Pilot study evaluation of suicide prevention gatekeeper training utilising STORM in a British university setting

Recent years have seen increasing awareness of the wide range of mental health problems faced by students. Gatekeeper training has been shown to have a positive impact on knowledge and attitudes about suicide prevention, although the evidence for skills acquisition is limited. We utilised the STORM® training package in an exploratory study to determine explore whether skills training could be successfully implemented in an educational establishment in the United Kingdom. In a pilot study assessing competence before and after the intervention there was evidence of acquisition of skills, improved attitudes and increased confidence. Further research should include a randomised controlled trial of such training.     

Does client self‐booking reduce ‘did not attends’ (DNAs) in a counselling service?

An important problem for our counselling service is the high number of clients who ‘did not attend’ (DNA) for their booked appointment. This paper aims to describe how we tackled this problem within our counselling service by using a Plan‐Do‐Study‐Act (PDSA) cycle (Langley, Nolan Norman and Provost, 1996). The results found that by devising a system whereby clients could self‐book their appointments we were able to reduce the DNA rate for first appointments from 31.70% to 2%. This has useful time and financial implications. We would expect that the self‐booking approach we have outlined here is adaptable for other counselling services.     

Parents’ Communication with Siblings of Children Affected by an Inherited Genetic Condition

The objective of this study was to explore parents’ communication about risk with siblings of children affected by an inherited genetic condition, and to ascertain what level of support, if any, is required from health professionals. Semi-structured interviews were conducted with affected and unaffected children and their parents. Families were affected by one of six genetic conditions representing different patterns of inheritance and variations in age of onset, life expectancy and impact on families. Interviews were analysed using constructivist grounded theory and informed by models which focused on three different aspects of family communication. Interviews with 33 families showed that siblings’ information and support needs go largely unrecognized by health professionals and sometimes by parents. Some siblings were actively informed about the genetic condition by parents, others were left to find out and assimilate information by themselves. Siblings were given information about the current symptoms and management of the genetic condition but were less likely to know about its hereditary nature and their own potential risk. When siblings were fully informed about the condition and included in family discussion, they had a better understanding of their role within their family, and family relationships were reported to be more harmonious. The information and support needs of siblings can be overlooked. Parents with the responsibility for caring for a child affected by a genetic condition may require support from health professionals to understand and respond to their unaffected children’s need for more information about the genetic condition and its implications for the children’s own future health and reproductive decision-making.     

“You cannot forgive and you cannot forget”: The Serbian refugee settlement experience in Australia

Currently, there is limited research on the settlement experiences of refugees from the Balkan regions and in particular Serbia. There is also a need to provide a contextual understanding of the refugee settlement experience. The current study explored the refugee experience of 12 male Serbian refugees (aged 30 to 65), who migrated to Australia following the Yugoslav Civil War (1991–2001). A qualitative, phenomenological methodology explored the experiences of the refugees from their own perspective. Thematic coding of the interview data revealed the two major themes of settlement and traumatic experiences, as central to the experiences of this group of refugees. Language difficulties, discrimination, stigmatization of Serbian identity, multiple losses and grief, and failing of the justice system to establish accountability and provide reparation to the victims were all significant obstacles to successful settlement. Most salient, however, were the experiences of torture and trauma. Participants were still trying to negotiate these memories years after the events. Nevertheless, some participants showed strong resilience and the belief that they became stronger as a consequence of their experiences. We encourage those working with Serbian refugees to help them search for meaning in their stories of trauma.     

Paying for kidneys: the case against prohibition

We argue that healthy people should be allowed to sell one of their kidneys while they are alive--that the current prohibition on payment for kidneys ought to be overturned. Our argument has three parts. First, we argue that the moral basis for the current policy on live kidney donations and on the sale of other kinds of tissue implies that we ought to legalize the sale of kidneys. Second, we address the objection that the sale of kidneys is intrinsically wrong because it violates the Kantian duty of respect for humanity. Third, we address a range of consequentialist objections based on the idea that kidney sales will be exploitative. Throughout the paper, we argue only that it ought to be legal for an individual to receive payment for a kidney. We do not argue that it ought to be legal for an individual to buy a kidney.     

Depression in the Context of Disability and the “Right to Die”

Arguments in favor of legalized assisted suicide often center on issues of personal privacy and freedom of choice over one's body. Many disability advocates assert, however, that autonomy arguments neglect the complex sociopolitical determinants of despair for people with disabilities. Specifically, they argue that social approval of suicide for individuals with irreversible conditions is discriminatory and that relaxing restrictions on assisted suicide would jeopardize, not advance, the freedom of persons with disabilities to direct the lives they choose. This paper examines the idea promoted by some proponents of assisted suicide that it is reasonable to be depressed about one's diminished quality of life in cases of irreversible illness or disability and, therefore, such depression should not call into question the individual's competence to request assistance in dying. The concept of rational depression is defined and examined in the context of: four real-life cases involving individuals with disabilities who requested assistance in dying; a set of criteria commonly applied to decision-making to determine rationality; and research bearing on the emotional status of people with disabilities. It is concluded that although disability is associated with particular socially mediated stressors, there is no theoretical or empirical evidence to indicate that depression and its role in the right to die is dynamically different, more natural, or more reasonable for disabled people than for non-disabled people.     

Post-Visit Reinforcement of Zoo Conservation Messages: The Design and Testing of an Action Resource Website

Wildlife tourism attractions such as zoos are uniquely placed to make an impact on people’s everyday environmentally responsible behaviors. However, research suggests that visitors who leave such sites with a heightened awareness and good intentions rarely translate their intentions into post-visit environmental actions. This article reports on the development of a website-based action resource designed to reinforce, complement, and extend zoos’ on-site conservation messages and support visitors’ translation of environmental behavioral intentions into actions. The effectiveness of the website in encouraging post-visit engagement in environmental behavior was tested using an experimental design with a follow-up sample of 475 zoo visitors across four sites in three countries. The group that had accessed the website scored significantly higher on a behavior change index than the group that had not accessed the website. Website features identified as most effective in engaging visitors and maximizing their uptake of environmentally sustainable behavior are discussed.