Home > Staff awareness of suicide and self-harm risk in healthcare settings: A mixed-methods systematic review.

Dillon, Christina B and Saab, Mohamad M and Meehan, Elaine and Goodwin, Mr John and Murphy, Margaret and Heffernan, Ms Sinead and Greaney, Ms Sonya and Kilty, Caroline and Hartigan, Irene and Chambers, Derek and Twomey, Una and Horgan, Aine (2020) Staff awareness of suicide and self-harm risk in healthcare settings: A mixed-methods systematic review. Journal of Affective Disorders, 276, pp. 898-906.

BACKGROUND
Suicide risk screening in healthcare settings plays a significant role in suicide prevention. Healthcare staff who are poorly informed about self-harm and suicide risk are less likely to identify and subsequently screen at-risk individuals. This mixed-method systematic review aimed to appraise and synthesise evidence from studies that explored and promoted healthcare staff's knowledge and awareness of suicide and self-harm risk in healthcare settings.

METHODS
Electronic databases (CINAHL, MEDLINE, APA PsycInfo, APA PsycARTICLES, Psychology and behavioural Science Collection, ERIC, and SocINDEX), the Cochrane Library, and various grey literature databases were searched for relevant studies. The level of evidence and methodological quality of the included studies were assessed.

RESULTS
Eighteen empirical studies were included. Levels of knowledge about suicide and self-harm risk varied significantly across the reviewed studies. Face-to-face group training and educational programmes, digital or online educational programmes, and an educational poster campaign were amongst the strategies used to promote awareness of suicide and self-harm risk, with the majority marginally succeeding in doing so.

LIMITATIONS
The reviewed studies were heterogeneous in terms of design, interventions, and outcome measures which made it difficult to make comparisons. The overall level of scientific evidence was classified as being relatively low. The lack of blinding and lack of a control group were amongst the limitations for experimental studies.

CONCLUSIONS
Long-term, routine face-to-face group training programmes should be established to educate healthcare staff about suicide risk across all professions and in specific patient groups.


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