Outreach Psychiatric Emergency Service

Winter, Remco F. P. de; Hazewinkel, Mirjam C.; Sande, Roland van de; Beurs, Derek P. de; Groot, Marieke

doi:10.1027/0227-5910/a000651

Cited by 10 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Between January 2018 and January 2020, a total of 503 cases of patients with suicidality were examined and assessed by the outreach psychiatric emergency service of The Hague in the Netherlands [ 42 ]. Of the 503 cases, 100 were included in this study in the order of entry.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A Clinical Model for the Differentiation of Suicidality: Protocol for a Usability Study of the Proposed Model

de Winter,

Meijer,

Enterman

et al. 2023

JMIR Res Protoc

View full text Add to dashboard Cite

Background Even though various types of suicidality are observed in clinical practice, suicidality is still considered a uniform concept. To distinguish different types of suicidality and consequently improve detection and management of suicidality, we developed a clinical differentiation model for suicidality. We believe that the model allows for a more targeted assessment of suicidal conditions and improves the use of evidence-based treatment strategies. The differentiation model is based on the experience with suicidality that we have encountered in clinical practice. This model distinguishes 4 subtypes of entrapment leading to suicidality. The earliest description of this model and a proposal for usability research has been previously presented in a book chapter. Objective In this study, we present the most recent version of the 4-type differentiation model of suicidality and a protocol for a study into the usability of the proposed model. Methods The 4-type differentiation model of suicidality distinguishes the following subtypes: (1) perceptual disintegration, (2) primary depressive cognition, (3) psychosocial turmoil, and (4) inadequate coping or communication. We plan to test the usability of the 4 subtypes in a pilot study of 25 cases, and subsequently, we will include 75 cases in a follow-up study. We looked at the case notes of 100 anonymized patients with suicidality who presented to mental health care emergency service in The Hague International Center. The summary and conclusions of the letters sent to the patients’ general practitioners after suicide risk assessment will be independently rated by 3 psychiatrists and 3 nurse-scientists for absolute and dimensional scores. The Suicidality Differentiation version 2 (SUICIDI-II) instrument, developed for this study, is used for rating all the cases. Intraclass correlation coefficients for absolute and dimensional scores will be calculated to examine type agreement between raters to examine the usability of the model and the feasibility of the SUICIDI-II instrument. Results We consider the model tentatively valid if the intraclass correlation coefficients are ≥0.70. Subsequently, if the model turns out to be valid, we plan to rate 75 other cases in a follow-up study, according to a similar or adjusted procedure. Study results are expected to be published by the end of 2023. Conclusions The theoretical roots of the differentiation model stem from classic and contemporary theoretical models of suicidality and from our clinical practice experiences with suicidal behaviors. We believe that this model can be used to adjust the diagnosis, management, treatment, and research of suicidality, in addition to distinguishing different dynamics between practitioners and patients with suicidality and their families. International Registered Report Identifier (IRRID) DERR1-10.2196/45438

show abstract

Section: Resultsmentioning

confidence: 99%

“…In a previous study conducted at The Hague Emergency Service, one-third of the assessed patients exhibited suicidality [41,42]. In this study, 100 cases of patients with suicidality were included in the order of entry.…”

Section: Samplingmentioning

confidence: 99%

A Clinical Model for the Differentiation of Suicidality: Protocol for a Usability Study of the Proposed Model

de Winter,

Meijer,

Enterman

et al. 2023

JMIR Res Protoc

View full text Add to dashboard Cite

show abstract

“…An independent, consultant psychiatrist decides which policy to follow, based on the assessment of the crisis service, for example whether or not to move a person will be voluntarily or involuntarily to a psychiatric emergency facility [30]. Crisis services and acute admission wards are frequently confronted with serious suicidal behaviour and make a signi cant contribution to the prevention of suicide [31,32].…”

Section: Introductionmentioning

confidence: 99%

First Step Validation Study for Four Subtypes of Suicidality in Mental Health

Winter,

Meijer,

Bos

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background Based on clinical experience, a differentiation model for suicidality consisting of four subtypes of suicidality was developed. 1) perceptual disintegration (PD), 2) primary depressive cognition (PDC), 3) psychosocial "turmoil" (PT) and 4) inadequate communication/coping (IC). A study was carried out to examine the validity of the proposed subtypes in absolute/discrete, gradual way and with a self -developed gradual questionnaire. Objective A first step was to examine the model and questionnaire for feasibility, reliability and validity in clinical practice. The “real life”, practical application of the model was examined, as were the resulting suggestions for improvement. Methods Discharge letters to general practitioners of 25 cases of anonymized suicidal emergency patients were independently reviewed and coded/classified by three psychiatrists, and three nurses. The SUICIDI-2 questionnaire was created to be able to describe our proposed subtypes of suicidal behaviour and was used in this study to allocate cases to these subtypes. Intraclass Correlation Coefficients (ICC) for absolute/discrete and gradual scores were calculated to examine the model’s validity. The study was approved by an ethical board.. Results All reviewers were able to assign subtypes, using the SUICIDI-2’s absolute and gradual scores, for all cases. We found an average measure of good reliability for absolute/discrete subtypes. For gradual scores, we found excellent average measures for the subtype PDC, and good for the subtypes PD, PT and IC. The reliability of gradual score for the SUICIDI-2 was relatively lower than an alternative gradual scoring, but had a good ICC value for all subtypes. The formulation for PD and IC was discussed with the reviewers and agreement was found about definitions. Conclusions The subtypes are validly delineated. After reviewing the results though, we found the interference of substance use was not consistently assessed by all raters. This was grounds to narrow down the criteria of the questionnaire and describe the model more clearly. The SUICIDI-2 questionnaire will be revised. A follow-up study with more conclusions for validation will looked at in relation to clinical and demographic aspects. It is essential for psychologists and other professionals to be involved in the further development and follow-up of the model and validation.

show abstract