Dreier Mareike, Baumgardt Johanna, Bock Thomas, Härter Martin, Liebherz Sarah
Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Res Involv Engagem. 2021 Sep 8;7(1):60. doi: 10.1186/s40900-021-00307-9.
Fear of stigmatization, self-stigmatization, and insufficient information can lead to secrecy, reduced help-seeking, lower self-esteem, and lower self-efficacy among people affected by suicidality or suicide. Therefore, we developed an online suicide prevention program aiming to improve knowledge about suicidality and suicide stigma.
Inspired by the Australian program The Ripple Effect, a German team comprising people with lived experience of suicide, researchers, and clinicians was established for developing an online suicide prevention program. Therefore, we oriented on guidelines for evidence-based health information, for reporting on suicide, and on dealing with suicidality. The lived experience team discussed and developed concept, structure, and content of the program. This manuscript presents summaries of protocols from 16 team meetings and 3 written text reviews to outline the program development process. A summative evaluation 3 years after program development began was qualitatively analyzed based on thematic analysis.
Between 2018 und 2021, the lived experience team (n = 10) discussed possibilities of support in suicidal crises, attitudes towards suicide, content, and design of the online program. In a structured process, six members of the lived experience team reviewed the content. Eight persons shared their lived experience of suicide in video reports by focusing on constructive ways of dealing with suicidality or a loss by suicide, conveying hope and encouraging people to continue living. Team members recommended greater public and patient involvement from the application stage, as well as more financial and personnel resources.
Through contributions to discussions and text reviews, the lived experience team shaped decisions in the program development process. While involving persons with lived experiences of suicide, it is important to consider that suicidality is 1. emotionally challenging, 2. a stigmatized issue, and 3. that the aspect of safety must be a priority. A distinction must be made between the duty of care based on actual risk and inappropriate overprotection. Hereby, transparency, autonomy, and a clear structure appeared to be helpful. For further research, we recommend a structured formative review process of the development of the program. Additionally, we recommend discussing the purpose and the specific design of the evaluation with a lived experience team in advance. Trial registration German Clinical Trial RegisterDRKS00015071 on August 6, 2018.
对污名化的恐惧、自我污名化以及信息不足，可能导致受自杀倾向或自杀影响的人群出现隐瞒行为、减少寻求帮助的行为、自尊心降低以及自我效能感降低。因此，我们开发了一个在线自杀预防项目，旨在提高对自杀倾向和自杀污名的认识。
受澳大利亚项目“涟漪效应”的启发，成立了一个由有自杀经历的人、研究人员和临床医生组成的德国团队，以开发一个在线自杀预防项目。因此，我们以基于证据的健康信息指南、自杀报告指南以及处理自杀倾向的指南为导向。有自杀经历的团队讨论并制定了该项目的概念、结构和内容。本文呈现了16次团队会议和3次书面文本审查的方案总结，以概述项目开发过程。在项目开发开始3年后进行的总结性评估基于主题分析进行了定性分析。
在2018年至2021年期间，有自杀经历的团队（n = 10）讨论了在自杀危机中提供支持的可能性、对自杀的态度、在线项目的内容和设计。在一个结构化的过程中，有自杀经历的团队的6名成员审查了内容。8人在视频报告中分享了他们的自杀经历，重点是应对自杀倾向或自杀造成的损失的建设性方法，传递希望并鼓励人们继续生活。团队成员建议在应用阶段让公众和患者更多地参与，以及提供更多的资金和人力资源。
通过参与讨论和文本审查，有自杀经历的团队在项目开发过程中做出了决策。在让有自杀经历的人参与时，重要的是要考虑到自杀倾向：1. 在情感上具有挑战性；2. 是一个有污名的问题；3. 安全方面必须是优先事项。必须区分基于实际风险的护理责任和不适当的过度保护。因此，透明度、自主性和清晰的结构似乎是有帮助的。对于进一步的研究，我们建议对项目开发进行结构化的形成性审查过程。此外，我们建议提前与有自杀经历的团队讨论评估的目的和具体设计。试验注册 德国临床试验注册中心DRKS00015071，于2018年8月6日注册。
