Is Suicide the End Point of Ageism and Human Rights Violations?

Wand, Anne; Verbeek, Hilde; Hanon, Cécile; Lima, Cabral; Rabheru, Kiran; Peisah, Carmelle

doi:10.1016/j.jagp.2021.05.025

Cited by 11 publications

(17 citation statements)

References 41 publications

(83 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, inpatient psychiatric care is neither necessarily warranted nor wanted after self-harm (Morrison et al, 1999), as reported by older people themselves who described complex responses to admission, including feeling imprisoned, under surveillance, invalidated or -in contrast -safe and relieved (Wand et al, 2018c(Wand et al, , 2019a. The rates of referrals from primary care to community mental health aftercare were low, perhaps reflecting limited understanding of the high risk of suicide in this vulnerable population and even ageism in clinical decision-making and care provision (Wand et al, 2021b). These findings highlight the need to find a balance between combatting ageist therapeutic nihilism with assertive aftercare, while also respecting consumer empowerment and choice where possible.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of evidence-based aftercare for older adults following self-harm

Wand

Browne

Jessop

et al. 2022

Aust N Z J Psychiatry

View full text Add to dashboard Cite

Objective: Self-harm is closely associated with suicide in older adults and may provide opportunity to intervene to prevent suicide. This study aimed to systematically review recent evidence for three components of aftercare for older adults: (1) referral pathways, (2) assessment tools and safety planning approaches and (3) engagement and intervention strategies. Methods: Databases PubMed, Medline, PsychINFO, Embase and CINAHL were searched from January 2010 to 10 July 2021 by two reviewers. Empirical studies reporting aftercare interventions for older adults (aged 60+) following self-harm (including with suicidal intent) were included. Full text of articles with abstracts meeting inclusion criteria were obtained and independently reviewed by three authors to determine final studies for review. Two reviewers extracted data and assessed level of evidence (Oxford) and quality ratings (Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative and Attree and Milton checklist for qualitative studies), working independently. Results: Twenty studies were reviewed (15 quantitative; 5 qualitative). Levels of evidence were low (3, 4), and quality ratings of quantitative studies variable, although qualitative studies rated highly. Most studies of referral pathways were observational and demonstrated marked variation with no clear guidelines or imperatives for community psychiatric follow-up. Of four screening tools evaluated, three were suicide-specific and one screened for depression. An evidence-informed approach to safety planning was described using cases. Strategies for aftercare engagement and intervention included two multifaceted approaches, psychotherapy and qualitative insights from older people who self-harmed, carers and clinicians. The qualitative studies identified targets for improved aftercare engagement, focused on individual context, experiences and needs. Conclusion: Dedicated older-adult aftercare interventions with a multifaceted, assertive follow-up approach accompanied by systemic change show promise but require further evaluation. Research is needed to explore the utility of needs assessment compared to screening and evaluate efficacy of safety planning and psychotherapeutic approaches.

show abstract

Section: Discussionmentioning

confidence: 99%

A systematic review of evidence-based aftercare for older adults following self-harm

Wand

Browne

Jessop

et al. 2022

Aust N Z J Psychiatry

View full text Add to dashboard Cite

show abstract

“…5 It may be a core contributing factor to suicide in older adults through ageist assumptions and communication styles, and missed opportunities for appropriate diagnosis and intervention. 8 Examples include considering depression as ‘understandable’ or ‘justifiable’ with associated therapeutic nihilism 9 and lack of active management; and judgements that suicide in an older adult is ‘not such a terrible thing’ 10 or understandable. 11 These must be challenged through training 12 and leadership 13 to prevent ineffective screening for suicide risk 14 and amplification of hopelessness in older adults in crisis.…”

Section: Towards Zero Suicide For Older Adultsmentioning

confidence: 99%

“…Knowledge deficits and ageism may reduce the effectiveness of assessments. 8,12 Improved access of primary care to older people's mental health services may assist with comprehensive assessment.…”

Section: Comprehensive Assessment and Risk Formulationmentioning

confidence: 99%

Towards Zero Suicide: need and opportunities to improve implementation of clinical elements for older adults

Wand

McKay

Pond

2021

Australas Psychiatry

Self Cite

View full text Add to dashboard Cite

Objective: The Zero Suicide (ZS) framework is increasingly used in Australia, but without published adaptations for older people, and limited access by older people when implemented. The aim of this paper is to inform Towards Zero Suicide (TZS) implementations to benefit older adults by considering the key differences in older adults at risk of suicide according to each clinical component of the ZS framework. Conclusion: TZS aspires to reduce deaths by suicide for people within healthcare by refocusing interventions on suicidality rather than diagnosis alone, emphasising evidence-based practices and cultural change. For TZS to be effective for older people, it is essential to ensure practices are based upon evidence relevant to older people and to ensure ageism is effectively counteracted. Older adults have distinct patterns of help seeking and service use, accompanied by differences in risk factors, presentations, and outcomes of suicidal behaviours. Ageism affects assessment, decision-making and actions to address self-harm and suicide for older people. Immediate and longer-term actions are essential to effectively implement TZS in this population.

show abstract

“…Finally, two areas of research on ageism need particular attention: the effect of ageism during the COVID-19 (Ayalon, 2020) and the effect of ageism on suicidal ideation and behavior (Wand et al, 2021) in older adults, a group at high suicide risk. The COVID-19 pandemic has exacerbated the mental health effects of ageism and contributed to a greater divide of young vs. old adults (Ayalon, 2020).…”

mentioning

confidence: 99%

“…Health care professionals or family members may not place significant emphasis on feelings of hopelessness or worthlessness, which contribute to suicidal ideation, because these emotions are considered a consequence of normal aging (Wand et al, 2021). Finally, lack of understanding of the unique aspects of aging contributes to the limited development and testing of psychosocial interventions for suicide prevention in late life.…”

mentioning

confidence: 99%

Current perspectives on research on ageism

Kiosses

Politis

2022

Int. Psychogeriatr.

View full text Add to dashboard Cite

In a recent report released in March 2021, the World Health Organization, Office of the High Commissioner of Human Rights (OHCHR), United Nations Department of Economic and Social Affairs (UN DESA) and United Nations Population Fund (UN-FPA) called for urgent action to combat ageism and provide better measurement and reporting "to expose ageism for what it isan insidious scourge on society" (World Health Organization, 2021b). According to the report, ageism is observed across many institutions and sectors of society, such as in the workplace, media, health care, and the legal system. Furthermore, ageism has serious and detrimental consequences on the individual, communities, and society.

show abstract

Is Suicide the End Point of Ageism and Human Rights Violations?

Cited by 11 publications

References 41 publications

A systematic review of evidence-based aftercare for older adults following self-harm

A systematic review of evidence-based aftercare for older adults following self-harm

Towards Zero Suicide: need and opportunities to improve implementation of clinical elements for older adults

Current perspectives on research on ageism

Contact Info

Product

Resources

About