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New Blog. Covid-19: Mental health research and the pandemic response

posted May 21, 2020, 5:14 PM by Karen Wetherall   [ updated May 22, 2020, 4:35 AM ]

Covid-19: Mental health research and the pandemic response

by Rory O’Connor

On Friday 13th March I was meant to fly to Australia.  But on advice from the University (not that I am superstitious) a couple of days beforehand, I had made the difficult decision to cancel my trip.  This was fortuitous for a couple of reasons; first, obviously, if I had flown I probably would have been quarantined on arrival. Second though, was that the following week, as concern about Covid-19 was growing, I got an email from Helen Munn, the CEO of MQ: Transforming Mental Health, the mental health research charity.  She had been consulting with MRC, Wellcome, ESRC and other organisations and she invited me to co-chair a group to rapidly pull together a Position Paper on the Covid-19 mental health science research priorities (in partnership with the Academy of Medical Sciences). She was responding to concern from within the research community that, without a coordinated effort, the mental health science response to Covid-19 may become fragmented.

As I was unexpectedly still in the UK, I agreed but didn’t quite know what I had let myself in for!  However, less than a month later, after daily author meetings, an intense period of writing, editing, consulting, and rapidly surveying 3,000 people with lived experience, the Position Paper was published on 15th April in Lancet Psychiatry.  The long days and late nights and the tight turnaround were worth it, though. The Paper garnered global media coverage, it highlighted the importance of mitigating mental health risks and it has already started to inform the Covid-19 mental health and neuroscience research agenda in the UK.  Around the same time, I also became part of the Covid-19 International Suicide Research Collaboration. This initiative, led by David Gunnell (University of Bristol), is important because we know from other public health and economic crises that risk of suicide can increase in their aftermath. So we worked quickly to issue another Call for Action, also published in Lancet Psychiatry, to ensure that suicide prevention is given the urgent attention that it warrants.

In terms of understanding the mental health impact of Covid-19 (including lockdown, social distancing and economic measures), UofG is playing a leading role in tracking the mental health and wellbeing of the nation during Covid.  Within days of lockdown, I was fortunate to secure funding from Samaritans and Scottish Association for Mental Health and supported by the Mindstep Foundation to set-up a UK-wide nationally representative multi-wave study to track the population’s mental health over six months initially (UK COVID-MH study; n=3077).  This study is a collaboration between colleagues in IHW (Katie Robb, Karen Wetherall, Seonaid Cleare, Jack Melson, Claire Niedzwiedz, Tiago Zortea, Heather McClelland) and the Universities of Edinburgh, Stirling, Leeds and Nottingham. I am particularly grateful to Jesse Dawson and Terry Quinn for expediting our ethics application so that the study could get up-and-running in super-fast time. We are also recruiting an additional Scottish only sample (n=2,500), funded by the Scottish Government, to track mental health outcomes over the next 12 months.  We plan to publish the initial findings from the UK survey in the coming weeks and we hope that our findings will inform policy and practice as we continue to recover from the pandemic.  Katie Robb (PI) and I, as part of the UofG’s CSO Covid Research portfolio, have also received funding to interview a sample of our survey respondents over the coming months.

Jack Melson and I, alongside Karen Wetherall, Seonaid Cleare and Cara Richardson have also been busy tailoring the Distress Brief Intervention (DBI), the Scottish Government’s flagship multi-agency response for people in distress, to be Covid-ready. In anticipation of the likely impact of Covid-19 on our mental health, First Minister Nicola Sturgeon made new funding available to extend this crisis-response service and roll it out nationally. We were charged with developing new training and intervention materials in light of Covid-19 which we had to turn around in record-quick-time. We are delighted to be able to play our part in the government’s mental health response; indeed the first referrals by this new DBI-Covid 19 service were made on the 13th May – with plans for the service to go nationwide in June.

Finally, as part of the Scottish Government’s Academic Advisory Group on suicide prevention, Tiago Zortea is leading on a systematic review to explore the impact of public health emergencies on suicidal behaviour, suicidal thoughts and self-harm.  This is another collaborative effort; Tiago, Heather McClelland and I are working with Steve Platt (University of Edinburgh) and colleagues in Ireland and Canada to see what we can learn from previous emergencies. It is our hope that if we act now, we can mitigate suicide risk in the longer term.

A final reflection.  It is incredibly humbling and rewarding to work with such a dedicated group of people, both here at the University and well beyond. Everyone has a shared goal of trying to do whatever we can to help and protect the most vulnerable during this global COVID-19 pandemic, as we all navigate an uncertain future ahead together. 

22/05/20

"Those unbearable thoughts do pass" - Rory O'Connor on BBC Scotland

posted Feb 24, 2020, 1:29 PM by rory o'c   [ updated Feb 24, 2020, 1:38 PM ]

Rory O'Connor was interviewed on BBC Scotland's The Nine news and current affairs programme in the aftermath of Caroline Flack's death.  Here's part of the interview here where he discusses the complexity of suicide and the importance of safety planning in suicide prevention.


If you are affected by suicide or concerned about yourself or someone else the following organisations offer advice and support:

Samaritans  116 123 (UK and ROI)

Childline 0800 1111 (UK)

Breathing Space 0800 83 85 87

Lifeline (N Ireland) 0808 808 8000

Young Minds 

NHS 24  111

National Suicide Prevention Lifeline (USA) 1 800 273 82


Distress Brief Intervention programme wins prestigious Scottish Health Award

posted Nov 23, 2019, 10:40 AM by Karen Wetherall   [ updated Nov 23, 2019, 10:44 AM ]

Distress Brief Intervention programme wins prestigious Scottish Health Award

A unique mental health programme set up to help those in distress, which was developed through work led by Rory O’Connor and Jack Melson, has won a prestigious Scottish Health Award.

The national Distress Brief Intervention programme which is a partnership between a range of statutory and 3rd sector organisations including the University of Glasgow received the Care for Mental Health award at the Scottish Health Awards event held in Edinburgh on the 14th of November.

 

Jack (2nd from right) attended the event on behalf of the UofG Intervention Development and Training team. Jack, Rory and Karen Wetherall developed the intervention and the training programme which enables frontline and 3rd sector services staff to provide the intervention. 

The Distress Brief Intervention programme has so far helped almost 5000 people in distress by bringing together frontline emergency department staff, police officers, primary care and Scottish Ambulance Service paramedics and 3rd sector services together to improve the frontline response to distress.

Rory O'Connor wins Mind Media Award for Best Podcast

posted Nov 17, 2019, 1:25 PM by Karen Wetherall   [ updated Nov 17, 2019, 2:32 PM ]


Mind Media Award Best Podcast 2019

Rory O'Connor was delighted to win a Mind Media Award for Best Podcast together with Paul McGregor and Hannah Myerson at an awards ceremony in London on the 13th November - watch Rory, Paul and Hannah say a few words on accepting the award, above.

Their award-winning podcast: 'MQ Open Mind: How can we work together to prevent suicide?' was hosted by MQ: Transforming Mental Health.  It aimed to inspire hope and move beyond awareness raising.  It was first broadcast on World Suicide Prevention Day last year.


MQ Open Mind brings together scientists and people with experience of mental health problems to explore current mental health research and its potential to transform lives. 

In this episode Paul McGregor, a mental health campaigner, shares his experience of losing his dad to suicide while Professor Rory O'Connor discusses the circumstances that might cause someone to take their own life. 

The discussion is wide-ranging, highlighting myths, stigma, the integrated motivational-volitional model of suicide as well as how we can best work together to prevent suicide.

The podcast is available to listen to here:

If you are affected by suicide or concerned about yourself or someone else the following organisations offer advice and support:

Samaritans  116 123 (UK and ROI)

Childline 0800 1111 (UK)

Breathing Space 0800 83 85 87

Lifeline (N Ireland) 0808 808 8000

Young Minds 

NHS 24  111

National Suicide Prevention Lifeline (USA) 1 800 273 82

BBC 1 Scotland documentary on suicide in young people

posted Oct 19, 2019, 7:17 AM by Karen Wetherall   [ updated Oct 25, 2019, 2:49 PM ]

Rory O'Connor has contributed to a new BBC Disclosure documentary, Lost Boys, about suicide in young people in Scotland. Against the backdrop of declining suicide rates in the past decade, the suicide rates in Scotland (as in England) increased in 2018.

He discussed the wider issues around suicide prevention on BBC Scotland's The Nine programme just before the initial broadcast of the documentary.



The documentary, which focuses on the families of a group of young people who have died by suicide, is a really powerful watch with heartbreaking interviews with those who've lost loved ones to suicide.

BBC 1 Scotland Wed 23 Oct 22.35
BBC News Channel Fri 25 Oct 21.30
BBC News Channel Sun 27 Oct 20:30
BBC iPlayer here after broadcast


If you are affected by suicide or concerned about yourself or someone else the following organisations offer advice and support:

Samaritans  116 123 (UK and ROI)

Childline 0800 1111 (UK)

Breathing Space 0800 83 85 87

Lifeline (N Ireland) 0808 808 8000

Young Minds 

NHS 24  111

National Suicide Prevention Lifeline (USA) 1 800 273 82

SBRL Talk: Matt Spittal

posted Sep 23, 2019, 2:30 AM by Karen Wetherall   [ updated Sep 23, 2019, 2:39 AM ]

The Suicidal Behaviour Research Lab have the pleasure of hosting Associate Professor Matthew Spittal from the University of Melbourne, who will be talking on 3.30pm on Wednesday 25th September, in Lecture room 2 at Lilybank Gardens (University of Glasgow). 

Identifying patients at high-risk of suicide: the problems and pitfalls of using predictive instruments to make treatment decisions

Tools for assessing suicide risk are widely used in the emergency department and other settings to identify people at high risk of suicide. This classification then often informs treatment decisions, such as whether to admit a person as a psychiatric inpatient. In this talk I (1) describe a program of research that has examined the clinical utility of these risk prediction instruments; (2) explain why these tools don’t work, and why in the era of big data and machine learning, better tools are unlikely to be developed; and (3) offer suggestions for how we can do better.

Biography

Matthew Spittal is an Associate Professor and Australian Research Council Future Fellow at the University of Melbourne. He is a biostatistician by training. His research program crosses several areas of public health. His main area of research is on the role of individual practitioner performance on patient safety and quality of care. He also studies the epidemiology of suicide and self-harm and is developing a new area of research on traffic safety.

 

 

 

(Re-) Live Stream Panel Discussion on Suicide

posted Jun 8, 2019, 4:36 PM by Karen Wetherall   [ updated Jun 8, 2019, 4:47 PM ]


As part of the 4th Suicide and Self-harm Early and Mid-Career Researchers' Forum in Glasgow (6-7 June 2019), Rory O'Connor (Glasgow), Siobhan O'Neill (Ulster) and Keith Hawton (Oxford) took part in a live stream discussion on suicide research and prevention

#EMCRF19

It is freely available by double-clicking below:


Blog by Tiago Zortea of his experience of the 18th Conference of the Portuguese Society of Suicidology

posted May 1, 2019, 8:16 AM by Karen Wetherall   [ updated May 2, 2019, 3:10 AM ]

Expanding suicide prevention: Inside the 18th Conference of the Portuguese Society of Suicidology 

Tiago Zortea 


Portugal is a beautiful country. Full of history, culture, architecture, music and it has some of the warmest people in Europe. Sadly though, a large number of people in Portugal are affected by suicide. Committed to promoting suicide prevention nationally, the Portuguese Society of Suicidology (PSS) has been working intensely for more than twenty years, to bring together people from different fields with a range of diverse perspectives on suicide and its prevention. Among its many activities, the PSS holds an annual conference, which this year (2019) took place in the beautiful city of Beja (region of Alentejo), on the 12th and 13th of April. I was kindly invited by the PSS to give a talk on attachment as a vulnerability factor for suicide risk, the main topic of my PhD*. Attending the event was also an excellent opportunity to learn about the work Portuguese scientists, clinicians, and activists have been undertaking in the country. 

Figure 1 – Photos of the city of Beja, the conference opening session, and a picture featuring Dr Ana Matos Pires, host of the event. 


The conference was comprised of several parallel sessions. However, the opening symposium entitled “Places and Sites: Geography, Architecture, and Multidisciplinary Work in Suicide Prevention” demonstrated the PSS’s commitment to understanding suicide risk and prevention from a broader perspective, moving beyond the well established psychopathological approach. In this symposium, geographers from the University of Coimbra presented a study showing that suicide rates are overrepresented in rural, less populated and more deprived areas of the country, mainly among men [1] (Fig. 2). Their findings have important implications for public health policies and the promotion of suicide prevention. Other topics such as the identification of areas of concern and means restriction, and the architects’ views on safety in public areas/buildings were also presented in this symposium. 

Figure 2 – Santana et al. (2015) [1]

Another impressive symposium included the work of the Observatory of Suicidal Behaviour (OSB) led by Dr Ana Matos Pires, Director of the Psychiatry Department of the Health Unit Service of Baixo Alentejo (who was also responsible for hosting the conference in Beja). Dr Pires chaired the symposium in which her psychiatry trainees and colleagues presented some of their recent work. The region of Alentejo has the highest suicide rates in Portugal (Figure 3), and the OSB team are trying to meet the challenge of tackling the high rates of suicide there. If it were a country, Alentejo would have one of the highest suicide rates in the world (43,6 deaths per 100,000 people). Alongside Dr Pires and without any public resources and investment, the mental health professionals Paulo Barbosa, Rodrigo Mota Freitas, Daniela Lascasas, and Joana Neto have been promoting and implementing suicide prevention campaigns, in a concerted effort to reduce suicide rates in the region.

Figure 3 – Mortality rates by intentional self-harm according to gender and region of residency, 2015 (Portugal, 2017) [2]. Numbers are equivalent of deaths per 100,000 people. Source: Portuguese National Institute of Statistics.

In the opening session of the conference, Dr Pires also presented a series of observations on the Portuguese National Suicide Prevention Plan proposed in 2017. She acknowledged that the suicide prevention plan itself is a good one, but the challenge lies in its implementation. Several barriers for the strategy implementation were discussed. Dr Pires’ considerations resonate with a recently published editorial on the implementation of national suicide prevention strategies by Platt and colleagues [3]. In the editorial, the authors mention that unsupportive political, social, or legal environment, and limited capacity to monitor implementation progress constitute challenging barriers for the successful implementation of any national suicide prevention strategy.

Another important highlight of the conference was a session of talks sharing experiences of public suicide prevention campaigns in Spain and Brazil presented by the president of the Spanish Society of Suicidology (Andoni Anseán), and the president of the Latin American Association of Psychiatry (Antônio Geraldo da Silva), respectively. Both speakers shared the current activities in their countries; their successes and challenges, as well as plans for suicide prevention at the national level.

I was saddened to learn about the extent of suicide in Portugal, the huge challenges to be overcome in the region of Alentejo, but I was inspired by the tireless efforts of Portuguese colleagues to save lives despite the lack of financial and political support. The broad view that suicide is a multifaceted phenomenon which needs to be considered from a multidisciplinary perspective was one of the key messages of the event. The Portuguese Society of Suicidology has been doing a brilliant job in Portugal, bringing people together to understand, intervene, and prevent the deaths of thousands of Portuguese people.

---

* I would like to thank Dr Inês Rothes (University of Porto; Portuguese Society of Suicidology) of the kind invitation to speak at their annual conference.

References

[1] Santana, P., Costa, C., Cardoso, G., Loureiro, A., & Ferrão, J. (2015). Suicide in Portugal: Spatial determinants in a context of economic crisis. Health & place, 35, 85-94.

[2] Portugal. (2017). National Programme for Mental Health 2017. Lisbon: Ministry of Health. Retrieved from https://www.dgs.pt/pns-e-programas/programas-de-saude-prioritarios/saude-mental.aspx

[3] Platt, S., Arensman, E., & Rezaeian, M. (2019). National Suicide Prevention Strategies – Progress and Challenges. Crisis, 40(2), 75–82.

The Son: a portrait of emotional pain and its devastating consequences

posted Mar 18, 2019, 2:52 PM by Karen Wetherall   [ updated Sep 4, 2019, 7:16 AM ]


UPDATE:  The Son is now showing in the West End's Duke of York's Theatre (London). For more info click here.

I spent the weekend in London catching up with a close friend from my university days.  The highlight, without doubt, was seeing The Son, the final part of a trilogy from French playwright Florian Zeller, on Friday night.

Perhaps highlight is the wrong word, I left the Kiln Theatre emotionally drained; The Son is immersive, uncompromising, raw and visceral.   I am still reflecting on it. 

The audience is taken on an emotional tsunami of teenage depression, self-harm and suicidality.  It focuses on one family’s attempt to deal with the unravelling of their son, Nicolas (Laurie Kynaston), against the backdrop of divorce and new family relationships.

We first see Nicolas before the play ‘begins’, pacing the stage furiously and scribbling on the walls as the audience are taking their seats.  Pain etched on his face. We then meet Anne (the mother, Amanda Abbington), Pierre (her work-focused ex-husband, John Light) and Sofia (his new partner, Amaka Okafor) and their baby.  Nicolas hasn’t been to school for three months,  Anne is struggling; she’s at a loss and thinks he would be better off living with his father, Sofia and his little half-brother. Sadly, this solution doesn’t have the desired effect and over the next 1 hour and 45 minutes, we track Nicolas’ angst, his hoped for recovery, his relationship with Sofia and his mother’s forlorn efforts to keep hold of her cherished son. 

Alongside exploring the relationships among the family, old and new, there are brief moments of light; when egged on by Sofia, Nicolas mocks Pierre’s dad-dancing with his father responding by throwing amusingly impressive shapes. This juxtaposition serves only to illuminate their struggle more profoundly; providing a glimpse of happier times. 

You really feel each family member’s angst and pain; right down to the pit of the stomach. It took my breath away in parts: in a not-able-to-breathe-sort-of-way. Incredible performances all round: Amanda Abbington and John Light are brilliant,  you get a sense of what bound them together in marriage, their helplessness to keep their son safe and Abbington’s thwarted desire to have her family back together. Both are utterly captivating.   Laurie Kynaston’s take on Nicolas is equally powerful.  It is vulnerable and nuanced, conveying the nothingness as well as overwhelmingness of depression and suicidal pain. Amaka Okafor’s Sofia is excellent also, as the new partner who is struggling to connect with Nicolas and understand his emotional pain.

The staging is exquisite; the clean, sharp lines and white walls of the Parisian apartment help to illuminate the emotional turmoil of this teenage life which is metaphorically strewn across the stage.

After the play, fortuitiously we banged into the cast and I asked Amanda Abbington how the cast deal with the emotional intensity every night, and as she also repeated in a tweet later, they are aware of the sensitivity of its content and make a real point of looking after each other.

If you are in London soon, try to catch The Son which is showing in The Kiln until 6th April 2019. 


If you are affected by suicide or you are worried about someone, Samaritans is available 24/7 on 116 123 or via email jo@samaritans.org. 

More crisis information is available here


Rory O'Connor

Director, Suicidal Behaviour Research Lab

18th March 2019

New Blog: “We love data” - Using data to inform suicide and self-harm prevention, Royal Statistical Society, London

posted Feb 28, 2019, 5:40 AM by Karen Wetherall   [ updated Feb 28, 2019, 6:08 AM ]

By Cara Richardson (PhD Student in SBRL) 

As part of NatCen’s 50th anniversary celebrations, the Royal Statistical Society hosted “Using data to inform suicide and self-harm prevention” in London on Monday 25th February. The question of the day was “How do we ensure the right data are available, analysed and communicated to address the major questions in suicide and self-harm reduction policy and practice?”

The presentations covered a variety of research areas, datasets and methods of analysis. The day started with a welcome from the chair Prof Louise Arseneault (Kings) and an overview from Prof Louis Appleby (Manchester) on the use of data in Suicide Prevention Strategies and a welcome reminder that “Behind the data there is tragedy to individuals and loved ones”. Then Liz Scowcroft (Samaritans, @Liz_Samaritans) made the case for accessible data as “Suicide is everyone’s business”. Following this general population and cohort surveys were covered; with Sally McManus from NatCen, who did an excellent job of organising this meeting, detailing the various datasets that are available and how to access these. Patience is key, though, as accessing the Adult Psychiatric Morbidity Survey (APMS) 2014 can take up to one year! The process involved in accessing the APMS 2014 is summarised below: 
Prof Tamsin Ford (Exeter) explained the use of surveys to investigate self-harm in children with emotional, behavioural, and neurodevelopmental disorders and Dr Becky Mars (Bristol) praised the use of longitudinal data from the ALSPAC cohort in adolescents. Dr Ben Windsor-Shellard from ONS explained the process involved in registering suicide deaths and the possibilities for data linkage of ONS and census data to provide UK suicide mortality data for different ethnic groups or students. Prof David Gunnell (Bristol) detailed the advantages and challenges of using national suicide mortality statistics, then Prof Louis Appleby (Manchester) presented data from the National Confidential Inquiry into Suicide and Homicide including the 10 ways to improve patient safety (see below).

Next we heard from Dr Sarah Cassidy (Nottingham) who advocated for increasingly accessible routine clinical data for those with autism and autistic traits. After lunch, Prof Nav Kapur (Manchester) emphasised the importance of using hospital self-harm data as it can help researchers and clinicians determine what works, what doesn’t work and when to intervene in this population. Next up was Dr Karyn Ayre (Kings) who covered her research in the area of self-harm in the perinatal period. Dr Ayre’s work has been submitted for publication and we hope to hear more about this soon. Then Dr Chris Fitch (Bristol) explained their work collaborating with financial services to investigate experiences of debt collections agencies with clients who express suicidal thoughts or behaviours and how best to intervene with these individuals. His message was to “step outside of health and think about engaging with other sectors”.

Caroline Turley, Head of Qualitative Research at NatCen, presented her research on self-harm interventions for mid-life men. This research led to recommendations for what men would like from services: Ask Don’t Assume, Recovery Takes Time and Be Mindful of Language and Imagery in the Media. Prof Ann John (Swansea) explained the various “big data” projects she is involved in and the importance of and utility of such data linkage. She also provided an overview of some exciting developments including artificial intelligence, specifically artificial neural networks, with routine health data to aid identification of those at risk of suicide and self-harm.

Following this Dan Collinson from NHS Digital provided an overview of the datasets available in relation to mental health, suicide and self-harm, how to access these as well as the possibilities for data linkage. Finally Helen Garnham and Cam Lugton from Public Health England described the Fingertips tool which collates and presents a range of publicly available data including facets of suicide prevalence, associated risk factors and service contact among groups at increased risk. This provides planners, providers and stakeholders with a means to profile their area and benchmark against similar populations.

Overall, the conference was a great experience and left everyone feeling excited and motivated about the future of research in suicide and self-harm. The take home messages from Prof Louise Arseneault, summarised by The Mental Elf (@Mental_Elf) were:

Take home messages:

- "A refreshing meeting" 

- Let's make self-harm & suicide data ACCESSIBLE 

- Keywords: GDPR, need, voice, trends, big, profile, harmonisation, story, gap, challenges & love "we love data!" 

Now let’s start analysing! (After we receive the data that is)

@_CaraRichardson

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