In this blog for World Mental Health Day 2019, Jessica Hendon, the Managing Editor of Cochrane Common Mental Disorders Group (CCMD), highlights the group’s ongoing work to bring together the best evidence on suicide prevention and self-harm.

Every year on 10 October many organisations, including the World Health Organisation (WHO), recognise World Mental Health Day. The objective is to raise awareness of mental health issues around the world and mobilize efforts in support of mental health. This year’s theme, set by the World Federation for Mental Health, is suicide prevention.

What are we doing about suicide prevention?

Suicide prevention is a major priority area for Cochrane Common Mental Disorders (CCMD). Our Group publishes systematic reviews in the Cochrane Library that cover suicide prevention and we have a dedicated Suicide and Self-Harm Satellite led by Professor Ann John at Swansea University.

Suicide is the second leading cause of death among 15-29 year olds [1]. Over the next 12 months our Suicide and Self-Harm Satellite will be working in close partnership with our new Children & Young People Satellite based at the University of Auckland to identify new priority reviews and deliver an important series of both new and updated reviews that consider interventions for suicide prevention and self-harm in children and young people.

What Cochrane EvidenceCochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. already exists in this area?

Self-harm (intentional self-poisoning or self-injury) is common, often repeated, and strongly associated with suicide. We currently have three reviews published in the Cochrane Library, authored by Professor Keith Hawton (University of Oxford) and colleagues, that focus on interventions in children, young people and adults who self-harm:

• Psychosocial interventions for self‐harm in adults
• Pharmacological interventions for self‐harm in adults
• Interventions for self‐harm in children and adolescents

We are pleased to announce that later this year an update will begin on the review Interventions for self-harm in children and adolescents.

Other high priority reviews currently being prepared by our CCMD Suicide and Self-Harm Satellite will consider Means restriction for the prevention of suicide.

Our CCMD Children and Young People Satellite is also leading the development of a new high priority review on Prevention of suicide and self-harm in education settings. The team are working with young people to co-design the outcomesOutcomes are measures of health (for example quality of life, pain, blood sugar levels) that can be used to assess the effectiveness and safety of a treatment or other intervention (for example a drug, surgery, or exercise). In research, the outcomes considered most important are ‘primary outcomes’ and those considered less important are ‘secondary outcomes’. that this new review will focus on.

How will we provide leadership in this important area?

To deliver more high quality evidence to inform health decision making for suicide prevention, we need to work with the best researchers in the field. We are delighted to announce that Dr Katrina Witt will now be working in a new cross-cutting role for Cochrane Common Mental Disorders as a joint Senior Editor for both our Suicide and Self-Harm Satellite and Children & Young People Satellite. Kat will provide additional leadership focused on the delivery of our Young People’s Self-Harm and Suicide Prevention portfolio.

Kat is an outstanding early career researcher based at Orygen, the National Centre of Excellence in Youth Mental Health, Australia. Her researchThe term research means different things to different people, but is essentially about finding out new knowledge that could lead to changes to treatments, policies or care. focuses on the epidemiologyThe study of the health of populations and communities, rather than individuals. of self-harm and suicide in the pre-hospital setting, with a view to using these insights to transform the ways in which self-harm and suicidal behaviour are treated.

Her work is recognised internationally, and has led to the award of numerous prizes including, most recently, the Rod Rickards Fellowship from the Australian Academy of Science and the France-Australia Science Innovation Collaboration (FASIC) (2015). She was also a finalist in the Victorian Young Achiever’s Foundation (2017), and received a commendation award for her work from the BUPA Foundation Young Researcher of the Year Award (2017).

In September this year Kat was awarded the 2019 International AssociationA relationship between two characteristics, such that as one changes, the other changes in a predictable way. For example, statistics demonstrate that there is an association between smoking and lung cancer. In a positive association, one quantity increases as the other one increases (as with smoking and lung cancer). In a negative association, an increase in one quantity corresponds to a decrease in the other. Association does not necessarily mean that one thing causes the other. for Suicide Prevention Andrej Marušič Award dedicated to young researchers.

Follow Kat on twitter @Dr_KatrinaWitt

WHO video – Preventing suicide: World Mental Health Day 2019

 

References

[1] https://www.who.int/en/news-room/fact-sheets/detail/suicide (accessed before 8 October 2019) Key facts about suicide can be found on the WHO website

Cochrane Protocols & Reviews

• Hawton K, Witt  KG, Taylor Salisbury  TL, Arensman  E, Gunnell  D, Hazell  P, Townsend  E, van Heeringen  Pharmacological interventions for self‐harm in adults. Cochrane Database of Systematic ReviewsIn systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2015, Issue 7. Art. No.: CD011777. DOI: 10.1002/14651858.CD011777.
• Hawton K, Witt  KG, Taylor Salisbury  TL, Arensman  E, Gunnell  D, Hazell  P, Townsend  E, van Heeringen  Psychosocial interventions for self‐harm in adults. Cochrane Database of Systematic ReviewsIn systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2016, Issue 5. Art. No.: CD012189. DOI: 10.1002/14651858.CD012189.
• Hawton K, Witt  KG, Taylor Salisbury  TL, Arensman  E, Gunnell  D, Townsend  E, van Heeringen  K, Hazell  Interventions for self‐harm in children and adolescents. Cochrane Database of Systematic ReviewsIn systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2015, Issue 12. Art. No.: CD012013. DOI: 10.1002/14651858.CD012013.
• John A, Hawton  K, Okolie  C, Dennis  M, Price  SF, Lloyd  Means restriction for the prevention of suicide: generic protocol. Cochrane Database of Systematic ReviewsIn systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. 2018, Issue 4. Art. No.: CD012995. DOI: 10.1002/14651858.CD012995.