2011 IASP News Bulletins

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Y/FEBRUARY 2 UAR 01 N A

International Association for Suicide Prevention

FROM THE PRESIDENT At the heart and soul of a public health approach to suicide prevention is a mental health approach; this is true at least in the developed countries around the globe. A large number of prevention programmes are based on a case-finding model. Gatekeeper programmes, screening programmes, public education and awareness programmes, for example, are designed to increase early detection of, referral for, and treatment of those at risk. A great deal of work has gone into developing these approaches, but each will fail to accomplish a reduction in suicide mortality and morbidity if they stand alone, unlinked to other links on the chain toward this end. Inherent in the success of these approaches are pathway roadblocks, many of which suicide prevention and mental health communities have yet to adequately address. To wit: 1.If we find and refer someone presumed to be at risk for suicide, will they seek the referred-for treatment? 2.If we find and refer someone presumed to be at risk for suicide, do we have sufficiently competent, trained clinical caregivers to whom they will be referred? 3.If they seek the referred-for treatment, will they adhere to the offered treatment recommendations? 4.If they adhere to treatment recommendations, will the implemented treatments be guideline-concordant and effective in reducing their assessed risk?

I suggest we are not doing all that well at any of these steps. Only a minority of those most at risk follow up on referrals and seek treatment (step1). There are painfully few clinical providers welltrained in assessing and treating those acutely suicidal (step 2), hence the majority of those who do make consultation appointments do so with ill-prepared caregivers. Rates of adherence among those who do seek treatment are woefully low (step 3). Lastly, where we have guidelines, they are rarely followed, and we have an insufficient array of evidence-based treatments to offer anyway (step 4). Considerable effort is being expended to better define treatments that work and the literature offers some promising efforts to increase adherence to

our offered treatments. Moreover, in many countries, there is a concerted effort to upgrade the competencies of clinical care providers, although progress here is painfully slow and far too many caregivers simply do not know how to reasonably assess and formulate a patient's risk, beyond merely asking about the presence of suicide ideation. Of great concern is how little attention is being given to improve and increase the rate of help-seeking and, thus, help-receiving by those at risk. A recently published study is a case in point.

Researchers from the Mayo Clinic, Johns Hopkins and other esteemed institutions reported in the January issue of the Archives of Surgery 1 on a cross sectional survey of almost 8,000 US surgeons (87% of whom were males). Their central finding: 6.3% reported suicide ideation in the last 12 months, only 26% of whom had sought mental health care, a rate of help-seeking only slightly more than half that of the general US population (44%). The authors noted that US surgeons are overwhelmingly insured, have ready access to medical (and other) care, and are well aware of the implications of untreated mental health problems. Thus, the low rate of help-seeking is particularly profound, given the absence of these barriers. Further, the primary disincentive to help-seeking reported by these surgeons at risk was their concern that seeking professional help and, correspondingly, having to identify the presence of a mental illness to their medical boards could affect their medical licensing. One terrifying consequence of not seeking help identified in this survey was a finding of an independent association between perceptions of having made a major medical error in the previous 3 months and having had suicide ideation in the past 12 months. Bottom line message: Better to put someone else's life at risk than to seek help to make your own better!

This is just one example of where we need to expend significantly greater effort to remove or lower barriers to care and to shift attitudes and behavior, such that we can better achieve our prevention goals. Keeping in mind that this model of prevention and its attendant problems to be solved is specific to the developed world, I can only imagine the magnitude of problems to be solved in the developing world. Lanny Berman, Ph.D., ABPP 1

Shanafelt, T D, Balch, C M, Dyrbye, L, Bechamps, G, Russel, T, Satele, D, et al. (2011). Suicide ideation among American surgeons, Arch. Surg., 146(1), 54–62.

REPORT FROM A NATIONAL REPRESENTATIVE

COUNTRY REPORT FROM DENMARK Officially, the national (governmental)

NORTH-JYLLAND

DENMARK MIDDLE-JYLLAND COPENHAGEN

SOUTH-JYLLAND

SJÆLLAND

suicide prevention programme ended in 2004. But that did not mean that governmental funding for suicide prevention dried up. During the years thereafter, the funding went towards a variety of projects and initiatives locally, regionally and nationwide.

During the period 2005–2009 the Danish Ministry of Social Affairs (www.vfm.dk) initiated funding for a follow-up of the national prevention programme, mainly focused on suicide attempts among young people, suicidal behaviour in the elderly (primarily men), and suicidal behaviour among psychiatric patients. Furthermore, funding from the Danish Ministry of Interior and Health (www.sum.dk) for the coming years was allocated to establish specialised prevention (and treatment) centres in each of the five Danish Regions. On the one hand these centres focus on quality assured treatment for all suicide attempters (age groups 15+). Yet they aim to reach a greater number of men and the elderly population with suicide attempts (65+). New initiatives will be taken to give better information to these groups. At the same time these centres act as competence and knowledge centres with regard to prevention, treatment and research. One objective is to distribute best practice guidelines to various professionals in areas with a low population density.

Several nationwide research groups were founded in relation to the follow-up of the national suicide prevention programme, and one group is still very active, in particular the research group for suicidal behaviour in the elderly (www.geronet.dk).

One important initiative of this group was the international conference 'The Elderly and Suicide - Research and Prevention' held on the 4th to the 6th of November 2009 in Aalborg. Recommendations from the conference are being disseminated. Another initiative which started in 2005 during the follow-up period of the national programme, is the regional (the northern part of Zealand) concept called Livsmod, which means 'life courage' (www.livsmod.net). Various professionals (approximately 500) such as psychologists, psychiatrists, teachers, nurses and others from eleven municipalities are part of a competence-lifting network, focusing on the broad range of challenges associated with children and adolescents showing suicidal behaviour and/or eating disorders, cutting etc.

An organisation for surviving relatives and bereaved has been established (www.efterladte.dk) and survivors can get psychological help through visitation from their general practitioner. Also an organisation for relatives of suicide attempters has been established (www.nefos.dk). At the moment, the Danish Parliament (Folketinget) continues to discuss various new proposals targeting prevention of suicidal behaviour, for example a proposal regarding a general right to treatment within 48 hours of a suicide attempt, and a proposal regarding establishing of a national council for the prevention of suicidal behaviour. Gert Jessen, Manager WISEMIND, Denmark, e-mail: gj@wisemind.dk, www.wisemind.dk. Gert Jessen is IASP National Representative for Denmark

President: Dr Lanny Berman

Treasurer: Professor Michael Philips

In official relations with

1st Vice President: Professor Heidi Hjelmeland

General Secretary: Dr Tony Davis

the World Health Organization

2nd Vice President: Professor Paul Yip

National Rep: Dr Murad Khan

3rd Vice President: Dr Ella Arensman

Organisational Rep: Dr Jerry Reed


REPORT FROM A NATIONAL REPRESENTATIVE

COUNTRY REPORT FROM GERMANY In Germany, every year about 10,000 people die by suicide. In 2009 the suicide rate per 100,000 was in total 10.4, in men 15.95 and in women 5.69. In Germany, the suicide risk follows the Hungarian pattern and increases with age. Older people are Thomas at particular risk for suicide. The suicide Bronish rate has been declining over the past decade - with 2009 as an exception, possibly due to the suicide of the famous German goal keeper Robert Enke.

Suicide prevention in Germany at present is primarily focusing on four main topics: 1. National Suicide Prevention Programme 2. Competence-Network in Medicine with special emphasis on depression and suicidality 3. Nürnberg Alliance Against Depression 4. The Working Group for Research in Suicidal Behaviour

threshold services, networking, and basic and advanced training, law, gender-related aspects and military. Each task force addresses a number of projects in its field. Up to now, almost all task forces have published informative literature. For example, the task force “elderly” published informative literature and a set of slides and a booklet, which can be downloaded from the website of the Ministry for Family, Seniors, Women and Youth. The German National Suicide Prevention Programme is chaired by Professor Armin Schmidtke. More than 80 organizations, institutions, and associations form this alliance. It is monitored by a scientific committee and collaborates with the World Health Organization and the European Network on Suicide Research and Prevention (International chair: Wolfgang Rutz, German chair: Elmar Etzersdorfer, co-chair: Thomas Bronisch). Furthermore, since 2006 Germany has participated under the auspices of the NaSPro in the World Suicide Prevention Day with different topics each year (Age, Youth, Workplace, Prejudices): www.welttag-suizidpraevention.de.

1. In Germany suicide prevention mainly relies on voluntary work. There are many initiatives and institutions all over the country, which cover a broad spectrum of services. In 2002, the German National Suicide Prevention Program (NaSPro), as an initiative of the the Deutsche Gesellschaft für Suizidprävention (DGS) - German Association for Suicide Prevention, became a reality due to strong efforts of many colleagues, particularly Armin Schmidtke (Würzburg) as chair of the NaSPro and Georg Fiedler (Hamburg) as secretary of the NaSPro. A first inaugural meeting which took place in Berlin on 26th November 2002 highlighted the wide interest of relevant people, organisations and institutions all over Germany, and beyond (WHO, IASP, IASR etc.). Several working groups were initiated.

3. Under the umbrella of the “German Research Network on Depression and Suicidality” scientists, medical doctors, psychotherapists and several of the most relevant institutions of the German health care system are aligned to examine the overlapping health problems of “depression” and “suicidality” (chair: Ulrich Hegerl). The project addresses professionals and scientists, affected patients and their relatives and the total population at the same time. Comprehensive PR-activities contribute to an overall sensitisation concerning the topics of depression and suicidality and informs about diagnosis and treatment options. The network is funded by the German Ministry of Education and Research and was established in 1999. Since then more than 20 individual projects have been initiated. Meanwhile more and more results of these projects become available and increasing efforts are undertaken to transfer these results into elements of standard health care.

2. The general structure of the NasPro consists of two levels; one might speak of a horizontal and a vertical one. The horizontal level consists of different measures (reduction of methods; media; specific interventions), the vertical level is comprised of different groups. There are eighteen task forces in the National Suicide Prevention Programme: primary suicide prevention, workplace, media and public relations, awareness of psychiatric disorders, children and adolescents, elderly, survivors, specific risk groups, specific psychiatric disorders, substance use disorders, medical care, low-

4. Suicidality often occurs in association with inadequately treated depression (>50%). Therefore suicide preventive actions focus on optimizing treatment for depression in order to reduce suicide rates. Over the last ten years we have witnessed national suicide prevention programmes in Germany. The 4-level-intervention programme Nuremberg Alliance Against Depression has been implemented nationwide: The German Alliance Against Depression comprises over 60 alliance partners and cooperates with the National Suicide Prevention Programme (chair: Ulrich Hegerl). Based on the

5. Section Suicide within the German Society for Psychiatry Psychotherapy and Neurology

The people behind the IASP News Bulletin The IASP News Bulletin is an important tool to inform and update IASP members about a wide range of initiatives and activities including reports from national representatives, updates from IASP Task Forces and Special Interest Groups, activities in connection with World Suicide Prevention Day, IASP awards and announcements of conferences. Considerable thought and work goes into each issue of the IASP News Bulletin.

positive evaluation results of the Nuremberg Alliance Against Depression, the programme was implemented in 17 European countries. The effectiveness is currently being evaluated in the European Commission funded OSPI (Optimized Suicide Prevention Programmes and their Implementation in Europe). 5. During the last 30 years The Working Group for Research in Suicidal Behaviour (Arbeitsgemeinschaft zur Erforschung suizidalenVerhaltens) of the German Society for Suicide prevention (chair: Barbara Schneider, co-chair: Reinhard Lindner) has carried out biannual scientific meetings in the realm of suicide prevention. This has had considerable impact on research activities in Germany as well as special initiatives for prevention and therapy of suicidal behaviour. 6. Suicide research is traditionally part of the research efforts at the German universities as well as part of the health services in psychiatric-psychotherapeutic clinics. The German Association for Suicide Prevention has existed since the seventies and is primarily concerned with suicide prevention. A growing interest in issues concerning suicidality emerged in Germany during the last 20 years, which resulted in a special “Suicide Section (Referat Suizidologie) of the German Society for Psychiatry Psychotherapy and Neurology Deutsche Gesellschaft für Psychiatry Psycho-therapie und Nervenheilkunde (DGPPN). This section “Suicidology” of the DGPPN is closely connected to the scientific community of the suicide researchers in Germany (chair: Manfred Wolfersdorf, co-chair: Barbara Schneider). Prof. Dr. med. Thomas Bronisch, Max-Planck-Institute of Psychiatry Clinic, Kraepelinstr. 10, D 80804 Munich, Germany, e-mail: bronisch@mpipsykl.mpg.de. Prof. Bronisch is IASP National Representative for Germany. Publications: Etzersdorfer E, Bronisch T (2004. Der wissenschaftliche Beirat des nationalen Suizidpräventions programmes. Suizidprophylaxe 31: 78–81. Hegerl U, Althaus D, Schmidtke A, Niklewski G (2006). The alliance against depression: 2-year evaluation of a community-based intervention to reduce suicidality. Psychol Med 36: 1225–1233. Hegerl U, Mergl R, Havers I, Schmidtke A, Lefeld H Niklewski G, Althaus D (2010). Sustainable effects on suicidality were found for the Nuremberg alliance against depression. Eur Arch Psychiatry Clin Neurosci 260: 401-406. Schmidtke A, Fiedler G (2002). DGS-Mitteilungen: Nationales Suizidpräventionsprogramm für Deutschland wird Wirklichkeit. Suizidprophylaxe 29: 157–165. Wolfersdorf M, Schneider B (2009). Suizidforschung in Deutschland - aktueller Stand. Vortrag am 12/13. Juni 2010 Charité Berlin.

THE PEOPLE BEHIND THE SCENES OF THE BULLETIN: Ella Arensman (Cork, Ireland) co-ordinates each issue of the IASP News Bulletin. She invites IASP members to prepare specific contributions, she edits all articles, and on a regular basis she prepares articles around specific themes. Tony Davis (Adelaide, Australia) takes care of the final editing and proof reading process. Ellen Jepson (Stavanger, Norway) is the person who formats the text and she does a magnificent job in converting internationally-sourced assorted items of information into the well-designed IASP News Bulletin. Kenneth Hemmerick (Montréal, Canada) is involved in final proofing of the text and adds links if necessary. He creates a synopsis of the bulletin for the IASP Website, he lists the bulletin with an image on the IASP Web site, including the IASP Resource Directory, and he promotes the bulletin on the IASP FB Fan Page to our over 7,600 fans and on IASP Twitter to our 330 followers.

International Association for Suicide Prevention

Ella Arensman

Tony Davis

Ellen Jepson

Kenneth Hemmerick

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IASP TASK FORCE ARTICLES:

TASK FORCE on suicide prevention for older people Studies show that in many countries suicide rates among older

IASP Awards Sylvie Lapierre

Annette

Erlangsen adults are higher than, or as high as in young people. However, suicide in old age is a much neglected area. Considering that the number and proportion of the senior population will increase significantly in the coming decades (not only in financially wealthy countries, but also in developing countries), it is probable that the absolute number of suicides in this group will increase accordingly. It was with this problem in mind that a Task Force on Suicide Prevention for Older People was established in 2005 during the IASP Congress in Durban, South Africa.

The International Association for Suicide Prevention (IASP) provides awards for those who have contributed in a significant way to the furthering of the aims of the Association. Awards are presented at the IASP biennial conference. INSTRUCTIONS: Please send your nomination directly to the Chair person of the appropriate Committee. Attach a brief summary of why you feel the nominee is deserving.Nominees do not necessarily have to be IASP members.

The objectives of the Task Force are to increase awareness and understanding on suicide in older people, and to assess the efficacy of intervention and prevention programmes, with older adults as the main target group. Two papers have been prepared in collaboration with members of the International Research Group on Suicide among the Elderly, and these will be published shortly in Crisis: 1) A systematic review of suicide prevention programmes for older people, and 2) Key considerations for preventing suicide in older adults: Consensus opinions of an expert panel. Planned activities include a review on psychosocial factors and suicidality in later life (project leader: Margda Waern from Sweden), as well as the organization of symposia at IASP Conferences.

If you would like to become a member of this Task Force, please contact one of the chairpersons: Annette Erlangsen (e-mail: aerlangs@jhsph.edu) or Sylvie Lapierre (e-mail: sylvie.lapierre@uqtr.ca) Professor Sylvie Lapierre, Ph.D, Co-Chair IASP Task Force on Suicide Prevention for Older People, Director of the Research Laboratory in Gerontology, Dept. of Psychology, Université du Québec à Trois-Rivières, Canada.

TASK FORCE on national systems for certifying suicidal deaths Restructuring the External Causes of Injury Chapter for ICD-11

By now, we may all have become accustomed to the change from 2010 to 2011. Paul Corcoran However, there is another 'twenty-ten' to 'twenty-eleven' change to which it may be far more difficult for the suicidology community to become accustomed. I am referring to the planned restructuring of Chapter 20 (External Causes of Injury) of ICD-10 for the update to ICD-11. As mentioned by IASP President Lanny Berman in the last News Bulletin, it is proposed to reduce the current priority given to the coding of Intent. The World Health Organization convened the Injuries and External Causes Topic Advisory Group which established a number of work groups leading to the production of a Background and Issues document and a Recommendations Paper. These highlighted some important issues needing to be addressed, for example, the need for better criteria for coding intentional self-harm and the underestimation of intentional self-harm because 'accidental' is sometimes the default where there are problems determining intent. Unfortunately, the difficulty in establishing intent is one of the reasons behind the recommendation to prioritise the coding of mechanism and object over intent.

Currently, ICD-10 requires coders to first choose which of six intents applied to the event (accidental, intentional self-harm, assault, undetermined, legal intervention or medical complication). Coders must then choose the mechanism involved (e.g. drowning, poisoning, fall, etc.) and then, where applicable, choose the object that was involved (e.g. sharp object, firearm, motor vehicle, etc.). The proposal for ICD-11 is that the order of coding be Mechanism-Object-Intent. Therefore, coders will choose from a list of dozens of mechanisms then identify the class, category and type of object involved (as up to 1,000 objects may be specified) and then assign intent. Prioritising the detailed coding of object over the coding of intent is almost certainly going to impact negatively on the completeness and quality of intentional self-harm data. We are all aware of the issues related to data quality in suicidology and we need to do what we can to prevent changes to ICD that will further compromise data quality.

The suicidology community are underrepresented on the groups associated with the proposed recommendations and therefore it is important that the IASP membership make its voice heard. Comments and requests for further information can be addressed to the Dr Paul Corcoran, Chair of the Task Force on National Systems for Certifying Suicidal Deaths at http://www.iasp.info/national_systems_for_certifying_suicidal_deaths.php.

Dr Paul Corcoran, Chair of the Task Force on National Systems for Certifying Suicidal Deaths, Deputy Director/Senior Statistician, National Suicide Research Foundation, Cork, Ireland, paul.corcoran@nsrf.ie

DEADLINE: 31 March 2011

The Stengel Research Award

has been provided since 1977 and is named in honour of the late Professor Erwin Stengel, one of the founders of the IASP. This award is for outstanding active research with at least 10 years of scientific activity in the field, as evidenced by number and quality of publications in internationally acknowledged journals.THE CRITERIA FOR SELECTION ARE: • Outstanding and active research with at least 10 years of scientific activity in the field, as evidenced by the number and quality of publications in internationally acknowledged journals.

THE STENGEL RESEARCH AWARD CHAIR PERSON: Prof. Kees van Heeringen, University of Ghent, Department of Psychiatry, Unit of Suicide Research, De Pintelaan 185, B-9000 Belgium. Tel: +32 [9] 332 43 30 / Fax +32 [9] 332 49 89. Email: cornelius.vanheeringen@UGent.be

The Ringel Service Award was instituted in 1995 and honours the late Professor Erwin Ringel, the founding President of the Association. This award is for distinguished service in the field of suicidology, and nominations can be made by National Representatives of IASP. THE CRITERIA FOR SELECTION ARE: • Actively involved in the practice of suicide prevention and crisis intervention and its dissemination • Acknowledged as a national initiator or leader in the field • Suicide prevention and/or crisis intervention should be the main portion of his/her work. RINGEL SERVICE AWARD CHAIR PERSON: Dr Morton Silverman, 4858 South Dorchester Avenue, Chicago Il 60615-2012, USA. Phone: +1 773 550 8179 / Fax: + 1 773 624 3995. E- mail: msilverma@edc.org

The Farberow Award was introduced in 1997 in recognition of Professor Norman Farberow, a founding member and driving force behind the IASP. This award is for a person who has contributed significantly in the field of work with survivors of suicide, and nominations can be made by any member of IASP. THE CRITERIA FOR SELECTION ARE: • Has been actively involved in the establishment and operation of bereaved by suicide/survivor programs • Has demonstrated national leadership in the area • Has contributed to the research and evaluation of such program • Will continue to be involved in this important area of work. FARBEROW AWARD CHAIR PERSON: Karl Andriessen, Vaartdijk 60, 2800 Mechelen, Belgium. Phone: +32 [9] 233 50 99 / Fax: +32 [9] 233 35 89. Email:karl.andriessen@pandora.be

The De Leo Fund Award honours the memory of Nicola and Vittorio, the beloved children of Professor Diego De Leo, IASP Past President. The Award is offered to distinguished scholars in recognition of their outstanding research on suicidal behaviours carried out in developing countries. Members of the International Association for Suicide Prevention (IASP) are invited to nominate suitable persons for the De Leo Fund Award. It is for the person who in the view of the award committee has contributed significantly to developing suicide research in a developing country. Nominees do not necessarily have to be IASP members. TO BE ELIGIBLE FOR THE DE LEO FUND AWARD, CANDIDATES SHOULD DEMONSTRATE THE FOLLOWING CRITERIA: • Be born in a developing country • Have performed their research in a developing country • Be a young/mid career researcher (no more than 20 years from graduation), with a prevailing interest in research in the field of suicide • Be able to demonstrate, through publications in internationally indexed journals, their competence in the field of suicide • Not to be a current nominee for any other IASP Award. DE LEO FUND AWARD CHAIR PERSON: Prof. Diego De Leo, Australian Institute for Suicide Research and Prevention, Griffith University, 176 Messines Ridge Rd, Mt. Gravatt Campus, Mt Gravatt QLD 4122, Australia. Phone: + 61 7 3735 3377 / Fax: + 61 7 3735 3450. E- mail: D.DeLeo@griffith.edu.au

International Association for Suicide Prevention

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IASP World Congress in Beijing

Sixth Aeschi Conference

IASP's 26th World Congress will be held in Beijing from September 13th to 17th, 2011. This is the second time a world conference on suicide prevention will be held in Asia. The first was in India in 2001– highlighting the important role of the Asia-Pacific in the global effort to reduce the toll of suicide. The relatively high rate of suicide in many countries in the region has stimulated researchers, clinicians and policy makers to develop and assess a range of innovative methods for addressing the problem of suicide. These efforts have drawn attention to the crucial role of culture in the understanding and prevention of suicide, so cultural perspectives has been selected as the central theme for the congress.

In the year 2000 our team from the University Psychiatric Hospital in Bern invited a number of international experts in suicide prevention to discuss the results of a clinical study which analysed narrative interviews with patients Konrad Michel who had attempted suicide. This 3-day conference was held in a conference hotel in Aeschi, a village in the Swiss Alps. The meeting had a remarkable dynamic and resulted in the foundation of the “Aeschi Working Group”. This group of clinicians and researchers produced a paper with guidelines for clinicians (1), and, above all, decided to open up the circle by inviting interested clinicians and researchers to future “Aeschi Conferences” (http://www.aeschiconference.unibe.ch).

The Congress will bring together the dynamic forces of rapidly transforming Asia with the rich experience of experts from other parts of the world, where there is a much longer history of working in the field of suicidology. Asian countries face many of the same challenges in suicide research and suicide prevention experienced by other parts of the world. But the limited health and mental health resources, large rural populations, rapid economic changes and ongoing political reforms in many Asian countries make it difficult to apply the standard methods of addressing these challenges developed in Western countries over the last several decades. Much of what is happening in China and other parts of the Asia-Pacific region is throwing new light on old problems, so the Congress will be a platform for exchanging ideas, renewing old friendships and, most importantly, for initiating new collaborative ventures.

The congress will include an exciting selection of plenary sessions by established and up and coming experts. Symposia, workshops, debates Yueqin Huang and master's classes will cover the full range of topics of interest to those working towards the global goal of preventing suicide and of improving our methods for dealing with the consequences of suicidal behaviour. A variety of social activities will be arranged for first visitors and old friends who wish to explore the rapidly transforming culture of China's capital or make side visits to other parts of China. Welcome to Beijing in September 2011! Yueqin Huang, MD, MPH, PhD Professor of Psychiatric Epidemiology, Institute of Mental Health, Peking University, Beijing

Important Deadlines 1 January, 2011: Registration opens 31 March, 2011: Deadline for abstract submission 1 May, 2011: Response to authors about acceptance of abstracts 15 June, 2011: Deadline for authors of abstracts accepted as oral presentations to confirm attendance A limited amount of bursary support for the registration fee is made available by Peter Lee Care for Life Foundation to the participants from low income countries who is going to make a presentation (oral/poster) in the congress. Please submit a brief CV to Paul Yip, co-chair of the scientific committee for consideration. E-mail: sfpyip@hkucc.hku.hk Congress Contact Details Telephone/Fax number: 010-8280 5411 E-mail: secretary@iaspchina.org academic@iaspchina.org Website: www.iaspchina.org

These biennial conferences have become an internationally acclaimed institution in the field of clinical suicide prevention. They are exceptional in that for three days they bring together in a very personal and creative setting clinically oriented suicide experts and practitioners. The Aeschi Working Group, together with other clinical experts, have recently published an edited book reflecting the “Aeschi philosophy” (2).

The theme of the sixth conference (20th-23rd March 2011) is Trauma and Suicide. Accumulating research – psychological, genetic, and neurobiological – has in recent years emphasized the importance of the trauma concept as a central etiological element for suicide. Research results will be discussed in the context of patients' personal suicidal developments. The presentations and workshops will range from basic considerations of the effects of trauma to more specific discussions of child abuse and war trauma as they bear on suicidality and its therapy. Professor Konrad Michel, Psychiatric Outpatient Clinic, University Hospital, Bern, Switzerland practice. E-mail: konrad.michel@spk.unibe.ch References: 1) Michel K, Maltsberger JT, Jobes DA, Leenaars AA, Orbach I, Stadler K, Dey P, Young RA, Valach L: Discovering the Truth in Attempted Suicide, American Journal of Psychotherapy 2002, 56/3, 424-437. 2) Michel K & Jobes DA (Eds.). Building a Therapeutic Alliance with the Suicidal Patient. APA Books, Washington DC, 2010.

The Aeschi Working Group The therapeutic approach to the suicidal patient: New perspectives for health professionals

Elections IASP Executive Committee Please note that the elections for the Executive Committee are underway. If you did not receive nomination papers, it may be due to the fact that the Central Administrative Office has yet to receive payment for 2010 or 2011 membership fees. If you have paid your membership fee and not received nomination papers, please contact the Central Administrative Office at admin@iasp.info as soon as possible and these papers will be sent to you immediately.

6th AESCHI CONFERENCE 20th-23rd March 2011 Patient-Oriented Concepts of Suicide: Trauma and Suicide Hotel Aeschi Park, Aeschi, Switzerland

www.aeschiconference.unibe.ch

44th American Association of Suicidology Annual Conference Changing the Legacy of Suicide April 13th - 16th, 2011 Hilton Portland & Executive Towers, Portland, OR, USA

For further information, see www.suicidology.org American Association of Suicidology (AAS)

International Association for Suicide Prevention

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MAY/JUNE 2011

newsbulletin International Association for Suicide Prevention

September 2011 marks the occasion for IASP’s 26th World Congress in Beijing, to be jump started with World Suicide Prevention Day on September 10th. I very much hope to see you in China and eagerly await hearing of your plans for promoting suicide awareness and prevention in your home country on the 10th. At our biannual general assembly meeting in Beijing, you will learn about several exciting programmatic initiatives being put into place by your

Lanny Berman

board, ranging from development projects to a significant new membership campaign, designed to increase the reach and strength of the organization. As an organization, we remain healthy and positioned to make significant impact – but we are an organization of individuals and each and every member needs to be part of the whole in a way that the whole is greater than the sum of its parts. Please make your plans NOW both to attend the Beijing Congress and to be active on WSPD. Thank you! Lanny Berman, Ph.D, ABP, IASP President

IASP World Congress in Beijing IASP's 26th World Congress will be held in Beijing from September 13th to 17th, 2011. This is the second time a world congress on suicide prevention will be held in Asia. The first was in India in 2001 – highlighting the important role of the Asia-Pacific in the global effort to reduce the toll of suicide. The central focus of the 26th IASP Conference is: Integrating Cultural Perspectives in the Understanding and Prevention of Suicide, a timely topic which will attract many participants from all continents! An exciting conference program has been prepared, including experts from all over the world, such as: Lanny Berman, Eric Caine, Cindy Claassen, Yeates Conwell, Paul Corcoran, Diego De Leo, Madelyn Gould, Onja Grad, Keith Hawton, Nav Kapur, Ad Kerkhof, Birthe Loa Knizek, Konrad Michel, Brian Mishara, Merete Nordentoft, Stephen Platt, Jane Pirkis, Ping Qin, Xiao Shuiyuan, Morton Silverman, and Wang Xiangdong. A wide range of important topics will be covered, including: • New insights into treatment of suicidal behavior • Postvention in different cultures • Evidence-based suicide prevention strategies in schools • Changing paradigms: Classification of suicide in ICD-11 and DSM-IV • Information-communication technologies and suicide prevention • Suicide prevention and new media

• Cross-cultural aspects of suicidal behavior in young people • Connectedness and suicide prevention in later life Yueqin Huang In addition to Plenary Sessions, participants can select a wide range of Symposia, Workshops, Debates and Master Classes to allow for in-depth discussion for those working towards the global goal of preventing suicide and of improving our strategies to deal with the consequences of suicidal behavior. A variety of social activities will be arranged for those who wish to explore the rapidly transforming culture of China's capital or make side visits to other parts of China.

Welcome to Beijing! Yueqin Huang, MD, MPH, PhD, Professor of Psychiatric Epidemiology, Institute of Mental Health, Peking University, Beijing

Important Dates: • 31st May: Response to authors about acceptance of abstracts • 15th June: Authors need to confirm participation • 1st September: Deadline for registration

Congress Contact Details Telephone/Fax number: 010-8280 5411 Email: secretary@iaspchina.org or academic@iaspchina.org Website: www.iaspchina.org

In official relations with the World Health Organization

World Suicide Prevention Day 2011 The theme for the World Suicide Prevention Day (WSPD), 10th September 2011 is ”Preventing Suicide in Multicultural Societies”. The theme aims at raising awareness of the fact that all countries in the world are multicultural. Many countries harbour different minority groups in the form of various indigenous and/or immigrant groups, refugees and/or asylum seekers. Some countries also comprise many different ethnic groups due to artificial borders having been drawn by former colonial powers. This means that in all countries there are a variety of ethnic and religious groups living in the same society. National suicide prevention strategies have now been implemented in several countries, but not all of them reflect the fact that the country is multicultural. The strategy/program is often aimed at a majority population, and a specific cultural perspective or focus is missing. Strategies therefore may need revision with this in mind and countries still not having initiated suicide prevention efforts should integrate a cultural perspective from the start.

Suicide prevention in multicultural societies requires cultural sensitivity as well as cultural competence, and needs to be targeted multidisciplinary. More information will be provided in the upcoming WSPDbrochure to be published shortly.

The World Suicide Prevention Day brochure is available online at: http://www.iasp.info/wspd/index.php You may want to use the actual link: http://www.iasp.info/wspd/pdf/ 2011_world_suicide_prevention_day.pdf Professor Heidi Hjelmeland, 1st Vice-President IASP, Department of Social Work and Health Science Norwegian University of Science and Technology, Trondheim, Norway, e-mail: Heidi.Hjelmeland@svt.ntnu.no.

President: Dr Lanny Berman 1st Vice President: Professor Heidi Hjelmeland 2nd Vice President: Professor Paul Yip 3rd Vice President: Dr Ella Arensman

Treasurer: Professor Michael Philips General Secretary: Dr Tony Davis National Rep: Dr Murad Khan Organisational Rep: Dr Jerry Reed


REPORT FROM A NATIONAL REPRESENTATIVE

DSM-V

FROM THE PRESIDENT Thomas Kuhn's 1962 book, The Structure of Scientific Revolution, presented and popularized the concept of "paradigm shift." The advancement of science, Kuhn argued, was not evolutionary, but rather a "series of peaceful interludes punctuated by intellectually violent revolutions". These revolutions serve to replace one conceptual view with another. Beyond the eyes and ears of most Suicidologists, such a paradigm shift may be occurring in our field at the very moment; in fact, paradigm shifts may be occurring and, at that, in diametrically opposed directions. One shift is occurring in the world of public health, the other in the world of mental health. Both have major implications for our field.

ICD-11

The International Classification of Diseases (ICD) provides the global standard to classify diseases and health-related problems. The ICD is revised periodically; the ICD-10 was adopted in 1990. Currently, proposed revisions toward the adoption of ICD-11 are open for comment.

One proposed revision is to restructure external causes of injury, suicide being an intentional injury. In ICD-10, when a non-natural death occurs or a nonfatal act of self-harm brings the perpetrator-victim to the emergency department (ED), the injury is coded first for Intent, then Mechanism, then Object. For example, if an individual shows up at an ED having cut him/her self with sharp glass, the coding might reflect the injury as intentional (assuming it was assessed to be), by cutting/piercing (Mechanism) by sharp glass (Object). Similarly, one might intentionally or unintentionally (Intent) fall (Mechanism) from a man-made structure (Object), such as a building. Further positions in the coding sequence delineate, for example, different sub-types of Object. In the current ICD-10, Intent is in the first coded position. What is being proposed and considered is to move Mechanism to the first coded position, to be followed by Intent, so, for example, the injury coding will then be sequenced fall (Mechanism) intentionally (Intent) from man-made structure (Object).

The primary rationale for demoting Intent in this coding sequence is that (a) intent is not always easy to ascertain, whereas Mechanism is, and (b) it is more important to the international injury prevention community to, first and foremost, learn about Mechanism. That said, injury prevention specialists who are in favor of this change may not include injury prevention specialists who are Suicidologists. Embedded in the rationale for the proposed change is the reason why many in the Suicidology community are less than sanguine about this proposal, i.e. the further down Intent is in the string of items to be coded, the less often Intent will be inquired about, hence coded; consequently, suicidal behaviors will simply be coded less frequently and valuable data will be lost. Many of our colleagues are quite anxious about the impact this proposed change may have.

Since 1952, the American Psychiatric Association has published the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of classification of mental disorders used in the United States and in many other countries around the world. The latest revision (DSM-V) is expected to be published in 2013 and its proposed changes are currently being discussed and field tested.

Two separate working groups are considering proposals to make both Suicidal Behaviors and Non Suicidal Self Injury unique diagnostic entities, i.e. disorders, in DSM-V. If these proposals become the law of the mental health land, a major shift in epidemiologic research will result; now non-existent data system linkages will become realities; documentation of clinical histories, hence inter-caregiver communication and patient care will improve dramatically, adverse events will be more validly reported, etc. – all powerful arguments for elevating suicidal behavior to the level of a disorder. That said, there are some major fault lines in the current proposal, and there also may be some major unintended negatives in doing this. In contrast to the proposed changes in the ICD, the process for which has been reasonably transparent and in which the proposals themselves have been and remain open to comment, proposed changes to the DSM have occurred behind closed doors among a closed circle (the working groups) and only just now are beginning to come to light. It is unclear, however, whether it is too late for that light to shine back on these proposals before they become set in stone. The lack of transparency in this process has made a great many of our colleagues anxious.

IASP's Death Certification Task force, headed by Paul Corcoran, is hard at work building its commentary regarding the proposed ICD-11 revision. Until we learn more about the DSM-V proposals, IASP members cannot build such a similar commentary. Cindy Claassen is on board to give a plenary presentation at IASP's Beijing Congress this coming September on both these paradigm shifts and will better explain them and offer much greater insight into their pros and cons than I am able to at the time of this writing.

That these paradigm shifts are being well attended to in these ways by IASP and its members is just one more argument in favor of getting our colleagues to join IASP and to come to Beijing. Whether proactively or reactively, IASP, organizationally, and its members collectively have a great deal to say to influence the future of our field. Cindy Claassen's presentation is but one great reason to (1) make plans now to come to Beijing, and the importance of these paradigm shifts to our field argues strongly for (2) encouraging your colleagues to join IASP to help make our collective voice all that stronger. I trust you will seriously consider and act favorably toward both of my proposals.

Lanny Berman, Ph.D., ABPP

International Association for Suicide Prevention

C O U N T RY R E P O RT FROM RUSSIA In Russia, in 2009 the suicide rate was 26.5 per 100,000 (vs 39.3 in 1999) and has declined during the past decade, possibly Evgeny Lyubov due to greater social stabilization in the country. Levels of suicide across regions in Russia vary considerably. Older people and rural residents are at particular risk for suicide as are social vulnerable groups. In Russia, there is no national suicide prevention programme. However, in some regions (e.g., Omsk, Sverdlovsk, Tomsk, Irkutsk) motivated and committed professionals (usually psychiatrists) have attempted to create integrated systems of care and prevention of suicidal behaviour. In the 80s the following steps were taken: telephone crisis care for adults, children and adolescents, medical and psychological support in mental health outpatient clinics and inpatient crisis clinics. Ten to fifteen percent of people who survived a suicide attempt with serious mental disorders received treatment in psychiatric hospitals and psychiatric outpatient clinics. Systematic care (mainly pharmacotherapy) has become available only in recent years. Scientific research into identification of risk factors for suicidal behaviour in different age, professional and national groups is conducted in a few Russian scientific centers (e.g., Moscow, Tomsk, Krasnodar). National conferences for psychiatrists cover issues in relation to suicide. The first National Clinical Guideline «Psychiatry» (Dmitriva et al, 2009) contributes to optimizing diagnosis and therapy, such as depression and acute suicidal crises. The Moscow Institute of Psychiatry offers a number of initiatives leading up to a future national suicide prevention programme: 1) Regional suicidological services, 2) Assessment of the burden of suicide and suicide attempts, 3) Suicide awareness in primary care, psychiatric services and in schools, 4) Holistic assessment of biopsychosocial approaches in specific patient groups. As part of national suicide prevention programme, we will establish other major initiatives such as interdisciplinary team cooperation of specialists and volunteers in public organizations, media guidelines for reporting of suicide, training of psychiatrists and social workers. Professor Evgeny Lyubov, Head of the Department of Suicidology, The Moscow Institute of Psychiatry and National Representative, Moscow, Russia, e-mail: lyubov.evgeny @mail.ru.

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REPORT FROM A NATIONAL REPRESENTATIVE

COUNTRY REPORT FROM NORWAY Since the first Norwegian Plan for Suicide Prevention was launched in 1994, major initiatives and activities have been implemented in Norway. The main objectives have been to establish and strengthen and resource Kari Dyregrov communities, stimulate more systematic research, initiate systematic knowledge distribution, and organise public information sessions. Several centres, institutions and NGO's are involved in a wide range of activities. Some institutions mainly focus on primary suicide prevention tasks through different kinds of research projects, whereas others are involved more intensively in increasing knowledge distribution and awareness. The suicide prevention work is located within three different groups which have collaborative links: 1. The National Centre for Suicide Research and Prevention (Professor Lars Mehlum) has research, dissemination of knowledge and counseling as their main areas of work. The centre is running a masters in psychosocial work and suicide prevention, a website, a journal (Suicidology), as well as several research projects. Among the studies are: a) A study of DBT versus TAU in child and youth psychiatric clinics, b) A study of the chain of care for suicide attempters, and c) Evaluation of existing routine treatment for patients that are hospitalized for deliberate self-harm in emergency medical hospital units.

At the Ullevål Hospital Research Unit (Professor Øivind Ekeberg) several research projects are being conducted: a) Clinical, psychosocial and prognostic aspects concerning self poisoning, b) Follow-up after a suicide attempt by general practitioners (RCT), suicidal behavior among the elderly, c) The reliability of the suicide statistics in Scandinavia, d) Medical, ethical and psychodynamic aspects of suicide, and e) A study of the registration processes, law regulations and changes of classification for mortality coding and mortality statistics.

Finally, The Norwegian Institute of Public Health, the Suicide Research and Prevention Unit (Dr Gudrun Dieserud/ Dr Kari Dyregrov/Professor Heidi Hjelmeland and 2 PhD students) are working on: a) A large qualitative autopsy study aiming at generating phenomenological based understanding of the psychological mechanisms that are involved in the development of suicidal behaviour, b) Mapping the frequency of suicide in single vehicle road traffic accidents, c) General suicide statistics, d) A study of gender differences and suicide attempts, e) A longitudinal prospective study of suicidal behaviour, and f) Suicide bereavement in Sami (indigenous) regions of Norway. 2. A second group consisting of five Regional Centers for Violence, Traumatic Stress and Suicide are working mainly on knowledge distribution and awareness. Important work includes: a) Suicide prevention education for elderly people, b) Supervision of refugee reception centres, c) Implementation of National Guidelines in

psychiatric health care, d) Cooperation with the Norwegian Association for Suicide Survivors (LEVE) to improve the situation for suicide bereaved people, e) Registration and evaluation of the effectiveness of bridge barriers to prevent suicide, and f) Suicide prevention education for lay people, teachers, students and professionals. 3. LEVE is an NGO for suicide bereaved people, working with support and care for their members through information, grief groups, telephone lines, etc. In 2009, a documentary for television was produced, and at present LEVE works on a list of local crisis teams to be distributed to all working in the field so that people bereaved by suicide can receive instant professional help when needed. A national conference about suicide prevention and immigration will be held in addition to local events in 19 counties on World Suicide Prevention Day 2011 (amounting to 25–35 registered activities including seminars, theatre plays, new circus, music, stand up). Also, LEVE is working on a project together with representatives from the ambulance service and police to get a public praxis of helping out with the expenses due to cleaning service after a suicide. Dr Kari Dyregrov, Norwegian Institute of Public Health / Center for Crisis Psychology, National Representative for IASP, Bergen, Norway, e-mail: kari@krisepsyk.no

US CONFERENCE A HUGE SUCCESS Despite rain and clouds outside of the conference center, in mid-April a recordsetting 950+ gathered from around the globe at the 44th Annual American Association of Suicidology Conference in Portland, Oregon, USA. The conference was entitled: Changing the Legacy of Suicide and inside highly involved discussions, information sharing and support took place with more than six plenary sessions, hundreds of workshops and several awards for work in suicidology and 70 posters during the 3-day conference. A gathering of over 100 also attended the Healing After Suicide conference focused on bereavement and survivor programs with a keynote address by the wife of former actor Spalding Gray.

The meetings offered clinicians, researchers, advocates, students and survivors a wealth of the most current thinking and understanding of suicide and suicide loss. During the conference the US recognized the 10th anniversary of the US National Strategy for Suicide Prevention, announced expansion of task forces for special populations for the recently developed National Action Alliance for Suicide Prevention and released the new Media Recommendations for Reporting on Suicide. A number of US and international IASP members were in attendance and presented at the meeting. IASP members can also congratulate Diego de Leo who both presented and received the Dublin Award given annually for recognition of a career of outstanding service and contributions to the field of suicide prevention as evidenced by leadership, devotion and creativity. Dr. Daniel Reidenberg, US National Representative, e-mail: dreidenberg@save.org

Mort Silverman (SPRC), Lanny Berman (AAS), Dan Reidenberg (SAVE), Jerry Reed (SPRC)

International Association for Suicide Prevention

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REPORT FROM AN ORGANIZATIONAL REPRESENTATIVE

GOOD WORKS OF LIVINGWORKS Leading up to the 2005 Durban conference, Lars Mehlum invited LivingWorks to do an article on new developments in suicide prevention training (Ramsay, 2004). It identified ASIST's (Applied Suicide Intervention Skills Training) historical links to earlier reports. Maris Richard Ramsay (1973) reported the existence of a core knowledge base in suicidology that wasn't adequately disseminated to practitioners. Practitioner surveys revealed the lack of adequate preparation in higher education and absence of continuing education programs (Boldt, 1982). Snyder's crisis management study (1971) advised against referrals as standard operating procedure in suicide prevention activities.

The founders of LivingWorks (Richard Ramsay, Bryan Tanney, Roger Tierney, Bill Lang) rose to the knowledge transfer challenge using state-of-the-art social R&D (Rothman, 1981) to develop a standardized and locally adaptable suicide intervention training program. The 2-day ASIST pioneered attitude inclusiveness with knowledge and skill components. A unique Suicide Intervention Model (SIM) was developed to integrate them through interactive simulation practice and to guide real interventions. Working with ambivalence and the collaborative skill to listen to reasons for dying is a new priority in suicide intervention. This parallels proponents in psychotherapy who favor a collaborative responsibility in treatment care (Jobes & Drodz, 2004). The newest development was virtual simulation technology to help bridge skill retention gaps between classroom training and real interventions. The John Hopkins Applied Physics Laboratory, LivingWorks and Army Material Command partnered to develop a state-of-theart ASISTR (Applied Suicide Intervention Skills Training Reinforcer). This program provides post-training support and practice with a virtual person, whose suicide risk is different each time it is activated. Although only a pilot

demonstration, ASIST was in the process of a major update. LivingWorks (and others) continue to be strong supporters of virtual technology for supplementary post-training activities.

In 2004, a significant new program emerged from an Australian Defense Forces (ADF) invitation to build something between their use of ASIST and 1-hour awareness presentations. The result was safeTALK, a 3-hour suicide alertness program. It was piloted with ADF and fully produced in partnership with a major metro transit system and a large regional health centre in Canada. It is rapidly becoming a broader community dissemination program that complements ASIST training. The value of this mix is increasingly apparent under national strategy implementations in Ireland and Scotland. Scotland did a national field trial and (positively) evaluated video conferencing delivery of safeTALK to rural and remote island regions. An exciting technology innovation for safeTALK is an approved Apple App of its “help card” for those trained in the program, complete with built-in GPS to locate referral resources. SuicideCare is 1-day post-ASIST training with a primary focus on refining helping (clinical for some) competencies of helpers of persons at risk beyond the initial suicide crisis. It caters to a small but growing number in longerterm care roles. LivingWorks has been thoughtful about online suicide prevention activities. Its awareness program, SuicideTALK, is provided to ASIST trainers. It goes further upstream than most programs to focus on “awareness exploration” that invites participants to explore attitudes about open and direct talk about suicide in personal and community contexts. Participants explore an extensive matrix of motivational opportunities to help create suicidesafer communities. The TALK steps are shaped to help participants be open about the possibility of their own risk and how they can engage others in safeplanning steps to be helpful when a trained helper is not immediately

available. The online adaptation is underway with a leading edge e-learning partner.

LivingWorks' founders have a long history on the side of seeing niche suicide intervention training become part of the “core business” of mental and behavioral health care providers. Collaboration with a large provider of adult services to persons with severe mental illness and incorporation of suicide prevention into their core business is a current test of whether a cultural shift of this magnitude can be modeled. LivingWorks also has a keen interest in furthering the field's differential use of gatekeeper training between those with required-referral procedures and those with referral options in their safeplanning framework and sufficient training for first aid intervention to be an end in itself.

Looking to the future, LivingWorks is engaged in higher level thinking about the traditional prevention, intervention and postvention framework for suicide prevention activities. A revised cycle model has led to some exciting possibilities in “upstream” prevention work and innovative responses to Ed Shneidman's long held belief that “postvention is prevention”. Some of the work is well into the R&D process. Some is still conceptual. The commitment of LivingWorks to suicide-safer communities is deep and robust. We are proud of our sustained contribution to the development and delivery of community-based suicide prevention activities. Richard Ramsay, Co-founder and President of LivingWorks, e-mail: richard.ramsay@livingworks.net Reference list available upon request.

IASP SPECIAL INTEREST GROUP on Helplines Best Practices Helplines are increasingly being recognised as vital com-

More recently, research on help-seeking behaviours and suicide

ponents of a suicide prevention strategy. Their effectiveness lies in the offer of accessible (by phone), convenient (often 24/7 delivery) and confidential (no names) support to people who are in crisis. Accordingly, helplines can attract suicidal persons to reach out for help at a critical time, thereby enabling a compassionate response to be provided and the potential for life-saving intervention towards safety and continuing support.

risk assessment has informed the practice of helplines towards clearer understandings of effective response to callers in crisis. Attention to safety planning with suicidal callers and the interAlan Woodward play between helplines and emergency services is reinforcing the life saving value of crisis outreach. An emphasis on creating pathways for callers towards accessing ongoing mental health services is also framing the role of helplines as gateway services – playing a key role in a national primary health care system.

International experiences on helplines are being shared and attention is being drawn towards framing principles and techniques for good practice. While helplines were developed as long ago as the 1960's through the community mental health movement, it is a relatively recent development that sees a shift towards 'evidence based' practice and definitions of intended consumer outcomes. Crisis theory and the principles of consumer empowerment have formed the basis for suicide helplines in their operation. Many helplines world-wide use volunteers and non-professional workforces in their delivery. This shows the ability of the helplines to harness community resources towards suicide prevention.

The Special Interest Group on Helplines Best Practice is being established within IASP to encourage sharing of experience amongst helpline practitioners and utilisation of research/evaluation findings towards improved satisfaction and outcomes for callers.

Those interested in Helplines are invited to contact the Convenor of this Special Interest Group, Alan Woodward, from Lifeline Australia, on email: alan.woodward@lifeline.org.au.

International Association for Suicide Prevention

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NEW REPORT

How to reduce risk of suicidal behavior after patients leave emergency departments and hospitals

International Association for Suicide Prevention (IASP)

The National Suicide Prevention Resource Center and the American Association of Suicidology are pleased to announce the release of Continuity of Care for Suicide Prevention and Research, a comprehensive report offering recommendations for the ongoing care of patients at risk for suicide who have been treated in emergency departments and hospitals. Based on an encyclopedic review and analysis of existing research, the 150-page report was authored by David Knesper, M.D., Department of Psychiatry, University of Michigan, and is the first review of continuity of care as a means to prevent suicide.

The International Association for Suicide Prevention (IASP) is a worldwide non-governmental organization dedicated to the prevention of suicide. In official relations with the World Health Organization, IASP's members come from over 50 countries across the world.

The report includes ten principles for improved continuity of care, and provides real-world examples of seven integrated systems of care in the U.S. and Europe. Other key recommendations for practice and research address: targeting high-risk individuals; improving education and training for suicide risk assessment; responding to patients who have become disengaged from treatment; coordinating care; and improving infrastructure to provide continuity of care.

BECOME AN IASP MEMBER TODAY! YOUR BENEFITS:

The American Association of Suicidology and the Suicide Prevention Resource Center have collaborated to produce this document which was funded by the Substance Abuse and Mental Health Services Administration.

It may be downloaded from the websites of either organization at http://www.sprc.org/library/continuityofcare.pdf or at www.suicidology.org. We would appreciate your assistance in promoting this report and forwarding it to others who may find it useful in their clinical or research work. Dr Jerry Reed, Director, Center for the Study and Prevention of Injury, Violence, and Suicide, Director, Suicide Prevention Resource Center, IASP Organizational Representative, e-mail: jreed@edc.org

Elections IASP Executive Committee Please note that the elections for the Executive Committee are underway. If you did not receive nomination papers, it may be due to the fact that the Central Administrative Office has ye t to receive payment for 2010 or 2011 membership fees. If you have paid your membership fee and not received nomination papers, please contact the Central Administrative Office at admin@iasp.info as soon as possible and these papers will be sent to you immediately.

IASP CONNECTS PEOPLE WORKING IN SUICIDE PREVENTION AND RESEARCH ACROSS THE WORLD! • Free access to Crisis - The Journal of Crisis Intervention and Suicide Prevention - 6 issues per year • Reduced registration fee for IASP conferences • Access to a large international network of experts in suicide prevention and research WHY WAIT ANY LONGER? BECOME PART OF IASP NOW! Membership Dues (Opportunity to pay for 3 year membership at a reduced fee) Membership dues according to the zones used by the World Bank. Here is the link for the Membership Application page: https://www.iasp.info/application.php Here is the PDF Application Form link: http://www.iasp.info/forms/2011_application_form_may.pdf Individuals Zone 1: US $170 (3 years $460) Zone 2: US $140 (3 years $380) Zone 3: US $120 (3 years $310) Zone 4: US $95 (3 years $260) Organization (Less than $1 million pa budget) Zone 1: US $200 (3 years $550) Zone 2: US $150 (3 years $400) Zone 3: US $130 (3 years $340) Zone 4: US $100 (3 years $270)

Organization (More than $1 million pa budget) Zone 1: US $220 (3 years $600) Zone 2: US $170 (3 years $460) Zone 3: US $150 (3 years $390) Zone 4: US $120 (3 years $300) Students, Volunteers and Associate Members US $90 (3 years $240)

Contact:

International Association for Suicide Prevention

IASP Central Administrative Office International Association for Suicide Prevention National Centre for Suicide Research and Prevention Sognsvannsveien 21, building 12; N-0372 Oslo, Norway Email: admin@iasp.info Web: www.iasp.info Tel: +47 22 92 37 15 / Fax: +47 22 92 39 58

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