The Mind Yourself Project Overview

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The Mind Yourself ProjectOverview
Preliminary Findings

• Dr. Paul Gaffney
• Senior Clinical Psychologist Mind Yourself
  Project Leader
• 11th June 2007

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Mind Yourself Team

• Project Team Members
• Paul Gaffney, Kiera Cosgrove, Francis Agnew,
  Katrina Collins, Shauna Carragher, Fiona Flynn,
  Peadar Mallon Sinead McElduff
• Steering Group Members
• Dr. Vincent Russell, Dr. Ella Arensman, Dr.
  Paddy Halligan, Dr. Declan Bedford, Eileen
  Williamson, Tom Cahill, John Kearney, Finian
  Murray Dr. Maeve Doyle

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Acknowledgements Thanks

• Grateful thanks to our colleagues in the HSE
  throughout Cavan, Monaghan, Meath and Louth, and
  the National Suicide Research Foundation.
• Our project assistants, our Regional Steering and
  Local Advisory groups, Monaghan Lions Club and
  The Wedding March, ESB-Electric Aid Rath na
  nOg Regional High Support Service
• To all who have participated in and facilitated
  the project

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A Thought to begin with

• If you always do what youve always done, youll
  always get what youve always got
• Anon

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What is the Background here?

• Mind Yourself was established in Cavan/Monaghan
  during the summer of 2004 following successful
  application for funding from the then North
  Eastern Health Board Health Inequalities Fund,
  in partnership with the National Suicide Research
  Foundation.
• A core group of professionals from various
  backgrounds had been trying to address issues
  related to suicide in Cavan since 2000, with the
  help of the Health Promotion Department, Local
  Management the National Suicide Review Group.

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How did Mind Yourself come about?

• Following publication of the East Cavan Project
  report (Russell et al, 2002), The Impact of
  Suicide on Front line staff (Gaffney et al,
  2002), and a presentation Banging Your Head
  Against the Wall? Problems encountered in
  research suicide (Gaffney et al, 2003), we
  decided on a more pro-active approach, and the
  original Mind Yourself leaflet was developed
  with the Gaelic Players Association in September
  2003.
• This helped formed the basis to the current
  project alongside 2004 findings from the NSRF.

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Why bother with this project?

• Irish Suicide rates are still (too) high,
  especially for younger males, and DSH seems to be
  increasing
• Intervention efforts are frustrated as young
  Irish people may be aware of our services, there
  is a question of how credible professionals are
  to them (Russell et al, 2002), and accessing
  services, availability and configuration of
  resources, and moving beyond fire-fighting have
  been problematic
• Suicide remains notoriously difficult to predict
  and prevent (Eagles et al, 2001), so we need to
  look for fresh ideas, especially in pre- and
  post-vention

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Looking for InspirationYoung Peoples Views

• UN Convention on the Rights of the Child (1989)
• Young people must be given a voice on matters
  that affect them.
• The Lifestyle and Coping Survey (Sullivan et al.,
  2004)
• Make services youth friendly consult young
  people when developing services
• Make information readily available to the friends
  and families of young people
• The East Cavan Project (Russell et al., 2002)
• While it may be perceived as quite easy to access
  help, young people are unlikely to go seeking it.
  Services need to come to them.

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Looking For Inspiration Youth Suicide
Prevention Strategies

• Individual Factors Vs Suicide Awareness style
  of programme (Gould et al, 2003 Hardon et al,
  2001 Patton Burns, 1998)
• More effective to tackle the factors that
  influence suicidality
• Skills Training Programmes (Gould et al, 2003)
• Problem Solving
• Coping Skills
• Cognitive Skills

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Looking For Inspiration Youth Suicide
Prevention Strategies

• The Youth Suicide Prevention Evidence Briefing
  (2004)
• support the multisystemic approach to suicide
  prevention
• OConnor Sheehys (2000) five general education
  and prevention strategies
• Promote communication
• Educate in coping strategies
• Destigmatise difficulties with coping
• Destigmatise affective disorders
• Promote services

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Reach Out National Strategy for Action on
Suicide Prevention (2005)

• 4 Level approach recommended
• General Population Approach
• Targeted Approach
• Responding to Suicide
• Information and Research
• General Population Approach Goal
• To promote positive mental health and
  well-being and bring about positive attitude
  change towards mental health, problem solving and
  coping in the general population
• www.dohc.ie/publications/reach_out.html

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Focus of Project 1 Positive Psychology
Emotional Intelligence

• Positive Psychology (Seligman 1999) endeavours
  to enhance well-being and happiness rather than
  remediate deficits (Carr, 2002), and complements
  traditional mental health work.
• Positive psychology is in vogue now but is much
  older, with lineage back to Rogers, Maslow even
  James in the early 1900s.
• Emotional Intelligence is viewed both as the
  ability to understand, process and regulate
  emotional data (Mayer, Caruso Salovey, 2000)
  and as a set of personality traits (Bar-on, 2000)

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Focus of Project 2 Personal Strengths
Resilience and Optimism

• Resilience can be described as the capacity to
  survive, to progress through difficulty, to
  bounce back, to move on positively again and
  again
• Benard (1992) identified four attributes
  characteristic of resilient Young people
• 1. Social competence
• 2. Problem solving skills
• 3. Autonomy
• 4. A sense of purpose
• The Importance of nurturing hope and optimism
  (Carr, 2002)

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Focus of Project 3 Cognitive Behavioural
Approaches

• Effective development of coping skills,
  especially problem-solving skills through
  Cognitive Behavioural Therapy (CBT) (Elliott and
  Frude, 2001)
• When CBT is aimed at addressing problem-solving
  abilities in adolescents (Reinecke Didie, 2005)
• Suicidality decreased
• Hopelessness decreased
• Social problem solving ability enhanced
• Perceived ability to cope enhanced

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Focus of Project 4 Validated Evidence Overview

• The SuggestedApproach
• Holistic life skills
• Strength based
• General population
• Community based
• CBT strategies that enhance problem solving
  skills and emphasise Optimism
• Provision of information and services
• Empirical evaluation of intervention programmes

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Focus of Project 5 Community Focus

• Previous research we have undertaken has
  highlighted the potential for community
  involvement, consultancy and direction in the
  area of suicide prevention, as well as
  significant amounts of local knowledge and
  insight within local communities (Russell et al,
  2002)
• Congruent with the notion that a death by suicide
  is not just a health phenomenon, but also related
  to prevailing cultural, social and political
  factors (as reflected by differing suicide rates
  and methods across countries and ethnic groups)

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Outline of Intervention

• Generally group based, approx 5,500 young people
  have received the intervention so far, throughout
  Cavan, Monaghan, Louth and Meath (including the
  pilot phase) across two 80 minute group sessions
• Groups predominantly in secondary schools, and a
  range of other venues, with two facilitators.
• Group maximum size is 15, average participant age
  is 16 years

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Evaluation of Intervention-Pilot Stage

• HSE Dublin North East ethics committee approval,
  evaluation based in Cavan/Monaghan
• Measured pre and post intervention by measures of
  depression (Birleson), emotional intelligence
  (Bar-On EQ YV) and open ended questionnaire
• Use of randomised experimental group (n 720)
  and control group ( n 420)
• Initial evaluation completed to be repeated at
  12 24 monthly intervals

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Evaluation Selected Preliminary Results 1

• A decrease in Depression scores between pre and
  post intervention was observed for the control
  female group, the experimental male and female
  group, with the greatest shift being found for
  the experimental female group.
• Analysis of variance between pre and post
  intervention scores for the experimental group
  showed significant effects for the Birleson, and
  certain Bar-On EQ scales.

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Evaluation Selected Preliminary Results 2

• Analysis of variance for school code and Birleson
  score found a statistically significant effect
  for the experimental and control groups,
  indicating differences between schools, which
  need to be investigated further.
• General increase in pre and post intervention
  Bar-On EQ total scores in the experimental and to
  a lesser extent, control group

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Evaluation Selected Preliminary Results 3

• 91 of female participants and 94 of male
  participants agreed or strongly agreed that they
  enjoyed the programme
• 83 of female participants and 86 of Male
  participants agreed or strongly agreed that the
  programme was useful (8 of males/6 of females
  disagreed)
• 51 of female participants and 55 of Male
  participants agreed or strongly agreed that they
  coped better following the programme (13 of
  males/11 of females disagreed)

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So What ?

• Preliminary results appear to suggest that the
  model can contribute to adolescent suicide
  prevention by helping lower depressive symptoms
  and enhancing emotional intelligence and
  strengths
• This needs to be monitored over , 12 and 24
  monthly intervals, and other factors considered.
• Intervention can only be of use if it is of
  benefit, and not as an end in itself

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What have we learned?

• The flexible approach we have adopted seems as
  important as the actual intervention, and is best
  utilised as part of an overall plan (ie, Reach
  Out).
• We are trying to learn from earlier mistakes in
  relation to the intervention and take on a
  broader range of opinions and outlooks
• We have come across tragedy and the development
  of a post-vention programme has been important in
  a range of situations/events

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Where from here?

• Manuals Materials available from April 2007,
  and distributed to interested parties in Ireland,
  UK Europe, please ask for more information
• Follow up evaluation, further analysis of
  initial findings and further dissemination
• Possible shift to more training and consulting
• Training for Trainers Postvention Programme
• Take the First Step Programme
• Extended Mind Yourself Clinical Setting
• Physical Wellbeing/Mind Yourself programme

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A thought to finish with..

• The problem can no longer be seen as an
  individual and family tragedy, to be borne in
  secrecy and stigma. Suicide is everybodys
  business.
• Psychological Society of Ireland (1992)