Role of alcohol in pesticide self-poisoning: a scoping review
Dr Lisa Schölin, University of Edinburgh

Alcohol, self-harm and community interventions in Sri Lanka
Prof Thilini Rajapakse, University of Peradeniya

The link between ACEs and suicidal behaviour among young in Greenland
Dr Christina Viskum Larsen, University of Southern Denmark

Panel discussion chair:
Prof Flemming Konradsen, University of Copenhagen

International Use of CAMS: An Overview and Cultural Considerations

David A. Jobes1, Bent Rosenbaum2 Remco de Winter3 Paulius Skruibis4 , Tone Bovim5, Zaffer Iqbal6
The Catholic University of America, Washington DC USA1, Private Practice, Copenhagen, Denmakr2, Vrije University, Amsterdam, Netherlands3 , Private Practice, Vilnius, Lithuania4, Regional Centre for Trauma and Suicide Prevention Health Region East, Oslo, Norway5 , Psychological Services, NAViGO CiC, Grimsby, United Kingdom6

Introduction: This two-part pre-conference workshop will provide an initial broad overview of CAMS and introduce various research projects, its application, clinical use, and its adaptation in various European countries. David Jobes will provide an initial overview to CAMS and its use abroad and then moderate the two panel presentation of European experts describing their experiences and perspectives within their own countries.
Aim: The aim of this preconference workshop is to show various developments of this evidence based intervention across several European countries. Special consideration will be given to cultural considerations and adaptations that may be needed to successfully provide the intervention.
Methods: Two panels will provide perspectives on CAMS research, training, and its clinical use in their
respective countries. Panel 1 will feature presentations by Bent Rosenbaum (Denmark), Remco de Winter
(Netherlands), and Paulius Skruibis (Lithuania). Panel 2 will feature presentations by Tone Bovim (Norway)
and Zaffer Iqbal (United Kingdom). These presentations will be followed by a general discussion of all
workshop panellists before a larger discussion and questions and answers with audience members.
Results: CAMS is one of the few suicide-focused clinical interventions to have empirical support from several clinical trials among European investigators. Its use and training varies from country to country. How to maintain adherence to the model while scaling up its use is a general consideration related to systems of care, costs of training, and other reality-based constraints. While CAMS is used effectively by providers abroad, there are some limits and constraints using it across different cultures. While CAMS is meant to be flexible and adaptive, we will consider some cultural and translational considerations that may impact its use and effectiveness.
Conclusion: No clinical intervention will be effective with every patient across every setting around the world. However, CAMS has seen some measure of success in being used across cultures with supportive research and training in various parts of the world. Successes and limitations will thus be discussed as to how to expand the use of any evidence-based clinical approach to meet the needs of patients suffering with suicidal thoughts, feelings, and behaviours.

Approximately 5% of all suicides occur by railway, equivalent to 3,000 deaths every year in Europe. Previous strategies for prevention of railway suicides include: instalment of platform doors, soothing blue lights, suicide pits, encouragement for help-seeking, gatekeeper training, public campaigns, and fencing/physical barriers. The level of evidence is relatively meagre for other types of intervention than platform doors, which is not a feasible solution at all railway stations.

The international network, Trespass and Suicide Prevention Network, is open for researchers interessted in suicide prevention. The group also maintains the REST-RAIL website.

The meeting at the ESSSB is intented as a network meeting where on-going efforts of different groups are presented. All interested are welcome!

Approximately 5% of all suicides occur by railway, equivalent to 3,000 deaths every year in Europe. Systematic reviews suggest that platform doors may be one of the most effective measures for preventing railway suicides. Yet, this might be challenging to implement on stations frequented by train sets of various lengths and door positions. Several other efforts have been suggested but there is limited evidence regarding their effectiveness.

It is obvious that a stronger collaboration between groups working in different countries will improv ethe exchange of experiences.

This meeting is a network meeting for practitioners and researchers interested in prevention of railway suicides. There will be a short presentation of on-going efforts in several countries and general information regarding existing networks and resources, such as RESTRAIL.

All interested are welcome.

The purpose of ONE OF US is to reduce stigma related to mental illness in Denmark and the vision is a society with no more discrimination and exclusion based on mental illness. ONE OF US is a national program based in the Danish Health Authority regionally rooted in the psychiatric information units (PsykInfo) within the five target areas: Service users and relatives; professionals in the health and social sectors; young people; the labour market; the public and the media. The presentation will give examples of highlights from the program and an ambassador will share their personal experience with stigma, suicidal ideation and a suicide attempt.

Anja Kare Vedelsby, ONE OF US, Health Promotion and Inequality, Danish Health Authority, Denmark

Sidonia Tabitha Waco, Ambassador in ONE OF US

This is an advanced workshop on how to conduct metanalyses

Lecturer: Prof. Stefan Lucht from Germany
Topics:

• General lecture about meta-analysis with focus on suiciidology
• Hands on exercise with RevMan (a software which is free to use for everybody)
• Specific topics: publication bias, risk of bias
• Question and answer session on ongoing projects

Chair: Gil Zalsman, IASR

Conceptualizing the commerical determinants of suicide broadening the lens on suicide and self-harm prevention
Dr Duleeka Knipe, University of Bristol &
Dr May van Schalkwyk, LSHTM

Initiatives to reduce suicides involvling analgesics
Prof Keith Hawton, University of Oxford

Firearms and the firearm industry
Dr Nason Maani, LSHTM

Enhancing governance for suicide prevention: Towards managing conflict of interest
Prof Jeff Collin, University of Edinburgh

Introduction: Helplines worldwide have a small proportion of clients who call quite often. Research shows that counselors may experience “emotional drain” and feel that their calls are difficult, and question the usefulness of the help provided.
Aims: 1) to better understand the nature of frequent callers to suicide prevention helplines; 2) to understand how to better help them, based upon recent empirical research; 3) to experience in role plays recommended intervention methods
Methods: We first present results from three studies of telephone interventions with frequent callers, and a comprehensive literature review. We discuss implications of the findings for practice. Then, role-play activities will demonstrate recommended intervention techniques.
The three complementary studies analysed complete audio recordings of calls from all 105 frequent callers (>30 calls/month) during one month to the U.S. National Suicide Prevention Lifeline network. Trained research assistants reliably assessed characteristics of their first and last calls during the month. We related caller and helper call characteristics to positive changes and callers’ appreciation in post call surveys of help received, and we conducted qualitative assessments of all the 318 calls from a random sample of 24.
Results: Frequent callers are a heterogeneous group with multiple and diverse serious chronic problems, including suicidal behaviors. Counsellors generally focused on short-term solutions to problems, and rarely on the person, their strengths and feelings. Counselor techniques associated with more positive outcomes and greater caller appreciation include: reformulating statements, providing moral support, asking about coping strategies, suggesting problem solving techniques, asking callers to call back if needed, counselors being sincerely interested in them, and counselors disclosing personal information. Callers often rejected suggestions but generally appreciated the calls.
Conclusions:**** We make 14 recommendations about better helping frequent callers. These include: being more warm and empathic, developing individual care plans, respecting callers who do not desire to discuss solutions, more consistent suicide risk assessments, learning interaction techniques for people with cognitive impairments and those in pain, allowing continued follow-up with the same counselor.

Meeting #1 of the Special Interest Group on Suicide in Older Adults

In the line of fire - Suicide prevention in the debate on legalization of assisted suicide in Germany
Lindner R.1,2
1Institute of Social Work, University of Kassel, Kassel, Germany; 2National Suicide Prevention Programme for Germany (NaSPro), Kassel, Germany

Legalizing assisted dying for older adults who are not seriously ill: the risk of ageism
Van Wijngaarden E.J.
Department of Anesthesiology, Pain and Palliative Medicine, Radboudumc, Nijmegen, the Netherlands

The experience of adults bereaved by the suicide of an older relative
Michaud Dumont G.1,2, Lapierre S.1,2, Viau-Quesnel C.1
1Laboratoire interdisciplinaire de recherche en gérontologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada; 2Centre for Research and Intervention on Suicide, Ethical Issues and End-of-life Practices, Université du Québec à Montréal, Montréal, Canada

Swiss older adults’ perceptions of end-of-life issues
Castelli Dransart D.A.1, Maggiori C.1, Lapierre S.2, Voélin S.3
1School of Social Work, HES-SO University of Applied Sciences Western Switzerland, Fribourg, Switzerland; 2Dept. of Psychology, University of Quebec, Trois Rivieres, Canada; 3School of Social Work, HES-SO University of Applied Sciences Western Switzerland, Geneva, Switzerland

Future research on older adults’ attitude toward or request for euthanasia and assisted-suicide
Lapierre S.1, Castelli Dransart D.A.2, Erlangsen A.3, Canetto S.S.4, Heisel M.5, Lindner R.6, Scocco P.7 and members of the Special Interest Group
1Department of psychology, Universite du Quebec, Trois-Rivieres, Canada; 2School of Social Work, HES-SO University of Applied Sciences Western Switzerland, Fribourg, Switzerland; 3Danish Research Institute for Suicide Prevention, Copenhagen, Denmark; 4Department of Psychology, Colorado State University, Fort Collins, USA; 5Department of Psychiatry, Western University, London, Canada; 6Institute of Social Work, University Kassel, Kassel, Germany; 7ULSS-6 Euganea, Padova, Italy.

Problem solving therapy for suicidal people in the digital age
Dr. Simon Hatcher
Department of Psychiatry, Ottawa Hospital Research Institute, Ottawa, Canada

Learning objectives:

By the end of this workshop:

1. Participants will have a basic knowledge of the steps of problem-solving therapy.
2. Participants will understand how to use problem solving therapy when working with people who have presented to hospital with intentional self-harm.
3. Participants will be able to explore the advantages and disadvantages of using a blended problem-solving therapy that combines face to face therapy supplemented by an electronic case management system (patient facing app and clinician facing dashboard)

Problem solving therapy has been recommended in NICE guidelines on the longer-term management of self-harm and in the Cochrane Review on Psychosocial interventions for adults who self-harm. Problem solving therapy aims to teach a cognitive skill of problem solving over the course of six to eight sessions. It makes sense to patients and clinicians as it directly addresses the fact that by the time people present to hospital with self-harm they have usually run out of effective ways of solving their problems. Training in problem solving therapy is often hard to access and this workshop is an opportunity to gain an understanding of the intervention.

Dr. Hatcher and his team have designed a treatment programme and provided problem solving therapy for people who presented to the emergency departments of major hospitals in New Zealand and Canada following an episode of self-harm. Our results from these large-scale randomised controlled trials have indicated that PST resulted in reductions in hopelessness, suicidal thinking and depression, and improvements in problem solving abilities among people who received the therapy. There was also evidence that it decreased recurrence of self-harm in those who presented two or more times.

The workshop will be an experiential learning experience where participants will use their own problems (these do not require any intimate personal revelations) to gain a basic understanding of problem-solving therapy. This will be supplemented by online and hard copy materials. Participants will also be able to explore and discuss an ongoing trial of blended problem-solving therapy that combines face to face therapy supplemented by an electronic case management system (patient facing app and clinician facing dashboard).

ATTEMPTED SUICIDE SHORT INTEVENTION PROGRAM

Gysin-Maillart, A. 1, 2, 3
1Translational Research Centre, University Hospital of Psychiatry and Psychotherapy,
University of Bern, 2Switzerland, 2Unit for Clinical Suicide Research, Department of Clinical
Sciences, Psychiatry, Faculty of Medicine, Lund University, Sweden, 3University of Leipzig
Department of Medical Psychology and Medical Sociology, Germany

Suicide may appear as an option to escape from a subjectively unbearable life situation and may repeatedly emerge throughout life as a possible coping strategy when major life or identity goals are seriously threatened. Treatment of this high-risk group is challenging. The Attempted Suicide Short Intervention Program (ASSIP) is a three to four session brief therapy with an ongoing contact by semi-standardized letters, and has been found to be efficacious in reducing suicidal behavior. The brief intervention ASSIP emphasizes an early collaborative therapeutic alliance with the suicidal patient with the aim to reach a shared understanding of the suicidal crisis in a life-career (biographical) context. Meaningful preventive measures can then be developed. ASSIP is offered to suicide attempters in addition to treatment as usual and does not replace a long-term treatment.
This workshop will introduce the main theoretical concepts and the practice of the brief therapy ASSIP. Workshop participants will be walked through the five ASSIP elements sessions step-by step. Video examples, role-play, and case discussions will be provided.

By Ulrich Hegerl, Ella Arensman, Daniel Rock, Meike Baretta

Completed and attempted suicides are ever present challenges in global public health. Nearly 800,000 people die from suicide every year and the number of attempted suicides is estimated to be around 20 times higher. Most suicides occur in the context of psychiatric disorders, depression being by far the most important one. A variety of factors such as misconceptions about depression, stigma related to mental disorders, underdiagnosis at the primary care level, a lack of specialised care for suicidal persons or access to lethal means, all contribute to the high rates of attempted and completed suicides. Therefore, multilevel and community based interventions are most promising and have the best evidence base to be efficient in preventing suicidal behaviour.

The 4-level intervention concept of the European Alliance Against Depression (EAAD) targets both depression and prevention of suicidal behavior. It has already been implemented in 120 regions in- and outside of Europe. Within this concept, local alliances of relevant stakeholders are built, and activities are started simultaneously, addressing 1) primary care professionals, 2) the general public, 3) community facilitators and gatekeepers (clergy, caregivers, police, journalists, teacher, pharmacists), and 4) patients and their relatives. A broad catalogue of intervention materials is available in many languages, comprising digital self-management tools (iFightDepression-tool) educational workshop packages and professional awareness campaign materials. The 4-level intervention concept and the iFightDepression self-management tool were voted as “Best Practice” by representatives of the European Union Member States in 2019 and are presently being transferred to several new European countries within the EU-funded project EAAD-Best.

This symposium will share and address best practice examples, evidence for efficacy and concrete implementation experiences concerning community-based interventions targeting depression and suicidal behaviour. Aspects such as i) transfer and implementation of the 4-level intervention concept (Hegerl U); ii) application within the context of an existing national suicide prevention strategy and the resulting 'win-win' situation from an implementation research perspective (Arensman E); iii) further activities in Australia (Rock D); iv) and the Netherlands (Baretta M) will be presented.

Meeting #1 of the Special Interest Group on Suicide in Older Adults

Clinical characteristics of older, middle-aged and young adults with suicide attempts at psychiatric emergency departments
Wiktorsson S.1,2, Strömsten L.3, Renberg E.S.3, Runeson B.4, Waern M.1,2
1Department of Psychiatry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden; 3Department of Clinical Sciences, Umeå University, Umeå, Sweden; 4Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, and Stockholm Health Care Services, Region Stockholm, Sweden.

Recent epidemiological findings from Sahlgrenska Suicide Studies in Göteborg, Sweden
Waern M.1,2, Jonson M.1,3, Hedna K.1
1 Department of Psychiatry, Institute of Neuroscience and Physiology, Göteborg University, Göteborg, Sweden; 2Psychosis Clinic, Sahlgrenska University Hospital, Göteborg, Sweden; 3Affective Clinic, Sahlgrenska University Hospital, Göteborg, Sweden.

Distinct pathways to late-life suicidal behavior: Difference between early-onset and late-onset attempters
Szanto K.a, Galfalvy H.bc, Gujral S.a, Saplicki C.d, Berry A.d
aUniversity of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA; bColumbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY, USA; cNew York State Psychiatric Institute, Department of Molecular Imaging and Neuropathology, New York, NY, USA; dSouthern Methodist University, Dallas, TX,USA

A mobile intervention for suicide prevention in aging adults hospitalized for suicidality.
Kiosses D.N.1, Czaja S.2, Banerjee S.2, Putrino D.3
1Psychiatry Department, Weill Cornell Medicine, New York, USA; 2Department of Medicine, Weill Cornell Medicine, New York, USA; 3Department of Rehabilitation Medicine, Mount Sinai, New York, NY

Psychosocial interventions for depressed aging adults after a suicide-related hospitalization.
Kiosses D.N.1
1Psychiatry Department, Weill Cornell Medicine, New York, USA.

Older adult women and men’s attitudes and experiences of suicidality in Sweden: A phenomenological perspective
Hed S.1,2, Wiktorsson S.1,3 Berg A.2,4, Canetto S.S.5, Waern M.1,3
1Department of Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden; 2Older Adult Psychiatric Clinic, Sahlgrenska University Hospital, Göteborg, Sweden; 3Psychosis Clinic, Sahlgrenska University Hospital, Göteborg, Sweden; 4Department of Psychology, University of Gothenburg, Sweden; 5Department of Psychology, Colorado State University, Fort Collins, Colorado, USA.

Organizer/Chair: Prof. Dr. Thomas Forkmann, University of Duisburg-Essen/Germany, Department of Clinical Psychology,

Co-Chair: Prof. Dr. Heide Glaesmer, University of Leipzig/Germany, Department of Medical Psychology and Medical Sociology

Although the prevention of suicide attempts and suicides is among the major goals of international and national public health plans, it remains challenging. The valid prediction of suicidal thoughts and behaviors (STBs) is crucial for improving our understanding of suicidal developments, including acute suicidal crises. This symposium will present four talks on innovative research projects that apply different methodological approaches in order to improve our ability to predict suicidality.
Thomas Forkmann will present the study protocol and first results of an ongoing multicenter study that prospectively examines acute risk factors for suicidal ideation and behavior after discharge from inpatient psychiatric treatment using ecological momentary assessments (EMA) and passive monitoring. Lena Spangenberg’s talk will be about efforts on phenotyping suicidal thinking and behavior. Juliane Brüdern will present results from an ongoing study that aims at measuring a suicide-specific attentional bias with a modified version of the Suicide Stroop Task in patients with acute suicidality and at investigating its associations with depression, hopelessness and suicidal thoughts. Finally, Inken Höller will present results from a study that compared networks of depressive symptoms and suicide risk factors assessed with EMA in outpatients before and after cognitive behavioral therapy.

List of presentations

Forkmann, T., Glaesmer, H., Plein, L., Lucht, L., Schönfelder, A., Spangenberg, L. Acute risk factors for suicidal ideation and behaviour after discharge from inpatient treatment: the APOS-project

Spangenberg, L., Friedrich, M., Forkmann, T., Hallensleben, N., Schönfelder, A., Rath, D., Paashaus, L., Teismann, T., Glaesmer, H.1. Phenotyping suicidal thinking and behavior – Do suicidal subtypes differ in clinical characteristics and future suicide attempts?

Brüdern, J., Glaesmer, H. Behavioral measures of suicide risk: The Suicide Stroop Task

Höller, I., Rath, D., Wichelhaus, E., Forkmann, T. Networks of depressive symptoms and suicide risk factors before and after CBT

Sarchiapone M.1, Olie E.2, Balazs J.3, Apter A.4, Barzilay S.4, Hoven C. 5
1Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy; 2Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; 3Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eotvos Lorand University, Budapest, Hungary; 4Schneider Children's Medical Centre of Israel, Petach Tikvah, Israel; 5Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States

According to the World Health Organization estimates, suicide is the fourth leading cause of death in young people aged 15 to -19 years old, thus representing a serious public health issue. In this symposium, promoted by the EPA Section on Suicide and Suicide Prevention, several findings will be presented about suicide risk, assessment and prevention among adolescents. Judit Balazs will discuss the role of perfectionism as a risk factor for self-injurious behaviours. Marco Sarchiapone will review epidemiological findings on suicidal behaviour among adolescents with Autism Spectrum Disorder. Alan Apter will present the results of a study on the use of Ecological Momentary Assessment in high-risk suicidal adolescents. Finally, Christina Hoven will discuss the findings of a longitudinal study on suicide risk factors and prevention conducted in Guyana, one of the countries with the highest suicide rates worldwide.

Chair: Sarchiapone M.,
Co-Chair: Olie E.
Presenters:

1. Balazs J.: Self-injury and perfectionism
2. Sarchiapone M.: Suicidal behaviour among adolescents with Autism Spectrum Disorder
3. Apter A., Barzilay S.: Feasibility and acceptability of longitudinal passive and active digital monitoring in high-risk suicidal adolescents
4. Hoven C.: Youth suicide prevention in Guyana