The aim of this research is to gain insight and knowledge about the perception of adolescents, social workers and their chain partners in living groups where suicide problems occur.To achieve this goal, a main research question has been formulated…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
leefklimaat op leefgroepen
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The semi-structured in-depth interviews will consist of open questions in order
to ask the participants' experiences as fully as possible. We work with a topic
list. The topic list will be exploratory in nature and focus on gathering
knowledge and experiences around the topic. In the preparatory phase, the
project team, including experience experts, care providers and researchers,
will generate participatory questions in the topic list. The topic list will be
adjusted during the course of the research, based on advancing insight, during
meetings with the project team. The following themes will be discussed for each
target group (these themes will of course be elaborated in more detail and only
give an indication):
Group 1: Adolescents (12 to 18 years) who stay in a JeugdzorgPlus institution
- How should care providers act with regard to adolescents who expresse
suicidal thoughts or suicidal behavior? What are the measures taken by
institutions?
- What is the effect on the group in case of a suicide or suicidal expression
by a group member?
- How do you deal with a group member who has suicidal manifestations?
Group 2: Social workers within the JeugdzorgPlus
- What is the institution's suicide prevention policy?
- Which evidence-based interventions for psychological problems (such as trauma
or depression) are used?
- How is the chain acted (or omitted) in the (ortho) pedagogical field and / or
in relation to suicide prevention?
- Do they have the impression that there is a lot more psychiatric problems and
if so, roughly in how many percent of the cases and which problems in
particular?
- How does are the triangle of adolescents - parents - care provider act in
case of signaling suicidal behavior?
- What are the experiences of care providers in the JeugdzorgPlus regarding
suicidal thoughts / suicidal behavior?
- What is the effect of a suicide on the care provider's actions (and needs)?
- What does the action consist of?
- What are the needs of care providers in the youth care plus for acting?
- What are possible reasons why adolescents who are confronted with this
problem are placed sooner in the JeugdzorgPlus then earlier?
- In what way would the JeugdzorgPlus provide an answer with regard to the
suicide problem (located in the treatment climate or in the safety offered)?
Group 3: Social workers from cooperating chain partners
- How is the chain acted (or omitted) in the (ortho) pedagogical field and / or
in relation to chain partners?
- What are the experiences of care providers with regard to suicidal thoughts /
suicidal behavior: what does the action consist of?
- What are the needs of care providers in the chain for cooperation?
- In which way would the chain partners of JeugdzorgPlus provide an answer with
regard to the suicide problem (located in the treatment climate or in the
safety offered)?
- If there is an increase in admission of adolescents with suicidal behavior in
the JeugdzorgPlus, what is the basis for this?
Secondary outcome
Not applicable
Background summary
During the summer/fall of 2018, various media expressed the concerns about the
increased number of suicide attempts in closed Youth mental health care
institutions (JeugdzorgPlus).
ZonMw has, on behalf of the Ministry of Health, Welfare and Sport (VWS), the
Directorate of Youth and input from the institutions involved, launched the
*Longitudinal Impact Monitor Youth Care Plus* with various research themes. In
one of these themes the central question is how suicidal thoughts and suicide
among adolescents influence the cooperation between chain partners and the
(group) dynamics in the *JeugdzorgPlus*.
*JeugdzorgPlus* is offered to children and adolescents who are not eligible for
lighter forms of mental health care. JeugdzorgPlus aims to realize behavioral
change so that the adolescents can again participate in society. JeugdzorgPlus
is imposed as short as needed but as long as necessary.
A number of problems within the JeugdzorgPlus may be relevant for the problems
concerning suicides. Firstly, institutions aiming at mental health care have
traditionally been specialized in specific problems. JeugdzorgPlus aimes at
adolescents with (mainly) behavioral problems, whereas *Youth GGZ* institutions
are especially for adolescents with psychiatric problems. Due to recent budget
cuts within the *Youth GGZ*, which means that fewer beds are available,
adolescents with internalizing problems (such as fear of failure,
automutilation, suicidal thoughts, mood swings, anxiety, depression, etc.) are
increasingly entering the JeugdzorgPlus. Although a lot of differentiation has
already taken place, the approach in the JeugdzorgPlus is traditionally aimed
at adolescents with externalizing behavior (such as, lying, no respect for
others, self-determining behavior, sexual cross-border behavior, destruction,
theft, violence, verbal and / or physical aggression, etc.). As a consequence,
the approach to teenagers in the JeugdzorgPlus does not always seem to be in
line with the problems of the adolescents with internalizing problems.
Secondly, adolescents both in JeugdzorgPlus and youth mental healthcare
institutions usually stay in community groups. In view of their problems, where
there may be a mix of disorders, it is very complicated to stay in a group for
these adolescents. In addition, if there are also youngsters with suicidal
thoughts and / or attempts at suicide in the living groups, this increases the
pressure on staff. The result is increasing tensions among the adolescents
themselves, the staff and other residents.
Thirdly, it is important to offer a positive, responsive relationship between
staff and residents with a good balance between support and structure.
Suicidality and suicidal expressions often call on care providers and
bystanders to be monitored and protected. The danger of these repressive,
controlling measures is that the connection with the adolexcents will be lost.
In a situation in which there is regular violation of rules, negative behavior,
aggression and imminent violence, it is anything but easy to enter into a
positive relationship with adolescents . Anxiety and uncertainty about the
actions of care providers is understandable. Employees are overburdened, partly
due to rapid staff changes and the shortage of experienced professionals. As a
result, there is often too little room for anything other than security and
control.
With this qualitative research, we would like to get answers to the question
whether the above-mentioned problems are recognized by, among others, the
adolescents who stay at the JeugdzorgPlus, employees within the institutions
and their chain partners.
Study objective
The aim of this research is to gain insight and knowledge about the perception
of adolescents, social workers and their chain partners in living groups where
suicide problems occur.
To achieve this goal, a main research question has been formulated with a
number of sub questions. The final result of the research provides guidance to
professionals on how to deal with suicide problems (in particular the
interaction between adolescents and staff in the living groups).
The central research question in this study is:
How do suicidal thoughts and suicide (attempt) of group members influence the
living environment within the treatment groups on JeugdzorgPlus?
Sub questions are:
1) How do chain partners act and react during transfer between institutes when
a adolescents expresses suicidal thoughts or suicidal behavior?
2) What is the role of the staff in relation to the group process when a
adolescents expresses suicidal thoughts or suicidal behavior?
3) How do adolescents deal with a group member who expresses suicidal thoughts
or suicidal behavior?
Study design
Using qualitative methods, this research is conducted at at least three
JeugdzorgPlus institutions, namely Pluryn HoenderlooGroep, the Ottho Gerhard
Heldring and Ambulatorium Foundation and Horizon Youth Care and Education and
two of its chain partners, namely Karakter and Entrea / Lindenhout.
Qualitative research is in particular a suitable to explore. This means that
the research design will be flexible and open (and provisional) in nature. We
work with a topic list. The topic list is created by the project team,
consisting of experiential experts, JeugdzorgPlus counselors and its partners
and researchers. The implementation cannot be fully documented in advance,
since part of it depends on what is going on during the investigation, and what
we encounter while investigating. There is an iterative process.
To increase the reliability and validity of the results, the COREQ
(Consolidated criteria for Reporting Qualitative research) checklist will be
followed. The qualitative study comprises individual, semi-structured
interviews.
Experience experts play a crucial role in this project. All interviews in this
study are conducted by the project leader together with an experience expert.
The project leader of this application has done a large number of projects
using experience experts. The input of an experience expert ensures that
teenagers as well as social workers will open up more easily and therefore
provides clear added value and depth for the interview. With the input of an
experience expert, experiences and insights are brought in from an insider's
perspective. This perspective has an important additional value on the
scientific research perspective.
Study burden and risks
There is no expected risk for the participants. No interventions are performed.
The project leader is responsible for the interviews and has extensive
experience with this target group and conducting interviews with both
adolescents and social workers. It is noted that in clinical practice, it
relieves adolescents to talk about what they are experiencing.
The participating JeugdzorgPlus institutions use suicide prevention protocols.
In the event of escalations, various actions are undertaken. Conversations with
adolescents is one of these. The participating JeugdzorgPlus institutions
indicate that talking about this subject is not harmful to adolescents, but is
helpful.
Group leaders of the teenagers participating in the study are informed about
the study. They are informed about the content and know when they will
participate in the interview. They will monitor the participants and are
available after the interview if the participants needs a conversation. The
following days attention is also paid to thissubject by the group leaders.
After the interview, the researchers will contact the participants (by mail,
app or telephone) to ask how they are doing, how he / she looks back on the
conversation and who needs aftercare.
The information letter for participants contains information about the help
lines of Mind Korrelatie and 113.
Reinier Postlaan 12
Nijmegen 6525 GC
NL
Reinier Postlaan 12
Nijmegen 6525 GC
NL
Listed location countries
Age
Inclusion criteria
Group 1: Adolescents staying in a mental Youth health care institution
Group 2: Social workers / carge givers in the mental Youth healthcare
institutions
Group 3: Social workers from cooperating chain partners
Exclusion criteria
Group 1: Adolescents staying in a mental Youth health care institution
- Adolescents who do not have sufficient command of the Dutch language.
- Adolescents <12 years old.
- Adolescents with whom are concerns about their current safety.
- Adolescents where parents or other people directly involved estimate that
they are unable to complete a 30 - 60 minute interview.
- Adolescents placed within the mental Youth health care institution less than
4 weeks ago
- Adolescents with a recent suicidal past
Group 2: Social workers within a mental Youth health care institution
- Interns
- Temporary employees who work in the institute for less than a month
Group 3: Social workers from cooperating chain partners
- Interns
- Temporary employees who work in the institute for less than a month
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL70722.091.19 |