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Relevance of the study

Importance of the study to health and social care in Ireland

The four-level community intervention study is expected to contribute to early identification and improved care of depressed patients and those who engage in DSH, as well as the prevention of suicide. The proposed pilot study is highly relevant in the Irish context, considering the increasing rates of deliberate self harm among adolescent females and males and increasing rates of suicide in young adult males in recent years.

The intervention study will be the first integrative and systematic approach to address the increase in depression, DSH and suicide in Ireland at different levels, and can therefore be considered innovative. The high level of depression, the increasing rates of DSH in young people and increasing rates of suicide in young men further underline the relevance of piloting the four-level intervention programme in Ireland.

The intervention study will contribute to implementing goals and priorities of the Health Strategy, Quality and Fairness (Department of Health and Children, 2001), in particular objective 4: “Specific quality of life issues are targeted”, stating that “suicide prevention programmes will be intensified”, as part of the new action programme for mental health. With regard to suicide prevention, suicide reduction and prevention are key targets of the Strategy for Health research. Considering the multiple factors that are associated with suicidal behaviour, a multi-level and multidisciplinary approach aimed at increasing awareness, improving early detection of those who are at risk of committing suicide and improving prevention is expected to have promising effects.
With regard to deliberate self harm, the four-level community based intervention programme will increase awareness, improve early detection of those who are at risk of engaging in deliberate self harm and will contribute to improved confidence and competence of health care professionals and community facilitators in working with people who engage in deliberate self harm.

The pilot study will examine the efficacy of an intervention programme which is in line with recommendations made by the National Task Force on Suicide (Department of Health and Children, 1998), for example to develop and test suicide prevention programmes, to provide specialist information and support for GPs in working with depressed suicidal patients and to promote positive mental health.

If the pilot study, testing the feasibility, acceptability and efficacy of the four-level community based intervention programme will provide positive and significant effects, the intervention programme may well be implemented at a national level during a third phase of a three tiered approach, which will be in line with current developments in Germany. This would start by the implementation of the Four-level community based intervention programme into the two comparison regions based on the availability of resources. In this regard, information on the outcomes of the pilot study will also be of relevance for the purpose of the National Action Strategy for Suicide Prevention, which is currently being prepared in Ireland.

If one reviews the original pilot study in Nuremberg, two years following the four-level intervention programme, a significant decrease was observed in the number of DSH episodes, as well as a significant decrease in the use of highly lethal methods in DSH episodes. These positive outcomes of the German pilot study provided the basis for implementation of the four-level intervention programme at a national level in Germany. Furthermore, the positive outcomes of the German pilot study have also contributed to a successful application to the EU, who will provide partial funding to carry out a pilot study in 16 regions in other European countries, including Ireland.

Considering the findings of the German pilot study, this intervention study, aiming to examine the feasibility, acceptability and efficacy of the four-level intervention programme in one Irish region, has the potential to provide guidance on how to organise efficient and effective future action programmes in the field of depression, suicidal behaviour and mental health in general.

Última actualização em: 28.02.2011