83 results on '"Too, LS"'
Search Results
2. Cost-effectiveness of Installing Barriers at Bridge and Cliff Sites for Suicide Prevention in Australia
- Author
-
Bandara, P, Pirkis, J, Clapperton, A, Shin, S, Too, LS, Reifels, L, Onie, S, Page, A, Andriessen, K, Krysinska, K, Flego, A, Schlichthorst, M, Spittal, MJ, Mihalopoulos, Cathy, Le, LKD, Bandara, P, Pirkis, J, Clapperton, A, Shin, S, Too, LS, Reifels, L, Onie, S, Page, A, Andriessen, K, Krysinska, K, Flego, A, Schlichthorst, M, Spittal, MJ, Mihalopoulos, Cathy, and Le, LKD
- Published
- 2022
3. A Pilot Case-Control Study of the Social Media Activity Following Cluster and Non-Cluster Suicides in Australia
- Author
-
Law, PCF, Too, LS, Hill, NTM, Robinson, J, Gould, M, Occhipinti, J-A, Spittal, MJ, Witt, K, Sinyor, M, Till, B, Osgood, N, Prodan, A, Zahan, R, Pirkis, J, Law, PCF, Too, LS, Hill, NTM, Robinson, J, Gould, M, Occhipinti, J-A, Spittal, MJ, Witt, K, Sinyor, M, Till, B, Osgood, N, Prodan, A, Zahan, R, and Pirkis, J
- Abstract
Social media may play a role in the "contagion" mechanism thought to underpin suicide clusters. Our pilot case-control study presented a novel methodological approach to examining whether Facebook activity following cluster and non-cluster suicides differed. We used a scan statistic to identify suicide cluster cases occurring in spatiotemporal clusters and matched each case to 10 non-cluster control suicides. We identified the Facebook accounts of 3/48 cluster cases and 20/480 non-cluster controls and their respective friends-lists and retrieved 48 posthumous posts and replies (text segments) referring to the deceased for the former and 606 for the latter. We examined text segments for "putatively harmful" and "putatively protective" content (e.g., discussion of the suicide method vs. messages discouraging suicidal acts). We also used concept mapping, word-emotion association, and sentiment analysis and gauged user reactions to posts using the reactions-to-posts ratio. We found no "putatively harmful" or "putatively protective" content following any suicides. However, "family" and "son" concepts were more common for cluster cases and "xx", "sorry" and "loss" concepts were more common for non-cluster controls, and there were twice as many surprise- and disgust-associated words for cluster cases. Posts pertaining to non-cluster controls were four times as receptive as those about cluster cases. We hope that the approach we have presented may help to guide future research to explain suicide clusters and social-media contagion.
- Published
- 2022
4. Quantitative Methods to Detect Suicide and Self-Harm Clusters: A Systematic Review.
- Author
-
Benson, R, Rigby, J, Brunsdon, C, Cully, G, Too, LS, Arensman, E, Benson, R, Rigby, J, Brunsdon, C, Cully, G, Too, LS, and Arensman, E
- Abstract
Suicide and self-harm clusters exist in various forms, including point, mass, and echo clusters. The early identification of clusters is important to mitigate contagion and allocate timely interventions. A systematic review was conducted to synthesize existing evidence of quantitative analyses of suicide and self-harm clusters. Electronic databases including Medline, Embase, Web of Science, and Scopus were searched from date of inception to December 2020 for studies that statistically analyzed the presence of suicide or self-harm clusters. Extracted data were narratively synthesized due to heterogeneity among the statistical methods applied. Of 7268 identified studies, 79 were eligible for narrative synthesis. Most studies quantitatively verified the presence of suicide and self-harm clusters based on the scale of the data and type of cluster. A Poisson-based scan statistical model was found to be effective in accurately detecting point and echo clusters. Mass clusters are typically detected by a time-series regression model, although limitations exist. Recently, the statistical analysis of suicide and self-harm clusters has progressed due to advances in quantitative methods and geospatial analytical techniques, most notably spatial scanning software. The application of such techniques to real-time surveillance data could effectively detect emerging clusters and provide timely intervention.
- Published
- 2022
5. What works in community-led suicide prevention: Perspectives of wesley lifeforce network coordinators
- Author
-
Reifels, L, Morgan, A, Too, LS, Schlichthorst, M, Williamson, M, Jordan, H, Reifels, L, Morgan, A, Too, LS, Schlichthorst, M, Williamson, M, and Jordan, H
- Abstract
Community coalitions have been recognised as an important vehicle to advance health promotion and address relevant local health issues in communities, yet little is known about their effectiveness in the field of suicide prevention. The Wesley Lifeforce Suicide Prevention Networks program consists of a national cohort of local community-led suicide prevention networks. This study drew on a nationally representative survey and the perspectives of coordinators of these networks to identify the key factors underpinning positive perceived network member and community outcomes. Survey data were analysed through descriptive statistics and linear regression analyses. Networks typically reported better outcomes for network members and communities if they had been in existence for longer, had a focus on the general community, and had conducted more network meetings and internal processes, as well as specific community-focused activities. Study findings strengthen the evidence base for effective network operations and lend further support to the merit of community coalitions in the field of suicide prevention, with implications for similar initiatives, policymakers, and wider sector stakeholders seeking to address suicide prevention issues at a local community level.
- Published
- 2021
6. Workplace bullying and suicidal ideation: Findings from an australian longitudinal cohort study of mid-aged workers
- Author
-
Leach, LS, Too, LS, Batterham, PJ, Kiely, KM, Christensen, H, Butterworth, P, Leach, LS, Too, LS, Batterham, PJ, Kiely, KM, Christensen, H, and Butterworth, P
- Abstract
Workplace bullying adversely affects mental health, yet little is known about the outcomes for suicidal ideation. The current study used Australian population-based data to investigate the association between workplace bullying and suicidal ideation. The sample included 1488 employed participants aged 52–58 from wave 4 of the Personality and Total Health (PATH) Through Life Study. Workplace bullying was measured in two ways: (a) a single item asked about experiences of bullying ‘currently’, ‘previously in the current workplace’ and ‘in a past workplace’, and (b) 15 items asked about bullying behaviours experienced in the past 6 months. Suicidal ideation was measured using items from the Psychiatric Symptom Frequency Scale (PSF) and the Patient Health Questionnaire-9 (PHQ-9). Psychosocial job quality, both current and prior, was adjusted for. Current and past experiences of workplace bullying were associated with increased risk of suicidal ideation. Current experiences were no longer associated after adjusting for concurrent indicators of psychosocial job stress, although a tendency for increased ideation remained. Reported prior experience of workplace bullying in a past workplace remained associated with higher odds of suicidal ideation after adjusting for prior psychosocial job stressors and excluding individuals with prior suicidal ideation. Being bullied at work is associated with increased risk of suicidal thoughts, although this occurs within the broader influence of other psychologically stressful employment conditions.
- Published
- 2020
7. Suicide Clusters Among Top 10 High-Risk Occupations A Study From 2001 to 2016 in Australia
- Author
-
Too, LS, Spittal, MJ, Too, LS, and Spittal, MJ
- Abstract
A number of studies have demonstrated elevated risk of suicide in certain occupational groups. We seek to understand a possible new risk factor: suicide contagion, as demonstrated through a suicide cluster analysis. National-level coronial data and census population data were used for the study. We calculated suicide rates to identify "risky" occupations. SaTScan v9.4.1 was used to perform Poisson discrete scan statistic. Suicides occurring in arts and media professionals, construction, manufacturing, and skilled animal and horticultural workers seemed to cluster in time and/or space. Those working in construction settings were at risk of being in both time and space clusters.
- Published
- 2020
8. Understanding the characteristics and mechanisms underlying suicide clusters in Australian youth: a comparison of cluster detection methods
- Author
-
Hill, NTM, Too, LS, Spittal, MJ, Robinson, J, Hill, NTM, Too, LS, Spittal, MJ, and Robinson, J
- Abstract
AIMS: There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide clusters among each method, (2) compare the spatial and temporal parameters associated with different suicide clusters and (3) identify the demographic characteristics and rates of exposure to suicide among cluster and non-cluster members. METHODS: Suicide data were obtained from the National Coronial Information System. N = 3027 Australians, aged 10-24 who died by suicide in 2006-2015 were included. Suicide clusters were determined using: (1) poisson scan statistics, (2) a systematic search of coronial inquests and (3) descriptive network analysis. These methods were chosen to operationalise three different definitions of suicide clusters, namely clusters that are: (1) statistically significant, (2) perceived to be significant and (3) characterised by social links among three or more suicide descendants. For each method, the demographic characteristics and rates of exposure to suicide were identified, in addition to the maximum duration of suicide clusters, the geospatial overlap between suicide clusters, and the overlap of individual cluster members. RESULTS: Eight suicide clusters (69 suicides) were identified from the scan statistic, seven (40 suicides) from coronial inquests; and 11 (37 suicides) from the descriptive network analysis. Of the eight clusters detected using the scan statistic, two overlapped with clusters detected using the descriptive network analysis and one with clusters identified from coronial inquests. Of the seven clusters from coronial inquests, four overlapped with clusters from the descriptive network analysis and one with clusters from the scan sta
- Published
- 2020
9. Wesley LifeForce Suicide Prevention Networks Evaluation: Draft Report
- Author
-
Reifels, L, Williamson, M, Schlichthorst, M, Too, LS, Morgan, A, Roberts, R, Mercer, P, Munkara-Murray, K, Jordan, H, Reifels, L, Williamson, M, Schlichthorst, M, Too, LS, Morgan, A, Roberts, R, Mercer, P, Munkara-Murray, K, and Jordan, H
- Published
- 2020
10. Mental Health Problems and Internet Access: Results From an Australian National Household Survey
- Author
-
Too, LS, Leach, L, Butterworth, P, Too, LS, Leach, L, and Butterworth, P
- Abstract
Background: Mental health support and interventions are increasingly delivered on the web, and stepped care systems of mental health services are embracing the notion of a digital gateway through which individuals can have access to information, assessment, and services and can be connected with more intensive services if needed. Although concerns have been raised over whether people with mental health problems are disadvantaged in terms of their access to the internet, there is a lack of representative data on this topic. Objective: This study aimed to examine the relationship between mental health and internet access, particularly lack of access because of affordability issues. Methods: Data from wave 14 of the Household, Income, and Labour Dynamics in Australia survey were used (n=15,596) in the analyses. Sample weights available in the survey were used to calculate the proportion of those with or without internet access for those with and without mental health problems and more severe long-term mental health conditions. These proportions were also calculated for those with and without internet access due, specifically, to affordability issues. Multinomial logistic regression analyses assessed the relationship between mental health status and internet access/affordability issues, adjusting for a range of covariates. Results: Access to the internet was poorer for those with mental health problems (87.8%) than those without mental health problems (92.2%), and the difference was greater when a measure of more severe mental health conditions was used (81.3% vs 92.2%). The regression models showed that even after adjusting for a broad range of covariates, people with mental ill health were significantly more likely to have no internet access because of unaffordability than those without mental ill health (mental health problems: relative risk ratio [RRR] 1.68; 95% CI 1.11-2.53 and severe mental health conditions: RRR 1.92; 95% CI 1.16-3.19). Conclusions: As Australia
- Published
- 2020
11. Psychosocial job characteristics and mental health: Do associations differ by migrant status in an Australian working population sample?
- Author
-
Unger, D, Liu, X, Bowe, SJ, Li, L, Too, LS, LaMontagne, AD, Unger, D, Liu, X, Bowe, SJ, Li, L, Too, LS, and LaMontagne, AD
- Abstract
Migrant workers may experience higher burdens of occupational injury and illness compared to native-born workers, which may be due to the differential exposure to occupational hazards, differential vulnerability to exposure-associated health impacts, or both. This study aims to assess if the relationships between psychosocial job characteristics and mental health vary by migrant status in Australia (differential vulnerability). A total of 8969 persons from wave 14 (2014-2015) of the Household Income and Labour Dynamics in Australia Survey were included in the analysis. Psychosocial job characteristics included skill discretion, decision authority and job insecurity. Mental health was assessed via a Mental Health Inventory-5 score (MHI-5), with a higher score indicating better mental health. Migrant status was defined by (i) country of birth (COB), (ii) the combination of COB and English/Non-English dominant language of COB and (iii) the combination of COB and years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age and educational attainment. Migrant status was analysed as an effect modifier of the relationships between psychosocial job characteristics and mental health. Skill discretion and decision authority were positively associated with the MHI-5 score while job insecurity was negatively associated with the MHI-5 score. We found no statistical evidence of migrant status acting as an effect modifier of the psychosocial job characteristic-MHI-5 relationships. With respect to psychosocial job characteristic-mental health relationships, these results suggest that differential exposure to job stressors is a more important mechanism than differential vulnerability for generating occupational health inequities between migrants and native-born workers in Australia.
- Published
- 2020
12. Calls to helplines in Australia following media reports of Robin Williams' suicide
- Author
-
Pirkis, J, Currier, D, Too, LS, Bryant, M, Bartlett, S, Sinyor, M, Spittal, MJ, Pirkis, J, Currier, D, Too, LS, Bryant, M, Bartlett, S, Sinyor, M, and Spittal, MJ
- Abstract
OBJECTIVE: In the United States, there was an increase in calls to helplines following media reporting of Robin Williams' suicide. We aimed to determine whether this was the case in Australia. METHOD: The helpline services Lifeline and Beyond Blue provided us with weekly data on calls received for 2013-2015. We conducted interrupted time series regression analyses to determine whether there was an increase in the average weekly number of calls received by each helpline in two periods after the story about Williams' suicide broke (1 week and 4 weeks). RESULTS: We found strong evidence of an increase in calls to Lifeline (incidence rate ratio [IRR] =1.13; 95% confidence interval [CI] =1.02-1.25; p = 0.016) and Beyond Blue (IRR = 1.32; 95% CI = 1.09-1.59; p = 0.004) in the week after Williams' suicide was first reported. We found no evidence of higher than normal call volumes for Lifeline (IRR = 1.04; 95% CI = 0.99-1.10; p = 0.104) or Beyond Blue (IRR = 1.10; 95% CI = 1.00-1.22; p = 0.058) over the four weeks following Williams' death, however, suggesting that calls leveled out over this period. CONCLUSION: Suicide prevention experts and media professionals must work together to minimize the negative impacts of reports on suicide and maximize their positive ones. In cases where the story is likely to receive extensive international coverage, it may be important for local media to encourage help-seeking.
- Published
- 2020
13. Community suicide prevention networks: A literature scoping review
- Author
-
Williamson, M, Schlichthorst, M, Jordan, H, Too, LS, Pirkis, J, Reifels, L, Williamson, M, Schlichthorst, M, Jordan, H, Too, LS, Pirkis, J, and Reifels, L
- Abstract
Suicide is a significant concern for the Australian population, claiming the lives of 3128 men and women in 2017. Wesley Mission, through its Wesley LifeForce Suicide Prevention Networks program (Wesley LifeForce program) has been working with the community to support the development of local community suicide prevention networks since 2007. Wesley Mission defines a network as ‘A union of people and organisations, working together to change the outcome relating to a specific problem.’ Networks are further described as being community based and as being ‘for the people, by the people’. In this report, we refer to this notion as ‘community led’. While the aims and objectives of each network vary, reflecting the unique identity of each community, there is a common thread: a focus on interagency cooperation and raising community awareness. Wesley LifeForce network functions typically include activities that seek to: • identify and bring together community participants with an interest or responsibility in suicide prevention, mental health issues and/or mental health promotion • facilitate the exchange of information • co-ordinate suicide prevention activities to maximise impact • encourage sharing of skills and learning • raise community awareness of suicide risk and protective factors and help create pathways
- Published
- 2019
14. Job Insecurity: A Comparative Analysis between Migrant and Native Workers in Australia
- Author
-
Liu, X, Bowe, SJ, Milner, A, Li, L, Too, LS, LaMontagne, AD, Liu, X, Bowe, SJ, Milner, A, Li, L, Too, LS, and LaMontagne, AD
- Abstract
Job insecurity is a modifiable risk factor for poor health outcomes, and exposure to job insecurity varies by population groups. This study assessed if job insecurity exposure varied by migrant status and if the differences varied by gender, age, educational attainment, and occupational skill level. Data were from wave 14 of the Household Income and Labour Dynamics in Australia Survey. The outcome was job insecurity. Exposure was migrant status defined by (1) the country of birth (COB), (2) the dominant language of the COB, and (3) the number of years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age, educational attainment, and occupational skill level. These covariates were also analysed as effect modifiers for the migrant status-job insecurity relationships. Migrant workers, especially those from non-English speaking countries (non-ESC-born), experienced higher job insecurity than Australia-born workers; however, these disparities disappeared after 11+ years post-arrival. The migrant status-job insecurity relationships were modified by educational attainment. Unexpectedly, the disparities in job insecurity between non-ESC-born migrants and Australia-born workers increased with increasing educational attainment, and for those most highly educated, the disparities persisted beyond 11 years post-arrival. Our findings suggested that continuing language skill support and discrimination prevention could facilitate migrant integration into the Australian labour market.
- Published
- 2019
15. The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies
- Author
-
Too, LS, Spittal, MJ, Bugeja, L, Reifels, L, Butterworth, P, Pirkis, J, Too, LS, Spittal, MJ, Bugeja, L, Reifels, L, Butterworth, P, and Pirkis, J
- Abstract
Background: There has long been debate about the extent to which mental disorders contribute to suicide. We aimed to examine the evidence on the contribution of mental disorders to suicide among record linkage studies. Methods: We performed a systematic search using eight major health databases for English-language studies published between 1 January 2000 and 11 June 2018 that linked collected data on mental disorders and suicide. We then conducted a meta-analysis to assess risk of suicide conferred by mental disorders. Results: Our search identified 20 articles representing 13 unique studies. The pooled rate ratio (RR) was 13.2 (95% CI 8.6–20.3) for psychotic disorders, 12.3 (95% CI 8.9–17.1) for mood disorders, 8.1 (95% CI 4.6–14.2) for personality disorders, 4.4 (95% CI 2.9–6.8) for substance use disorders, and 4.1 (95% CI 2.4–6.9) for anxiety disorders in the general population. The overall pooled RR for these mental disorders was 7.5 (95% CI 6.6–8.6). The population attributable risk of mental disorders was up to 21%. Limitations: The overall heterogeneity between studies was very high. Conclusions: Our findings underline the important role of mental disorders in suicide. This suggests that ongoing efforts are required to improve access to and quality of mental health care to prevent suicide by people with mental disorders.
- Published
- 2019
16. The Impact of the 'Pause. Call. Be Heard' Campaign on Help-Seeking and Suicidal Behaviors Within Rail Environment in Victoria, Australia
- Author
-
Too, LS, Ross, A, Pirkis, J, Reavley, N, Reifels, L, Too, LS, Ross, A, Pirkis, J, Reavley, N, and Reifels, L
- Abstract
OBJECTIVE: To assess the impact of the "Pause. Call. Be Heard" campaign on help-seeking and suicidal behaviors within rail environment in Victoria, Australia. METHODS: An anonymous online survey was conducted to measure noticeability of and engagement with the campaign and help-seeking intentions and behaviors among rail commuters at 10 rail stations. We generated descriptive statistics to report these data and used logistic regression models to examine the association between campaign-related factors and help-seeking. Changes in Lifeline crisis calls and rail suicide behaviors from precampaign to campaign periods were examined using proportion tests. RESULTS: About 25% of rail commuters noticed the campaign and rated the materials as "moderately noticeable." Over half of these individuals correctly identified the campaign intentions and 75% engaged with the materials. Approximately 80% indicated that the materials increased their help-seeking intentions and about half indicated that they had engaged with help-seeking and/or self-caring behaviors. Engaging with the campaign was positively associated with help-seeking. A significant increase in crisis calls but not in suicide-related calls, and a nonsignificant decrease in rail suicidal behaviors were found during the campaign period. CONCLUSIONS: Continued implementation of the campaign is warranted as it showed some desirable effects on help-seeking among rail commuters.
- Published
- 2019
17. Evaluation of the Lifeline “Pause, Call, Be Heard” Campaign: Interim Survey Report
- Author
-
Too, LS, Reifels, L, Ross, A, Reavley, N, Pirkis, J, Too, LS, Reifels, L, Ross, A, Reavley, N, and Pirkis, J
- Published
- 2018
18. Cluster Suicides Among Unemployed Persons in Australia Over the Period 2001-2013
- Author
-
Milner, A, Too, LS, Spittal, MJ, Milner, A, Too, LS, and Spittal, MJ
- Published
- 2018
19. Complaints about dental practitioners: an analysis of 6 years of complaints about dentists, dental prosthetists, oral health therapists, dental therapists and dental hygienists in Australia
- Author
-
Thomas, LA, Tibble, H, Too, LS, Hopcraft, MS, Bismark, MM, Thomas, LA, Tibble, H, Too, LS, Hopcraft, MS, and Bismark, MM
- Abstract
BACKGROUND: Previous research has found dental practitioners at elevated risk of complaint compared with other health professions. This study aimed to describe the frequency, nature and risk factors for complaints involving dental practitioners. METHODS: We assembled a national dataset of complaints about registered health practitioners in Australia between January 2011 and December 2016. We classified complaints into 23 issues across three domains: health, performance and conduct. We compared rates of complaints about dental practitioners and other health practitioners. We used negative binomial regression analysis to identify factors associated with complaints. RESULTS: Dental practitioners made up 3.5% of health practitioners, yet accounted for approximately 10% of complaints. Dental practitioners had the highest rate of complaints among fourteen health professions (42.7 per 1000 practitioners per year) with higher rates among dentists and dental prosthetists than allied dental practitioners. Male practitioners were at a higher risk of complaints. Most complaints about dentists related to treatments and procedures (59%). Around 4% of dentists received more than one complaint, accounting for 49% of complaints about dentists. In 60% of closed cases no regulatory action was required. Around 13% of complaints resulted in restrictive actions, such as conditions on practice. CONCLUSION: Improved understanding of patterns may assist regulatory boards and professional associations to ensure competent practice and protect patient safety.
- Published
- 2018
20. Interventions to reduce stigma towards people with severe mental illness: Systematic review and meta-analysis
- Author
-
Morgan, AJ, Reavley, NJ, Ross, A, Too, LS, Jorm, AF, Morgan, AJ, Reavley, NJ, Ross, A, Too, LS, and Jorm, AF
- Abstract
This review evaluates the evidence on what interventions are effective in reducing public stigma towards people with severe mental illness, defined as schizophrenia, psychosis or bipolar disorder. We included 62 randomised controlled trials of contact interventions, educational interventions, mixed contact and education, family psychoeducation programs, and hallucination simulations. Contact interventions led to small-to-medium reductions in stigmatising attitudes (d = 0.39, 95% CI: 0.22 to 0.55) and desire for social distance (d = 0.59, 95% CI: 0.37 to 0.80) post-intervention, but these were reduced after adjusting for publication bias (d = 0.24 and d = 0.40, respectively). Effects did not vary by type or length of contact. Effects at follow-up were smaller and not significant. Education interventions led to small-to-medium reductions in stigmatising attitudes (d = 0.30, 95% CI: 0.14 to 0.47) and desire for social distance (d = 0.27, 95% CI: 0.08 to 0.46) post-intervention. Small improvements in social distance persisted up to 6 months later (d = 0.27, 95% CI: 0.05 to 0.49), but not attitudes (d = 0.03, 95% CI: -0.12 to 0.18). The combination of contact and education showed similar effects to those that presented either intervention alone, and head-to-head comparisons did not show a clear advantage for either kind of intervention. Family psychoeducation programs showed reductions in stigma post-intervention (d = 0.41, 95% CI: 0.11 to 0.70). The effectiveness of hallucination simulations was mixed. In conclusion, contact interventions and educational interventions have small-to-medium immediate effects upon stigma, but further research is required to investigate how to sustain benefits in the longer-term, and to understand the active ingredients of interventions to maximise their effectiveness.
- Published
- 2018
21. Complaints about dental practitioners: an analysis of 6 years of complaints about dentists, dental prosthetists, oral health therapists, dental therapists and dental hygienists in Australia
- Author
-
Thomas, LA, primary, Tibble, H, additional, Too, LS, additional, Hopcraft, MS, additional, and Bismark, MM, additional
- Published
- 2018
- Full Text
- View/download PDF
22. Railway suicide clusters: how common are they and what predicts them?
- Author
-
Too, LS, Pirkis, J, Milner, A, Bugeja, L, Spittal, MJ, Too, LS, Pirkis, J, Milner, A, Bugeja, L, and Spittal, MJ
- Abstract
BACKGROUND: A growing number of studies have sought to detect clusters of all suicides, but few have sought to identify clusters of method-specific suicides. METHODS: Data on railway suicides occurring in Victoria, Australia, between 2001 and 2012 were obtained from the National Coronial Information System. We used the Poisson discrete scan statistic to identify railway suicides that occurred close together in space and/or time. We then used a case-control design to compare clustered railway suicides with non-clustered railway suicides on a range of individual and neighbourhood factors. RESULTS: We detected four spatial clusters that accounted for 35% of all railway suicides. Railway suicides by individuals who were hospitalised for mental illness had nearly double the odds of being in a cluster compared with those individuals who had never been hospitalised (OR 1.80, 95% CI 1.02 to 3.18). Higher frequency train services were associated with increased odds of being in a cluster (OR 1.11, 95% CI 1.03 to 1.19). No other predictors were associated with being in a cluster. CONCLUSIONS: Railway suicides that occur in clusters warrant particular attention because of the ripple effect they can have for communities and the risk that they may lead to copycat acts. Railway suicide prevention strategies should consider the fact that these suicides can occur in clusters, particularly among individuals who had previous hospitalisations for mental illness or live in areas with high-frequency train services.
- Published
- 2017
23. Clusters of suicides and suicide attempts: detection, proximity and correlates
- Author
-
Too, LS, Pirkis, J, Milner, A, Spittal, MJ, Too, LS, Pirkis, J, Milner, A, and Spittal, MJ
- Abstract
BACKGROUND: A suicide cluster is defined as a higher number of observed cases occurring in space and/or time than would typically be expected. Previous research has largely focused on identifying clusters of suicides, while there has been comparatively limited research on clusters of suicide attempts. We sought to identify clusters of both types of behaviour, and having done that, identify the factors that distinguish suicide attempts inside a cluster from those that were outside a cluster. METHODS: We used data from Western Australia from 2000 to 2011. We defined suicide attempts as admissions to hospital for deliberate self-harm and suicides as deaths due to deliberate self-harm. Using an analytic strategy that accounted for the repetition of attempted suicide within a cluster, we performed spatial-temporal analysis using Poisson discrete scan statistics to detect clusters of suicide attempts and clusters of suicides. Logistic regression was then used to compare clustered attempts with non-clustered attempts to identify risk factors for an attempt being in a cluster. RESULTS: We detected 350 (1%) suicide attempts occurring within seven spatial-temporal clusters and 12 (0.6%) suicides occurring within two spatial-temporal clusters. Both of the suicide clusters were located within a larger but later suicide attempt cluster. In multivariate analysis, suicide attempts by individuals who lived in areas of low socioeconomic status had higher odds of being in a cluster than those living in areas of high socioeconomic status [odds ratio (OR) = 29.1, 95% confidence interval (CI) = 6.3-135.5]. A one percentage-point increase in the proportion of people who had changed address in the last year was associated with a 60% increase in the odds of the attempt being within a cluster (OR = 1.60, 95% CI = 1.29-1.98) and a one percentage-point increase in the proportion of Indigenous people in the area was associated with a 7% increase in the suicide being within a cluster (OR = 1.07
- Published
- 2017
24. Predictors of using trains as a suicide method: Findings from Victoria, Australia
- Author
-
Too, LS, Bugeja, L, Milner, A, McClure, R, Spittal, MJ, Too, LS, Bugeja, L, Milner, A, McClure, R, and Spittal, MJ
- Abstract
This study aimed to investigate the factors associated with the choice of trains over other means of suicide. We performed a case-control study using data on all suicides in Victoria, Australia between 2009 and 2012. Cases were those who died by rail suicide and controls were those who died by suicide by any other means. A logistic regression model was used to estimate the association between the choice of trains and a range of individual-level and neighbourhood-level factors. Individuals who were never married had double odds of using trains compared to individuals who were married. Those from areas with a higher proportion of people who travel to work by train also had greater odds of dying by railway suicide compared to those from areas with a relatively lower proportion of people who travel to work by train. Prevention efforts should consider limiting access to the railways and other evidence-based suicide prevention activities.
- Published
- 2017
25. A suicide research agenda for people from immigrant and refugee backgrounds
- Author
-
Colucci, E, Too, LS, Minas, H, Colucci, E, Too, LS, and Minas, H
- Abstract
The aim of this study was to establish mental health and suicide research priorities for people from immigrant and refugee background in Australia. This article focuses on the data relevant to the development of the suicide research agenda. This study was conducted using Delphi consensus method with two rounds of online questionnaires. A total of 138 and 86 participants, respectively, completed the first and second rounds of survey. Participants were policy makers, service providers, academics, service users, and carer advocates in Australia with expertise in mental health and/or suicide among people from immigrant and refugee backgrounds. Of the total 268 research questions included in the questionnaires, 70 questions about suicide were ranked as essential by over 50% respondents (i.e., the set level of consensus). In particular, research questions regarded as the greatest priority related to access and engagement with suicide prevention services, suicide protective and risk factors compared to populations not from immigrant and refugee backgrounds, and culturally appropriate assessment of suicide risk.
- Published
- 2017
26. Individual and community factors for railway suicide: a matched case-control study in Victoria, Australia
- Author
-
Too, LS, Spittal, MJ, Bugeja, L, McClure, R, Milner, A, Too, LS, Spittal, MJ, Bugeja, L, McClure, R, and Milner, A
- Abstract
PURPOSE: This study aims to simultaneously examine individual- and community-level factors associated with railway suicide. METHODS: We performed a case-control study in Victoria, Australia between 2001 and 2012. Data on cases of railway suicide were obtained from the National Coronial Information System (a database of coronial investigations). Controls were living individuals randomly selected from the Household, Income and Labour Dynamics in Australia study, matching to cases on age groups, sex and year of exposures. A conditional logistic regression model was used to assess the individual-level and community-level influences on individual odds of railway suicide, controlling for socioeconomic status. RESULTS: Individual-level diagnosed mental illness increased railway suicide odds by six times [95 % confidence interval (CI) 4.5, 9.2]. Community-level factors such as living in an area with a presence of railway tracks [odds ratio (OR) 1.8, 95 % CI 1.2, 2.8], within a city (OR 3.2, 95 % CI 1.9, 5.4), and with a higher overall suicide rate (OR 1.02, 95 % CI 1.01, 1.04) were independently associated with greater individual odds of railway suicide compared to living in an area without a presence of railway tracks, outside a city, and with a relatively lower overall suicide rate. CONCLUSIONS: The effects of mental illness and high incidence of overall suicides are prominent, but not specific on railway suicide. The effects of presence of railway tracks and city residence suggest the importance of accessibility to the railways for individual risk of railway suicide. Prevention efforts should focus on vulnerable people live in areas with easy access to the railways.
- Published
- 2016
27. Spatial suicide clusters in Australia between 2010 and 2012: a comparison of cluster and non-cluster among young people and adults
- Author
-
Robinson, J, Too, LS, Pirkis, J, Spittal, MJ, Robinson, J, Too, LS, Pirkis, J, and Spittal, MJ
- Abstract
BACKGROUND: A suicide cluster has been defined as a group of suicides that occur closer together in time and space than would normally be expected. We aimed to examine the extent to which suicide clusters exist among young people and adults in Australia and to determine whether differences exist between cluster and non-cluster suicides. METHODS: Suicide data were obtained from the National Coronial Information System for the period 2010 and 2012. Data on date of death, postcode, age at the time of death, sex, suicide method, ICD-10 code for cause of death, marital status, employment status, and aboriginality were retrieved. We examined the presence of spatial clusters separately for youth suicides and adult suicides using the Scan statistic. Pearson's chi-square was used to compare the characteristics of cluster suicides with non-cluster suicides. RESULTS: We identified 12 spatial clusters between 2010 and 2012. Five occurred among young people (n = 53, representing 5.6% [53/940] of youth suicides) and seven occurred among adults (n = 137, representing 2.3% [137/5939] of adult suicides). Clusters ranged in size from three to 21 for youth and from three to 31 for adults. When compared to adults, suicides by young people were significantly more likely to occur as part of a cluster (difference = 3.3%, 95% confidence interval [CI] = 1.8 to 4.8, p < 0.0001). Suicides by people with an Indigenous background were also significantly more likely to occur in a cluster than suicide by non-Indigenous people and this was the case among both young people and adults. CONCLUSIONS: Suicide clusters have a significant negative impact on the communities in which they occur. As a result it is important to find effective ways of managing and containing suicide clusters. To date there is limited evidence for the effectiveness of those strategies typically employed, in particular in Indigenous settings, and developing this evidence base needs to be a future priority. Future research that
- Published
- 2016
28. Community beliefs about intentional injury and responsibility for prevention.
- Author
-
Too, LS, Haworth, N, Lennon, A, Titchener, K, Too, LS, Haworth, N, Lennon, A, and Titchener, K
- Abstract
Community beliefs related to intentional injury inflicted by others were examined in a population-based telephone survey (n = 1032) in Queensland, Australia. Young adults 18 to 24 years old were nominated as the most likely to be intentionally injured. It was found that 89.1% of respondents nominating this group believed that the injury incidents occur in alcohol environments. Though respondents from this age group also identified 18- to 24-year-olds as most likely to be intentionally injured, this was at a significantly lower level when compared with parents or 25- to 64-year-olds respondents. Responsibility for preventing injuries was placed on proprietors of licensed premises, schools, and parents/family of the victim for alcohol, school, and home environments, respectively. Beliefs were aligned with prevalence data on intentional injury, demonstrating a high level of awareness in the community about likely victims and situations where intentional injuries occur. Interventions could target families of young adults to capitalize on high levels of awareness about young adult vulnerability.
- Published
- 2015
29. An investigation of neighborhood-level social, economic and physical factors for railway suicide in Victoria, Australia
- Author
-
Too, LS, Spittal, MJ, Bugeja, L, Milner, A, Stevenson, M, McClure, R, Too, LS, Spittal, MJ, Bugeja, L, Milner, A, Stevenson, M, and McClure, R
- Abstract
BACKGROUND: This study investigates the associations between railway suicide and neighborhood social, economic, and physical determinants using postcode-level data. It also examines whether the associations are influenced by having high concentration of high-risk individuals in a neighborhood area. METHODS: Railway suicide cases from Victoria, Australia for the period of 2001-2012, their age, sex, year of death, usual residential address and suicide location were obtained from the National Coronial Information System. Univariate negative binomial regression models were used to estimate the association between railway suicide and neighborhood-level social, economic and physical factors. Variables which were significant in these univariate models were then assessed in a multivariate model, controlling for age and sex of the deceased and other known confounders. RESULTS: Findings from the multivariate analysis indicate that an elevated rate of railway suicide was strongly associated with neighborhood exposure of higher number of railway stations (IRR=1.30 95% CI=1.16-1.46). Other significant neighborhood risk factors included patronage volume (IRR=1.06, 95% CI=1.02-1.11) and train frequency (IRR=1.02, 95% CI=1.01-1.04). An increased number of video surveillance systems at railway stations and carparks was significantly associated with a modest reduction in railway suicide risk (IRR=0.93, 95% CI=0.88-0.98). These associations were independent of concentration of high-risk individuals. LIMITATIONS: Railway suicide may be under-reported in Australia. CONCLUSIONS: Interventions to prevent railway suicide should target vulnerable individuals residing in areas characterized by high station density, patronage volume and train frequency.
- Published
- 2015
30. Interventions to reduce suicides at suicide hotspots: a systematic review and meta-analysis
- Author
-
Pirkis, J, Too, LS, Spittal, MJ, Krysinska, K, Robinson, J, Cheung, YTD, Pirkis, J, Too, LS, Spittal, MJ, Krysinska, K, Robinson, J, and Cheung, YTD
- Abstract
BACKGROUND: Various interventions have been introduced to try to prevent suicides at suicide hotspots, but evidence of their effectiveness needs to be strengthened. METHODS: We did a systematic search of Medline, PsycINFO, and Scopus for studies of interventions, delivered in combination with others or in isolation, to prevent suicide at suicide hotspots. We did a meta-analysis to assess the effect of interventions that restrict access to means, encourage help-seeking, or increase the likelihood of intervention by a third party. FINDINGS: We identified 23 articles representing 18 unique studies. After we removed one outlier, interventions that restricted access to means were associated with a reduction in the number of suicides per year (incidence rate ratio 0.09, 95% CI 0.03-0.27; p<0.0001), as were interventions that encourage help-seeking (0.49, 95% CI 0.29-0.83; p=0.0086), and interventions that increase the likelihood of intervention by a third party (0.53, 95% CI 0.31-0.89; p=0.0155). When we included only those studies that assessed a particular intervention in isolation, restricting access to means was associated with a reduction in the risk of suicide (0.07, 95% CI 0.02-0.19; p<0.0001), as was encouraging help-seeking (0.39, 95% CI 0.19-0.80; p=0.0101); no studies assessed increasing the likelihood of intervention by a third party as a lone intervention. INTERPRETATION: The key approaches that are currently used as interventions at suicide hotspots seem to be effective. Priority should be given to ongoing implementation and assessment of initiatives at suicide hotspots, not only to prevent so-called copycat events, but also because of the effect that suicides at these sites have on people who work at them, live near them, or frequent them for other reasons. FUNDING: National Health and Medical Research Council, Commonwealth Department of Health.
- Published
- 2015
31. The socio-environmental determinants of railway suicide: a systematic review
- Author
-
Too, LS, Milner, A, Bugeja, L, McClure, R, Too, LS, Milner, A, Bugeja, L, and McClure, R
- Abstract
BACKGROUND: Railway suicide has significant adverse impacts for the victims, their family and friends, witnesses to the incident, general public and train network. There is no previous review on the socio-environmental factors and railway suicide. The research question asked in this review was: 'What socio-environmental risk and protective predictors are significantly associated with railway suicide?' METHODS: The review searched Medline, PsycINFO, Web of Science and Scopus for English-language studies that assessed the associations between socio-environmental (i.e. geographical, physical, economic and social) factors and railway suicide from their inception to June 2013. It was reported based on the PRISMA Statement. RESULTS: Eleven studies met the inclusion criteria. They were categorised into railway environments (availability of railways and trains, accessibility to railways and familiarity with trains), population characteristics and impact of media reporting. Findings from ecological studies using population level railway suicide data suggested weak and inconsistent evidence for the first two categories. The evidence on the impact of media reporting was moderately strong, with irresponsible media reporting being associated with an increased risk of railway suicide. CONCLUSIONS: There is a need for further research activity to strengthen evidence about socio-environmental risk factors for railway suicide. The focus of this research should be on the factors that determine individuals' decisions of using the railway as a method of suicide, with the consideration of a range of geographical, physical, social, and economic factors.
- Published
- 2014
32. Mental health research and evaluation in multicultural Australia: developing a culture of inclusion
- Author
-
Minas, H, Kakuma, R, Too, LS, Vayani, H, Orapeleng, S, Prasad-Ildes, R, Turner, G, Procter, N, Oehm, D, Minas, H, Kakuma, R, Too, LS, Vayani, H, Orapeleng, S, Prasad-Ildes, R, Turner, G, Procter, N, and Oehm, D
- Abstract
INTRODUCTION: Cultural and linguistic diversity is a core feature of the Australian population and a valued element of national identity. The proportion of the population that will be overseas-born is projected to be 32% by 2050. While a very active process of mental health system reform has been occurring for more than two decades - at national and state and territory levels - the challenges presented by cultural and linguistic diversity have not been effectively met. A key area in which this is particularly an issue is in the collection, analysis and reporting of mental health data that reflect the reality of population diversity. The purpose of this study was to examine: what is known about the mental health of immigrant and refugee communities in Australia; whether Australian mental health research pays adequate attention to the fact of cultural and linguistic diversity in the Australian population; and whether national mental health data collections support evidence-informed mental health policy and practice and mental health reform in multicultural Australia. METHODS: The study consisted of three components - a brief review of what is known about mental health in, and mental health service use by, immigrant and refugee communities; an examination of national data collections to determine the extent to which relevant cultural variables are included in the collections; and an examination of Australian research to determine the extent to which immigrant and refugee communities are included as participants in such research. RESULTS: The review of Australian research on mental health of immigrant and refugee communities and their patterns of mental health service use generated findings that are highly variable. The work is fragmented and usually small-scale. There are multiple studies of some immigrant and refugee communities and there are no studies of others. Although there is a broadly consistent pattern of lower rates of utilisation of specialist public mental
- Published
- 2013
33. Effectiveness of partial restriction of access to means in jumping suicide: lessons from four bridges in three countries.
- Author
-
Shin S, Pirkis J, Clapperton A, Spittal M, and Too LS
- Subjects
- Humans, Republic of Korea epidemiology, Canada epidemiology, United States epidemiology, Architectural Accessibility, Male, Female, Suicide Prevention, Suicide psychology, Suicide statistics & numerical data
- Abstract
Aims: Restricting access to means by installing physical barriers has been shown to be the most effective intervention in preventing jumping suicides on bridges. However, little is known about the effectiveness of partial restriction with interventions that still allow jumping from the bridge., Methods: This study used a quasi-experimental design. Public sites that met our inclusion criteria were identified using Google search and data on jumping suicides on Bridge A (South Korea), Bridges B and C (the United States) and Bridge D (Canada) were obtained from the relevant datasets. Incidence rate ratios (IRRs) were estimated using Poisson regressions comparing suicide numbers before and after the installation of physical structures at each site., Results: Fences with sensor wires and spinning handrails installed above existing railings on the Bridge A, and fences at each side of the entrances and the midpoint of main suspension cables on the Bridge D were associated with significant reductions in suicides (IRR 0.37, 95% Confidence Interval (CI) 0.26 - 0.54; 0.26, 95% CI 0.09 - 0.76). Installation of bird spike on the parapet on the Bridge B, and fences at the front of seating alcoves on the Bridge C were not associated with changes in suicides (1.21, 95% CI 0.88 - 1.68; 1.49, 95% CI 0.56 - 3.98)., Conclusions: Partial means restriction (such as fences with sensor wires and spinning bars at the top, and partial fencing at selected points) on bridges appears to be helpful in preventing suicide. Although these interventions are unlikely to be as effective as interventions that fully secure the bridge and completely prevent jumping, they might best be thought of as temporary solutions before more complete or permanent structures are implemented.
- Published
- 2024
- Full Text
- View/download PDF
34. Change in incidents of suicidal acts after intervention on a bridge in South Korea.
- Author
-
Shin S, Pirkis J, Spittal MJ, Too LS, and Clapperton A
- Abstract
Purpose: To investigate whether two novel interventions on a bridge - a Video Incident Detection System (VIDS) and spinning bar barriers - have an impact on suicidal behaviour on the bridge., Methods: A total of 146 suicidal acts were retrieved for analyses; 108 interventions before suicidal acts, 35 suicide deaths and 3 suicide attempts. Incident rate ratios (IRR) were calculated to estimate the change in incident rate associated with implementation of the two interventions: VIDS and the spinning bar 2-metre high barrier., Results: The results of the Poisson regression showed that the rate of suicide deaths, after installation the VIDS, did not change significantly (IRR: 1.23, 95% Confidence Interval [95% CI]: 0.59-2.56), although the rate of intervened suicidal acts increased (IRR: 2.40, 95% CI: 1.65-3.47). The results showed that subsequent spinning bar installation resulted in a decrease in the incident rate of intervened suicidal acts (IRR: 0.37, 95% CI: 0.25-0.57) as well as suicide deaths (IRR: 0.23, 95% CI: 0.07-0.71). Comparison of the period when both interventions were in place with the period with no interventions indicated a reduction in suicide deaths (IRR: 0.28, 95% CI: 0.10-0.82), but no change in intervened suicidal acts (IRR: 0.90, 95% CI: 0.59-1.38)., Conclusion: The rate of suicide death decreased after the installation of the spinning bar barrier but not after the implementation of VIDS alone. Our findings reinforce that restricting access to means is a highly effective way of preventing suicide on bridges and that spinning bars may be a helpful way to design barriers., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
35. High-Risk Suicide Locations in Australia.
- Author
-
Too LS, Shin S, Mavoa S, Law PCF, Clapperton A, Roberts L, Arensman E, Spittal MJ, and Pirkis J
- Subjects
- Humans, Male, Female, Australia epidemiology, Adult, Middle Aged, Case-Control Studies, Risk Factors, Aged, Young Adult, Suicide Prevention, Adolescent, Suicide statistics & numerical data
- Abstract
Importance: Although several interventions have been shown to be effective in preventing suicide at high-risk locations, the potential for these interventions to be deployed is limited by a lack of knowledge about where high-risk locations are and the factors associated with choosing these locations., Objective: To identify high-risk suicide locations in Australia and the factors associated with choosing these locations., Design, Setting, and Participants: This case-control study included data on individuals who died by suicide in Australia between January 2001 and December 2017, obtained from the National Coronial Information System. Data analysis was conducted from February to December 2021., Exposures: Sociodemographic, residential, incident time, and incident location variables., Main Outcomes and Measures: The scan statistic was used to detect spatial clusters of suicides in public locations. Suicide locations within significant clusters with at least 0.5 suicides per year were defined as high-risk locations. Multivariable logistic regression analyses were performed to examine the factors associated with choosing a high-risk location., Results: Over the study period, 10 701 suicides took place in public places. The individuals who died of suicide in public places included 8602 (80.4%) male individuals, and most were aged 25 to 49 years (5825 [54.5%]). A total of 17 high-risk suicide locations in Australia were detected. These involved 495 suicides, which accounted for 4.6% of suicides in public locations. For suicides at high-risk locations, 82.2% (407 of 495) occurred at cliffs and bridges. Being female (adjusted odds ratio [aOR], 1.73; 95% CI, 1.41-2.13), employed (aOR, 1.57; 95% CI, 1.20-2.04), never married (aOR, 1.64; 95% CI, 1.26-2.13), and from a major city (aOR, 3.94; 95% CI, 2.94-5.28) were associated with the choice of a high- over low-risk suicide location. High-risk locations tended to be in major cities., Conclusions and Relevance: This case-control study found 17 high-risk suicide locations in Australia and the factors associated with the choice of these locations. Actions should be taken to prevent suicide at these locations where possible.
- Published
- 2024
- Full Text
- View/download PDF
36. Road vehicle collision suicide in Australia: Trends, collision types, and individual characteristics.
- Author
-
Law PCF, Too LS, Spittal MJ, Pirkis J, and Clapperton AJ
- Subjects
- Humans, Australia epidemiology, Male, Female, Adult, Middle Aged, Aged, Young Adult, Retrospective Studies, Adolescent, Accidents, Traffic mortality, Accidents, Traffic statistics & numerical data, Accidents, Traffic trends, Suicide statistics & numerical data, Suicide trends
- Abstract
Background: Suicide by road vehicle collision in Australia is under-explored with mixed findings. We aimed to address this research gap by examining time trends, different types of vehicle collision, and individual characteristics related to vehicle-collision suicide., Method: We retrospectively analyzed deaths by suicide between 1st January 2001 and 31st December 2017 in Australia, using coronial records from the National Coronial Information System. The travel mode used and collision counterpart were retrieved from records of death by vehicle-collision suicide using all available information. We conducted negative binomial regression analysis to examine annual changes in suicide rate by vehicle collision on a public road (N = 640) and other methods of suicide (N = 41,890), and logistic regression analysis to examine individual characteristics associated with the likelihood of dying by suicide via road vehicle collision., Results: Overall, the national suicide rate involving road vehicle collision significantly increased, while the rate by other methods significantly decreased. Drivers accounted for 61% of suicide events by vehicle collision, of which 72% were single-vehicle collisions (commonly involving a tree). For multiple-vehicle collision suicide events, 82% involved collision with a truck. Pedestrians accounted for more than one-third of suicide events, of which 58% involved collision with a truck and 23% involved collision with a car/van. Individuals who were male (odds ratio 1.15; 95% CI 0.88-1.50), aged <25 years old (odds ratio 5.27; 95% CI 3.05-9.10), non-Indigenous (odds ratio 3.36; 95% CI 1.71-6.62), and born overseas (odds ratio 1.40; 95% CI 1.10-1.79) were more likely to die by vehicle-collision suicide than by other methods of suicide., Conclusions: This study provides a better understanding of road vehicle collision suicide in Australia and informs future research directions on topic. Our findings can be used to inform suicide prevention initiatives to reduce vehicle-collision suicide deaths., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Law et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
- Full Text
- View/download PDF
37. Does adolescent depression modify the association between psychosocial job stressors and mental health in emergent adulthood?
- Author
-
LaMontagne AD, Too LS, Witt K, Evans-Whipp T, Owen PJ, and Toumbourou JW
- Subjects
- Adult, Humans, Adolescent, Depression epidemiology, Stress, Psychological psychology, Cross-Sectional Studies, Surveys and Questionnaires, Australia epidemiology, Mental Health, Occupational Stress psychology
- Abstract
Background: Job stressors can be particularly harmful to the mental health of disadvantaged groups through differential exposure, differential sensitivity to the effects of exposure, or both. In this paper, we assess the extent to which emergent adult workers with an adolescent history of high depression symptoms may be differentially sensitive to the effect of job stressors on mental health., Methods: We conducted a secondary analysis of three waves of the Australian arm of the International Youth Development Study (n = 1262). We used multivariable linear regression to assess whether self-reported measures of high depression symptoms at one or two time points in adolescence (ages 11-16 years) modified the cross-sectional association between four self-reported job stressors (job demands, job control, job strain, and incivility at work) and psychological distress (Kessler-10 scores) in emergent adulthood (ages 23-27 years)., Results: For all four job stressors, there was a consistent pattern of approximately a doubling in the magnitude of association for participants with a history of high depression symptoms at two points in adolescence compared with those with no history of depression. However, results of effect modification analysisfor only job demands and job strain excluded chance as a potential explanation., Conclusions: Findings showed partial support for the hypothesis that a history of high depression symptoms in adolescence predicts stronger associations between job stressor exposures and psychological distress among those employed in emergent adulthood. The limitations of this secondary analysis suggest a need for purpose-designed studies to answer this important research question more definitively., (© 2023 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals LLC.)
- Published
- 2024
- Full Text
- View/download PDF
38. Poor psychosocial job conditions increase sickness absence: evidence from the PATH Through Life Mid-Aged Cohort.
- Author
-
Leach L, Milner A, Too LS, and Butterworth P
- Subjects
- Australia epidemiology, Cohort Studies, Humans, Job Satisfaction, Middle Aged, Prospective Studies, Stress, Psychological complications, Surveys and Questionnaires, Absenteeism, Sick Leave
- Abstract
Objectives: Evidence is mounting that poor psychosocial job conditions increase sickness absence, but there is a need for further rigorous prospective research to isolate the influence of psychosocial job quality from other measured and unmeasured confounders. This study used four waves of prospective longitudinal data (spanning 12 years) to investigate the extent to which increases in poor psychosocial job quality are associated with greater relative risk of day of sickness absence., Design: Prospective cohort study., Setting: Data were from the Australian PATH Through Life cohort study. The analyses adopted hybrid-regression estimations that isolated the effect of within-person change in psychosocial job quality on sickness absence over time., Participants: Participants were from a midlife cohort aged 40-44 at baseline (7644 observations from 2221 participants)., Primary Outcome Measure: Days sickness absence in the past 4 weeks., Results: The results show that after adjusting for a wide range of factors as well as unmeasured between-person differences in job quality, each additional psychosocial job adversity was associated with a 12% increase in the number of days of sickness absence (relative risk ratio: 1.12, 95% CI 1.03 to 1.21). Increases in psychosocial job adversity were also related to greater functional impairment (relative risk ratio: 1.17 (1.05 to 1.30))., Conclusion: The results of this study strengthen existing research highlighting the importance of addressing poor psychosocial job quality as a risk factor for sickness absence., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
- Full Text
- View/download PDF
39. Quantitative Methods to Detect Suicide and Self-Harm Clusters: A Systematic Review.
- Author
-
Benson R, Rigby J, Brunsdon C, Cully G, Too LS, and Arensman E
- Subjects
- Data Management, Humans, Research Design, Risk Assessment, Self-Injurious Behavior epidemiology, Suicide
- Abstract
Suicide and self-harm clusters exist in various forms, including point, mass, and echo clusters. The early identification of clusters is important to mitigate contagion and allocate timely interventions. A systematic review was conducted to synthesize existing evidence of quantitative analyses of suicide and self-harm clusters. Electronic databases including Medline, Embase, Web of Science, and Scopus were searched from date of inception to December 2020 for studies that statistically analyzed the presence of suicide or self-harm clusters. Extracted data were narratively synthesized due to heterogeneity among the statistical methods applied. Of 7268 identified studies, 79 were eligible for narrative synthesis. Most studies quantitatively verified the presence of suicide and self-harm clusters based on the scale of the data and type of cluster. A Poisson-based scan statistical model was found to be effective in accurately detecting point and echo clusters. Mass clusters are typically detected by a time-series regression model, although limitations exist. Recently, the statistical analysis of suicide and self-harm clusters has progressed due to advances in quantitative methods and geospatial analytical techniques, most notably spatial scanning software. The application of such techniques to real-time surveillance data could effectively detect emerging clusters and provide timely intervention.
- Published
- 2022
- Full Text
- View/download PDF
40. Cost-effectiveness of Installing Barriers at Bridge and Cliff Sites for Suicide Prevention in Australia.
- Author
-
Bandara P, Pirkis J, Clapperton A, Shin S, Too LS, Reifels L, Onie S, Page A, Andriessen K, Krysinska K, Flego A, Schlichthorst M, Spittal MJ, Mihalopoulos C, and Le LK
- Subjects
- Australia, Cost Savings, Cost-Benefit Analysis, Humans, Models, Economic, Suicide Prevention
- Abstract
Importance: Installation of barriers has been shown to reduce suicides. To our knowledge, no studies have evaluated the cost-effectiveness of installing barriers at multiple bridge and cliff sites where suicides are known to occur., Objective: To examine the cost-effectiveness of installing barriers at bridge and cliff sites throughout Australia., Design, Setting, and Participants: This economic evaluation used an economic model to examine the costs, costs saved, and reductions in suicides if barriers were installed across identified bridge and cliff sites over 5 and 10 years. Specific and accessible bridge and cliff sites across Australia that reported 2 or more suicides over a 5-year period were identified for analysis. A partial societal perspective (including intervention costs and monetary value associated with preventing suicide deaths) was adopted in the development of the model., Interventions: Barriers installed at bridge and cliff sites., Main Outcomes and Measures: Primary outcome was return on investment (ROI) comparing cost savings with intervention costs. Secondary outcomes included incremental cost-effectiveness ratio (ICER), comprising the difference in costs between installation of barriers and no installation of barriers divided by the difference in reduction of suicide cases. Uncertainty and sensitivity analyses were undertaken to examine the association of changes in suicide rates with barrier installation, adjustments to the value of statistical life, and changes in maintenance costs of barriers., Results: A total of 7 bridges and 19 cliff sites were included in the model. If barriers were installed at bridge sites, an estimated US $145 million (95% uncertainty interval [UI], $90 to $160 million) could be saved in prevented suicides over 5 years, and US $270 million (95% UI, $176 to $298 million) over 10 years. The estimated ROI ratio for building barriers over 10 years at bridges was 2.4 (95% UI, 1.5 to 2.7); the results for cliff sites were not significant (ROI, 2.0; 95% UI, -1.1 to 3.8). The ICER indicated monetary savings due to averted suicides over the intervention cost for bridges, although evidence for similar savings was not significant for cliffs. Results were robust in all sensitivity analyses except when the value of statistical life-year over 5 or 10 years only was used., Conclusions and Relevance: In an economic analysis, barriers were a cost-effective suicide prevention intervention at bridge sites. Further research is required for cliff sites.
- Published
- 2022
- Full Text
- View/download PDF
41. Understanding the Context of Suicides by Older Men Compared With Younger Old Men and Women.
- Author
-
King K, Schlichthorst M, Millar C, Sutherland G, and Too LS
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Intention, Male, Suicidal Ideation, Mental Disorders, Suicide
- Abstract
Background: The rate of suicide among men aged 85 years or older is the highest of any age or gender group in many countries, but little is known about their pathways to suicide. Aims: This study aimed to determine the context of suicide by men aged 85 years or older. Method: Data were extracted from the Victorian Suicide Register regarding suicide deaths between 2009 and 2015. Chi-squared test or Fisher's exact test was used to compare old men (65-84 years old) and older men (85 years or more), and old women and old men (both 65 years or more). Results: The context of suicide by older men differed significantly from that of old men, as did that of old men compared with old women, on variables related to suicidal behavior and intention, mental illness, mental health treatment, and life stressors. Limitations: The study is limited by the small numbers of deaths by suicide in this age group in Victoria. Conclusion: The context of suicide by older and old men is different from that of old men and old women, respectively. More research is needed to understand the pathways to suicide by older men.
- Published
- 2022
- Full Text
- View/download PDF
42. A Pilot Case-Control Study of the Social Media Activity Following Cluster and Non-Cluster Suicides in Australia.
- Author
-
Law PCF, Too LS, Hill NTM, Robinson J, Gould M, Occhipinti JA, Spittal MJ, Witt K, Sinyor M, Till B, Osgood N, Prodan A, Zahan R, and Pirkis J
- Subjects
- Australia epidemiology, Case-Control Studies, Humans, Sentiment Analysis, Social Media, Suicide
- Abstract
Social media may play a role in the "contagion" mechanism thought to underpin suicide clusters. Our pilot case-control study presented a novel methodological approach to examining whether Facebook activity following cluster and non-cluster suicides differed. We used a scan statistic to identify suicide cluster cases occurring in spatiotemporal clusters and matched each case to 10 non-cluster control suicides. We identified the Facebook accounts of 3/48 cluster cases and 20/480 non-cluster controls and their respective friends-lists and retrieved 48 posthumous posts and replies (text segments) referring to the deceased for the former and 606 for the latter. We examined text segments for "putatively harmful" and "putatively protective" content (e.g., discussion of the suicide method vs. messages discouraging suicidal acts). We also used concept mapping, word-emotion association, and sentiment analysis and gauged user reactions to posts using the reactions-to-posts ratio. We found no "putatively harmful" or "putatively protective" content following any suicides. However, "family" and "son" concepts were more common for cluster cases and "xx", "sorry" and "loss" concepts were more common for non-cluster controls, and there were twice as many surprise- and disgust-associated words for cluster cases. Posts pertaining to non-cluster controls were four times as receptive as those about cluster cases. We hope that the approach we have presented may help to guide future research to explain suicide clusters and social-media contagion.
- Published
- 2021
- Full Text
- View/download PDF
43. What Works in Community-Led Suicide Prevention: Perspectives of Wesley LifeForce Network Coordinators.
- Author
-
Reifels L, Morgan A, Too LS, Schlichthorst M, Williamson M, and Jordan H
- Subjects
- Community Networks, Health Promotion, Humans, Suicide Prevention
- Abstract
Community coalitions have been recognised as an important vehicle to advance health promotion and address relevant local health issues in communities, yet little is known about their effectiveness in the field of suicide prevention. The Wesley Lifeforce Suicide Prevention Networks program consists of a national cohort of local community-led suicide prevention networks. This study drew on a nationally representative survey and the perspectives of coordinators of these networks to identify the key factors underpinning positive perceived network member and community outcomes. Survey data were analysed through descriptive statistics and linear regression analyses. Networks typically reported better outcomes for network members and communities if they had been in existence for longer, had a focus on the general community, and had conducted more network meetings and internal processes, as well as specific community-focused activities. Study findings strengthen the evidence base for effective network operations and lend further support to the merit of community coalitions in the field of suicide prevention, with implications for similar initiatives, policymakers, and wider sector stakeholders seeking to address suicide prevention issues at a local community level.
- Published
- 2021
- Full Text
- View/download PDF
44. Changes in Job Security and Mental Health: An Analysis of 14 Annual Waves of an Australian Working-Population Panel Survey.
- Author
-
LaMontagne AD, Too LS, Punnett L, and Milner AJ
- Subjects
- Adolescent, Adult, Age Factors, Australia epidemiology, Educational Status, Female, Humans, Male, Middle Aged, Occupations statistics & numerical data, Risk Factors, Sex Factors, Socioeconomic Factors, Young Adult, Employment psychology, Employment statistics & numerical data, Mental Health statistics & numerical data
- Abstract
We examined whether job security improvements were associated with improvements in mental health in a large, nationally representative panel study in Australia. We used both within-person fixed effects (FE) and random effects (RE) regression to analyze data from 14 annual waves covering the calendar period of 2002-2015 (19,169 persons; 106,942 observations). Mental Health Inventory-5 scores were modeled in relation to self-reported job security (categorical, quintiles), adjusting for age, year, education, and job change in the past year. Both FE and RE models showed stepwise improvements in Mental Health Inventory-5 scores with improving job security, with stronger exposure-outcome relationships in the RE models and for men compared with women. The RE coefficients for improvements in job security in men were 2.06 (95% confidence interval (CI): 1.67, 2.46) for 1 quintile, steadily increasing for 2- (3.94 (95% CI: 3.54, 4.34)), 3- (5.82 (95% CI: 5.40, 6.24)), and 4-quintile (7.18 (95% CI: 6.71, 7.64)) improvements. The FE model for men produced slightly smaller coefficients, reaching a maximum of 5.55 (95% CI: 5.06, 6.05). This analysis, with improved causal inference over previous observational research, showed that improving job security is strongly associated with decreasing depression and anxiety symptoms. Policy and practice intervention to improve job security could benefit population mental health., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
45. Calls to helplines in Australia following media reports of Robin Williams' suicide.
- Author
-
Pirkis J, Currier D, Too LS, Bryant M, Bartlett S, Sinyor M, and Spittal MJ
- Subjects
- Australia, Humans, Mass Media, Surveys and Questionnaires, United States, Famous Persons, Suicide Prevention
- Abstract
Objective: In the United States, there was an increase in calls to helplines following media reporting of Robin Williams' suicide. We aimed to determine whether this was the case in Australia., Method: The helpline services Lifeline and Beyond Blue provided us with weekly data on calls received for 2013-2015. We conducted interrupted time series regression analyses to determine whether there was an increase in the average weekly number of calls received by each helpline in two periods after the story about Williams' suicide broke (1 week and 4 weeks)., Results: We found strong evidence of an increase in calls to Lifeline (incidence rate ratio [IRR] =1.13; 95% confidence interval [CI] =1.02-1.25; p = 0.016) and Beyond Blue (IRR = 1.32; 95% CI = 1.09-1.59; p = 0.004) in the week after Williams' suicide was first reported. We found no evidence of higher than normal call volumes for Lifeline (IRR = 1.04; 95% CI = 0.99-1.10; p = 0.104) or Beyond Blue (IRR = 1.10; 95% CI = 1.00-1.22; p = 0.058) over the four weeks following Williams' death, however, suggesting that calls leveled out over this period., Conclusion: Suicide prevention experts and media professionals must work together to minimize the negative impacts of reports on suicide and maximize their positive ones. In cases where the story is likely to receive extensive international coverage, it may be important for local media to encourage help-seeking., (© 2020 The American Association of Suicidology.)
- Published
- 2020
- Full Text
- View/download PDF
46. Suicide Clusters Among Top 10 High-Risk Occupations: A Study From 2001 to 2016 in Australia.
- Author
-
Too LS and Spittal MJ
- Subjects
- Adult, Agriculture, Art, Australia epidemiology, Cluster Analysis, Construction Industry, Engineering, Female, Forestry, Humans, Male, Manufacturing Industry, Mining, Risk Factors, Spatial Analysis, Spatio-Temporal Analysis, Transportation, Occupations statistics & numerical data, Suicide statistics & numerical data
- Abstract
A number of studies have demonstrated elevated risk of suicide in certain occupational groups. We seek to understand a possible new risk factor: suicide contagion, as demonstrated through a suicide cluster analysis. National-level coronial data and census population data were used for the study. We calculated suicide rates to identify "risky" occupations. SaTScan v9.4.1 was used to perform Poisson discrete scan statistic. Suicides occurring in arts and media professionals, construction, manufacturing, and skilled animal and horticultural workers seemed to cluster in time and/or space. Those working in construction settings were at risk of being in both time and space clusters.
- Published
- 2020
- Full Text
- View/download PDF
47. Psychosocial job characteristics and mental health: Do associations differ by migrant status in an Australian working population sample?
- Author
-
Liu X, Bowe SJ, Li L, Too LS, and LaMontagne AD
- Subjects
- Adolescent, Adult, Australia epidemiology, Educational Status, Employment psychology, Female, Humans, Male, Mental Health statistics & numerical data, Middle Aged, Occupational Health, Occupational Stress psychology, Racial Groups, Surveys and Questionnaires, Workplace psychology, Young Adult, Accidents, Occupational, Occupational Injuries epidemiology, Occupational Stress epidemiology, Transients and Migrants psychology
- Abstract
Migrant workers may experience higher burdens of occupational injury and illness compared to native-born workers, which may be due to the differential exposure to occupational hazards, differential vulnerability to exposure-associated health impacts, or both. This study aims to assess if the relationships between psychosocial job characteristics and mental health vary by migrant status in Australia (differential vulnerability). A total of 8969 persons from wave 14 (2014-2015) of the Household Income and Labour Dynamics in Australia Survey were included in the analysis. Psychosocial job characteristics included skill discretion, decision authority and job insecurity. Mental health was assessed via a Mental Health Inventory-5 score (MHI-5), with a higher score indicating better mental health. Migrant status was defined by (i) country of birth (COB), (ii) the combination of COB and English/Non-English dominant language of COB and (iii) the combination of COB and years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age and educational attainment. Migrant status was analysed as an effect modifier of the relationships between psychosocial job characteristics and mental health. Skill discretion and decision authority were positively associated with the MHI-5 score while job insecurity was negatively associated with the MHI-5 score. We found no statistical evidence of migrant status acting as an effect modifier of the psychosocial job characteristic-MHI-5 relationships. With respect to psychosocial job characteristic-mental health relationships, these results suggest that differential exposure to job stressors is a more important mechanism than differential vulnerability for generating occupational health inequities between migrants and native-born workers in Australia., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
- Full Text
- View/download PDF
48. Cumulative impact of high job demands, low job control and high job insecurity on midlife depression and anxiety: a prospective cohort study of Australian employees.
- Author
-
Too LS, Leach L, and Butterworth P
- Abstract
Objective: There is a lack of evidence concerning the prospective effect of cumulative exposure to psychosocial job stressors over time on mental ill-health. This study aimed to assess whether cumulative exposure to poor quality jobs places employees at risk of future common mental disorder., Methods: Data were from the Personality and Total Health Through Life project (n=1279, age 40-46 at baseline). Data reported on the cumulative exposure to multiple indicators of poor psychosocial job quality over time (ie, a combination of low control, high demands and high insecurity) and future common mental disorder (ie, depressive and/or anxiety symptom scores above a validated threshold) 12 years later. Data were analysed using logistic regression models and controlled for potential confounders across the lifespan., Results: Cumulative exposure to poor-quality work (particularly more secure work) on multiple occasions elevated the risk of subsequent common mental disorder, independent of social, health, verbal intelligence and personality trait confounders (OR=1.30, 95% CI 1.06 to 1.59)., Conclusions: Our findings show that cumulative exposure to poor psychosocial job quality over time independently predicts future common mental disorder-supporting the need for workplace interventions to prevent repeated exposure of poor quality work., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
- Full Text
- View/download PDF
49. Understanding the characteristics and mechanisms underlying suicide clusters in Australian youth: a comparison of cluster detection methods.
- Author
-
Hill NTM, Too LS, Spittal MJ, and Robinson J
- Subjects
- Adolescent, Australia, Child, Cluster Analysis, Epidemiologic Studies, Female, Humans, Residence Characteristics, Risk Factors, Suicide trends, Young Adult, Suicide statistics & numerical data
- Abstract
Aims: There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide clusters among each method, (2) compare the spatial and temporal parameters associated with different suicide clusters and (3) identify the demographic characteristics and rates of exposure to suicide among cluster and non-cluster members., Methods: Suicide data were obtained from the National Coronial Information System. N = 3027 Australians, aged 10-24 who died by suicide in 2006-2015 were included. Suicide clusters were determined using: (1) poisson scan statistics, (2) a systematic search of coronial inquests and (3) descriptive network analysis. These methods were chosen to operationalise three different definitions of suicide clusters, namely clusters that are: (1) statistically significant, (2) perceived to be significant and (3) characterised by social links among three or more suicide descendants. For each method, the demographic characteristics and rates of exposure to suicide were identified, in addition to the maximum duration of suicide clusters, the geospatial overlap between suicide clusters, and the overlap of individual cluster members., Results: Eight suicide clusters (69 suicides) were identified from the scan statistic, seven (40 suicides) from coronial inquests; and 11 (37 suicides) from the descriptive network analysis. Of the eight clusters detected using the scan statistic, two overlapped with clusters detected using the descriptive network analysis and one with clusters identified from coronial inquests. Of the seven clusters from coronial inquests, four overlapped with clusters from the descriptive network analysis and one with clusters from the scan statistic. Overall, 9.2% (12 suicides) of individuals were identified by more than one method. Prior exposure to suicide was 10.1% (N = 7) in clusters from the scan statistic, 32.5% (N = 13) in clusters from coronial inquest and 56.8% (N = 21) in clusters from the descriptive network analysis., Conclusion: Each method identified markedly different suicide clusters. Evidence of social links between cluster members typically involved clusters detected using the descriptive network analysis. However, these data were limited to the availability information collected as part of the police and coroner investigation. Communities tasked with detecting and responding to suicide clusters may benefit from using the spatial and temporal parameters revealed in descriptive studies to inform analyses of suicide clusters using inferential methods.
- Published
- 2020
- Full Text
- View/download PDF
50. A systematic review on the effect of work-related stressors on mental health of young workers.
- Author
-
Law PCF, Too LS, Butterworth P, Witt K, Reavley N, and Milner AJ
- Subjects
- Adolescent, Female, Humans, Male, Stress, Psychological, Workload statistics & numerical data, Young Adult, Mental Disorders epidemiology, Mental Health statistics & numerical data, Occupational Stress psychology
- Abstract
Purpose: There is no review on the effect of work-related stressors on mental health of young workers. We systematically reviewed epidemiological evidence on this relationship., Methods: The review searched eight databases: Embase, PubMed, Web of Science, Cinahl, Cochrane Library, Informit, PsycINFO, and Scopus from their respective start dates until May 2017. Studies that have examined a mental health outcome in relation to a work-related stressor as exposure in young workers were included. The review was reported based on the PRISMA statement., Results: Three cross-sectional studies and six longitudinal cohort studies were included. Cross-sectional evidence showed that adverse work conditions including working overtime, job boredom, low skill variety, low autonomy, high job insecurity, and lack of reward were associated with poor mental health of young workers. Longitudinal evidence showed that high job demands, low job control, effort-reward imbalance, and low work support (men only) were associated with poor mental health. There was evidence on the contemporaneous relationship between two or more adverse work conditions and poor mental health., Conclusions: Although more research (particularly high-quality longitudinal studies) is warranted in this area, our review indicates that work-related stressors have a negative impact on the mental health of young workers. The current review suggests that workplace interventions and policy are required to improve the quality of work for young workers.
- Published
- 2020
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.