty soldiers, and how they cope or struggle when they return from a deployment," said Reed. "Those studies hit the tip of the iceberg of how families are coping and how their children are doing."

Adolescents are uniquely vulnerable to adverse health effects from parental military deployment. Healthy development, including identifying a sense of self and separation from family, can be interrupted during parents' active military service.

Media exposure and the developmental ability to understand the consequences of war may further disrupt adolescents' adjustment and coping. Teens may also have additional responsibilities at home after a parent's deployment, researchers said.

UW researchers used data from the Washington state 2008 Healthy Youth Survey, administered to more than 10,000 adolescents in 8th, 10th- and 12th grade classrooms. Female 8th graders with parents deployed to combat appear to be at risk of depression and thoughts of suicide, while male counterparts in all grades are at increased risk of impaired well-being in all of the areas examined (low quality of life, binge drinking, drug use and low academic achievement). 

Read the entire story here.

Wednesday, July 27, 2011

Bullying and Suicide: Detection and Intervention

By Anat Brunstein Klomek, PhD, Andre Sourander, MD and 
Madelyn S. Gould, PhD, MPH
Psychiatric Times

Bullying is recognized as a major public health problem in the Western world, and it appears to have devastating consequences. Cyberbullying has become an increasing public concern in light of recent cases associated with youth suicides that have been reported in the mass media.



Most of the studies that have examined the association between bullying and suicidality have been cross-sectional. Those studies show that bullying behavior in youth is associated with depression, suicidal ideation, and suicide attempts. These associations have been found in elementary school, middle school, and high school students. Moreover, victims of bullying consistently exhibit more depressive symptoms than nonvictims; they have high levels of suicidal ideation and are more likely to attempt suicide than nonvictims.

The results pertaining to bullies are less consistent. Some studies show an association with depression, while others do not. The prevalence of suicidal ideation is higher in bullies than in persons not involved in bullying behavior. Studies among middle school and high school students show an increased risk of suicidal behavior among bullies and victims. Both perpetrators and victims are at the highest risk for suicidal ideation and behavior.

Suicide risk by sex

Cross-sectional studies of the differential impact of school bullying by sex on the risk of depression and suicidal ideation have shown significant associations, but the results are not consistent. Some researchers have found stronger associations among girls.
Kim and colleagues1 reported that girls who were involved with school bullying (as either victim or perpetrator) were at significantly greater risk for suicidal ideation. Roland2 found that girls who were bullies had more suicidal thoughts. Van der Wal and colleagues3 found a strong association between being bullied and depression and suicidal ideation in girls, and Luukkonen and colleagues4 found that being bullied and bullying others are both potential risk factors for suicidal behavior in girls.

On the other hand, Rigby and Slee5 found that the association between being a bully and suicidal ideation applied only to boys. McMahon and colleagues6 recently reported that boys who had been bullied at school were more depressed and had a higher risk of thoughts about harming themselves and self-harming behavior than boys who had not been bullied. Kaltiala-Heino and colleagues7 reported that among girls, severe suicidal ideation was associated with frequently being bullied or being a bully and for boys it was associated with being a bully. No association was found between boys and girls for depressive symptoms.8

Our earlier work tried to explain the differences in the risks of depression and suicidality between girls and boys; we suggested that there is a difference in the threshold for depression and suicide between the sexes.9 Girls who bullied others were at risk for depression, suicidal ideation, and suicide attempts even when the bullying was infrequent. However, only frequent bullying was associated with depression, suicidal ideation, and suicide attempts among boys.

There may be a different sex threshold in victimization as well. Among girls, victimization at any frequency increased the risk of depression, suicidal ideation, and suicide attempts. On the other hand, only frequent victimization increased the risk of depression and suicidal ideation in boys, although infrequent victimization was associated with an increased risk of suicide attempts.

The rest of the article can be found here.  The reader can sign up for Psychiatric Times (free) or google the title of this blog for the entire story.