Comparison of the Effects of Telephone Suicide Prevention Help by Volunteers and Professional Paid Staff: Results from Studies in the USA and Quebec,Canada

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.     

Terror in the countertransference: extreme anxiety as a clinician and organisational leader and its effects

Experiencing fear is a central feature of managing disturbed states of minds. In this paper, I will describe the experience of being terrified by a patient who was overtaken by extreme anxiety. Aetiologically, I will suggest that the lack of containment created terror in her mind. I will also describe my experience of leadership in a voluntary organisation. Using Hopper’s concept of a fourth basic assumption, I will highlight the omnipresence of annihilatory anxiety in an example of organisational trauma. I will suggest that focusing on the issues of countertransference, working through experiences of being terrorised and paying attention to how you emotionally respond are crucial to lessening terror.     

State of the States: A survey of statutory law,regulations and court rules pertaining to guilty pleas across the United States

A psycholegal research agenda on guilty pleas is in its nascent stage. Multijurisdictional surveys of related law and policy may advance this research agenda by focusing investigators on the specifics of existing policies and motivating cross‐jurisdictional comparisons of diverse policies. We thus conducted a systematic, national survey of statutes, regulations and court rules across the United States pertaining to nine aspects of the guilty plea process, including sentencing differentials, collateral consequences and waiver of rights, which have been identified in existing legal and psycholegal research and commentary. Following a discussion of these issues, including legal concerns and existing research findings, we present the results of our systematic survey. We supplement this review with a non‐systematic sampling of appellate case law. Broadly, there was notable diversity in whether and how jurisdictions approached these issues. We discuss general and specific implications of our findings for future research, emphasizing the importance of data on actual policies and procedures to the design of studies that may contribute to evidence‐based criminal justice policy.     

Addressing the brain drain: A partial cosmopolitanism approach

This paper joins the thorny debates on the “brain drain”. It first examines some of the core issues and debates around international migration and the asymmetry in the arguments that defend the right to restrict entry but are critical of any attempts to rein in exit. It then argues that the empirical evidence on this issue is contingent on multiple factors, which weakens the case for universal recommendations. Instead, the paper lays out a form of “partial cosmopolitanism” that attempts to balance an individual’s freedom to exit with the larger social good in two distinctive ways: first, by allowing some grains of sand in the wheels of skilled migration flows through contingent contracts in higher education; and second, enhanced temporary migration that encourages greater international mobility but with temporal curbs. The paper concludes by suggesting that in an era of international migration, welfare considerations need to account for both people within territorially bounded countries and territorially unbounded nations.     

Zur Dynamik der Interaktion in der Supervision

The manifold functions of a supervisor in following the course of complex processes together with the trainee, are: ? to keep the goals of the supervision in view, ? to establish a teaching alliance and to support the wish and ambitions of the candidate to learn, ? to build a platform for the complex interactions with the trainee with regard to the dynamics of the training situation and keeping in mind the institutional influences, ? to lay down the setting for the work, ? to explore and to reflect how transference and counter-transference influence the interaction between patient and analyst as well as between trainee and supervisor, ? to examine these interactions together focussing continuously on the interaction between candidate and patient, and to encourage the candidate to do the same on his own, ? to continuously formulate hypotheses about the core conflict, the transference phenomena and resistance of the patient, ? to explore and reflect on the cooperative work.     

Characteristics of a French African Caribbean Epidemiological Psychiatric Sample with a History of Suicide Attempt

Research on vulnerability factors among ethnic groups, independent of primary psychiatric diagnosis, may help to identify groups at risk of suicidal behavior. French African Caribbean general psychiatric patients (N = 362) were recruited consecutively and independently of the primary psychiatric diagnosis. Demographic and clinical characteristics and lifetime history of suicide attempts were recorded. Sixty‐five patients (18%) had a history of at least one suicide attempt. Presence of professional qualifications, children, poor social contacts, treatment with benzodiazepine at inclusion, and poor treatment compliance were all associated with a lifetime history of suicide attempts.     

Do Geographic Regions with Higher Suicide Rates also have Higher Rates of Nonfatal Intentional Self‐Harm?

Fatal and nonfatal intentional self‐harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self‐harm across event types. The state‐level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone.     

The Beliefs in the Inheritance of Risk Factors for Suicide Scale (BIRFSS): Cross‐Cultural Validation in Estonia,Malaysia, Romania,the United Kingdom,and the United States

The genetics of suicide is increasingly recognized and relevant for mental health literacy, but actual beliefs may lag behind current knowledge. We examined such beliefs in student samples (total N = 686) from Estonia, Malaysia, Romania, the United Kingdom, and the United States with the Beliefs in the Inheritance of Risk Factors for Suicide Scale. Cultural effects were small, those of key demographics nil. Several facets of construct validity were demonstrated. Marked differences in perceived plausibility of evidence about the genetics of suicide according to research design, observed in all samples, may be of general interest for investigating lay theories of abnormal behavior and communicating behavioral and psychiatric genetic research findings.