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Suicide, the second leading cause of death among adolescents, requires an integrative approach to maximize the effectiveness of prevention efforts. The current study draws on the social-ecological model and its relevance to the ecosystem at Vocational Education and Training (VET) high schools in the context of suicide prevention. The study examined the school-related factors of school connectedness, academic self-efficacy and school autonomy support in relation to suicidal thoughts and behavior. Participants included 5688 students (mean age 15.58) drawn from 62 vocational high schools across Israel. Structural equation modeling revealed that school connectedness and academic self-efficacy exhibit negative links to suicide ideation and behavior; moreover, these links were partly mediated by depressive symptoms. School autonomy support was found to be positively linked to suicide ideation and suicide attempts. The paper discusses the results with respect to suicide prevention efforts in the unique context of adolescents attending vocational schools.

We examined the effectiveness of a mindfulness-based intervention (MBI) compared to a social-emotional empathy-based intervention (EBI), and a passive control group in promoting compassion among Jewish-Israeli kindergartners. Three middle-class public kindergartens were randomly assigned to the MBI (n = 26;Mage = 5.03), EBI (n = 24;Mage = 5.02), or control groups (n = 24;Mage = 5.16; Ngirls = 40). The interventions lasted 12-weeks. Pre- and post-intervention, children's cognitive compassion was assessed utilizing computerized continuous performance tasks for attention/impulsivity, and structured observations of attention to teacher and on-task behaviors; emotional compassion was measured with structured observations of prosociality, negative affect, social-emotional difficulties, and aggression; intentional and actual compassion was measured using a compassionate responding paradigm. Research Findings: Results showed that MBI participants decreased impulsivity and improved sustained attention, increased attentiveness to the teacher, and reduced social difficulties and aggression – these effects did not appear for either other group. Additionally, the MBI and EBI participants increased prosociality and compassionate behaviors more than the control group, however the magnitude of change from the MBI was significantly larger. The MBI increased cognitive, emotional, intentional, and behavioral skills and understanding that are essential components necessary to engage in compassion. Practice or Policy: MBIs can be effectively led by teachers and integrated into school curriculum to facilitate just and caring educational communities. [ABSTRACT FROM AUTHOR]

Peer victimization is a major stressor adolescents often face in the school environment, and has been linked to depression and suicidal risk. This study analyzed the associations between three behavioral coping strategies (avoidance, seeking social support from adults/peers, and retaliation) and depression and suicidal ideation. Participants included 4,254 victimized students who were part of the Saving and Empowering Young Lives in Europe (SEYLE) study that compared three school-based prevention interventions and collected information on health risk behaviors in adolescents from 11 European countries. Results showed behavioral avoidance to be associated with an increase in levels of depression, as compared to the other coping strategies (adult social support, peer social support, retaliation). Seeking social support from adults was associated with lower depression and suicidal ideation rates. A more than 25% increase in suicidal ideation was associated with behavioral avoidance, compared to seeking social support from adults. By contrast, retaliation to peer victimization was not found to be associated with increased depression or suicidal ideation. The findings support the Coping Deficit model and may suggest that abstaining by doing nothing when victimized can be associated with certain adverse emotional outcomes.

Background: This study compared Bedouin mothers of adolescents with developmental disabilities (DD) and Bedouin mothers of typically developing adolescents using measures of social support, depression, and somatisation. It further examined whether social support and raising a child with DD would predict maternal depression and somatisation beyond demographic variables. Methods: Ninety-five Bedouin mothers of adolescents with and without a DD filled out self-report questionnaires. Results: Bedouin mothers raising a child with DD reported more depression and somatisation symptoms and less social support than their counterparts. Social support was negatively correlated with depression among Bedouin mothers of typical children, but not among mothers raising a child with DD. Furthermore, raising a child with DD significantly contributed to the prediction of depression and somatisation among Bedouin mothers. Conclusions: The findings suggest that Bedouin mothers raising a child with DD are at risk of experiencing mental-health issues, specifically depression and somatisation symptoms.

Background: This study addresses the suicide risk predicting challenge by exploring the predictive ability of machine learning (ML) models integrated with theory‐driven psychological risk factors in real‐time crisis hotline chats. More importantly, we aimed to understand the specific theory‐driven factors contributing to the ML prediction of suicide risk. Method: The dataset consisted of 17,654 crisis hotline chat sessions classified dichotomously as suicidal or not. We created a suicide risk factors‐based lexicon (SRF), which encompasses language representations of key risk factors derived from the main suicide theories. The ML model (Suicide Risk‐Bert; SR‐BERT) was trained using natural language processing techniques incorporating the SRF lexicon. Results: The results showed that SR‐BERT outperformed the other models. Logistic regression analysis identified several theory‐driven risk factors significantly associated with suicide risk, the prominent ones were hopelessness, history of suicide, self‐harm, and thwarted belongingness. Limitations: The lexicon is limited in its ability to fully encompass all theoretical concepts related to suicide risk, nor to all the language expressions of each concept. The classification of chats was determined by trained but non‐professionals in metal health. Conclusion: This study highlights the potential of how ML models combined with theory‐driven knowledge can improve suicide risk prediction. Our study underscores the importance of hopelessness and thwarted belongingness in suicide risk and thus their role in suicide prevention and intervention. [ABSTRACT FROM AUTHOR]

Introduction: Mothers faced an increased risk of adverse mental health outcomes during the COVID-19 pandemic compared to other populations. However, there is little data on the factors that placed mothers at increased risk of distress. Aims: The present study explored a range of individual, familial, and environmental factors associated with psychological distress in mothers during the COVID-19 pandemic. Method: This repeated cross-sectional study was composed of a convenience sample of mothers who completed an online survey that included a demographic questionnaire, an emotion regulation questionnaire, and the Depression, Anxiety, and Stress scale. The survey was administered during the second and third lockdowns in Israel in 2020–2021. Results: The study included 575 mothers (M age = 39). The findings of a hierarchical regression indicated that individual-level factors, composed of age and emotion regulation tendencies predicted psychological distress. The family-level factors of household income and number of children in the family also predicted distress. In terms of environmental-level factors, COVID-19-related media consumption and school status (open or closed) were also significant predictors of psychological distress. Importantly, the results showed that the most important predictors of psychological distress in mothers during the COVID-19 outbreak were school closures, household income, and the use of adaptive and maladaptive emotion regulation strategies. Conclusions: The findings highlight the intersection of individual, familial, and environmental factors in mothers' mental health during crises. [ABSTRACT FROM AUTHOR]

Children in Sub-Saharan Africa are living under chronic adversity due to poverty, serious health issues, physical and sexual abuse, and armed conflicts. These highly stressful conditions have deleterious effects on their mental health and socio-emotional adjustment. Since many children lack adequate access to mental health care, culturally adapted school-based resiliency programs could provide a resource to scaffold their development and promote their mental health. This study evaluated the efficacy of a universal school-based intervention in enhancing the resiliency of Tanzanian primary school children and cultivating prosocial behaviors. A total of 183 students from grades 4 to 6 were randomly assigned to either the 16-session “ERSAE-Stress-Prosocial (ESPS)” structured intervention or to a Social Study curriculum (SS) active control group. The original ESPS program was adapted by Tanzanians mental health professionals who modified the program based on local idioms of distress and indigenous practices. Students' resilience was evaluated before, after and 8 months following the intervention by assessing social difficulties, hyperactivity, somatization, level of anxiety, prosocial behaviors and school functioning as well as academic achievements and disciplinary problems. There was significant improvement on all outcome measures for the ESPS group compared to the control group post-intervention and at the 8-month follow up. The ESPS intervention was equally effective on most measures for students experiencing different adversity levels. The results indicate that a culturally adapted universal school-based intervention can be effective in enhancing Tanzanian students' resiliency and promoting prosocial behaviors. Should these results be replicated and found enduring, the modified ESPS could be a valuable mental health-promoting intervention in other low-income countries. [ABSTRACT FROM AUTHOR]

Importance: Changes in suicide rates after a nationwide trauma may be different from changes in psychiatric symptoms or general distress after such events. However, very few studies have examined short-term suicide-related reactions after such an event., Objective: To evaluate the short-term outcome of the events in Israel on October 7, 2023, a large-scale terror attack and unfolding war, on changes in suicidality as reflected in percentages of suicide-related calls in relation to all calls to a national mental health first aid helpline, the Israeli Association for Emotional First Aid (ERAN)., Design, Setting and Participants: The data included all interactions via the various ERAN helpline services between January 1, 2022, and December 31, 2023., Exposures: The October 7, 2023, terror attack on Israel., Mean Outcomes and Measures: Changes in the numbers of overall calls and suicide-related calls to the ERAN helpline using an interrupted time-series analysis., Results: A total of 602 323 calls were received by the ERAN helpline. The number of calls reflecting psychological distress in the 3 months before October 7, 2023, was 67 555 compared with 89 445 calls in the 3 months after. Analysis indicated that overall calls increased significantly on October 7 (β = 2089.16; 95% CI, 1918.97-2259.35). In addition, the daily trajectory of all calls changed significantly after October 7 (β = -22.77; 95% CI, -33.37 to -12.16), such that there was a decrease in the number of calls per day (β = -11.34; SE = 1.213; t = -9.35; P < .001). The number of suicide-related calls in the 3 months before October 7 was 1887, whereas 1663 suicide-related calls were registered in the 3 months after. Analysis showed that there were no changes in the daily number of suicide-related calls from before October 7 (β = -0.001; 95% CI, -0.005 to 0.03) or on October 7 (β = -0.22; 95% CI, -3.69 to 3.25). Therefore, the percentage of suicide-related calls decreased significantly on October 7 (β = -1.42; 95% CI, -1.92 to -0.92) and gradually increased in the following period (β = 0.016; 95% CI, 0.006-0.026)., Conclusions and Relevance: The findings of this cohort study suggest that although short-term emotional distress increased after national trauma, the percentage of suicide-related calls decreased. These results support previous studies suggesting that suicidality is not one of the immediate reactions to such traumas.

Terror exposure has become commonplace in Israel, with civilians needing to develop appropriate coping mechanisms. This study investigated coping mechanisms of those who are able to return to leisure activity at sites of previous terror attacks. A specially designed questionnaire, exploring knowledge of the terror event, previous terror exposure, coping mechanisms, state of anxiety, and mood, was administered to 93 restaurant attendees at sites of well-known recent terror attacks (2001-2005). Most respondents were aware of the previous terror attack (92.3%) and most reported no fear at revisiting (70.3%), with 20.9% reporting some anxiety and 5.5% reporting moderate or severe anxiety. Sixty percent reported that they have no fear that a terror attack will reoccur at the same place. Some (27.7%) reported change in practices or decrease in one or more activity, especially use of public transport (18%). The most helpful reported resource for facilitating stress coping following a suicide bombing was to "call or be in touch with friends or relatives," and least helpful was "medicines." Over half of respondents (53%) reported that the current security climate affected their mood. Older individuals and females were more affected by terror events. Study observations confirm that resilience develops in the general population in response to ongoing terror attacks. Response to terror is heterogeneous with a range of coping mechanisms expressed.

Background: Analysis of the trends in psychiatric admissions and discharges is necessary to correctly plan and distribute resources, especially given the current international climate of "deinstitutionalization." Israel, too, is implementing "reform" in the national psychiatric system - to transfer psychiatric treatment from a hospital to a community setting., Objectives: To analyze admission and discharge patterns, explore trends in psychiatric hospital length of stay, and compare these characteristics between first-episode and chronic patients, between children, youth and adults, and between hospitals., Methods: All admissions and discharges from inpatient psychiatric wards between the years 2000 and 2004 were analyzed and characterized according to age, length of hospitalization, legal status, and nature of admitting institution (state hospital, health fund, general hospital)., Results: Mean length of stay in adults decreased during the 5 year study period, from 37.6 days in 2000 to 36.4 days in 2004. In years with higher admissions, hospital stay was shorter (P < 0.05). Length of stay in psychiatric wards in general hospitals was shorter than in state hospitals (P < 0.001). In contrast to adults and children, length of stay among adolescents showed a gradual increase (P < 0.05). Involuntary hospitalization comprised 25.3% of all admissions, and 16.8% of discharged patients were re-admitted within 30 days. A dramatic decrease (24.3%) in the number of chronic hospitalizations was noted., Conclusions: Various factors may account for these developments. Protracted hospitalizations may be reduced through changes in various aspects of treatment planning and psychiatric care continuum. The decrease in number of admissions, length of stay and number of chronically admitted patients remains in line with international practices. Particular attention needs to be devoted to planning and funding so that availability of community services matches reduction in psychiatric hospitalization.