Sharna Mathieu

Background: Although there have been assumptions about the link between eco-emotions and suicidality, there is currently no systematic evidence. Aim: To systematically examine literature analyzing the link between eco-emotions and suicidal ideation and behaviors. Methods: A systematic literature review, registered in PROSPERO (CRD42022352379) following the PRISMA checklist, involved searches in seven databases for peer-reviewed articles published from January 2000 until January 2026. All study designs that presented primary empirical analyses of eco-emotions in connection with suicidal ideation and behaviors were included. The Joanna Briggs Institute’s tools were used for quality assessment. Results: Searches revealed 2,074 records. After removal of duplicates, 1,505 articles were screened for abstracts and 79 for full text. Twelve papers satisfied the inclusion criteria: eight cross-sectional, two qualitative studies, a quasiexperimental, and a case report. Eight studies statistically analyzed the link between eco-emotions and suicidality on individual level. The univariate analyses showed positive correlations between different eco-emotions and suicidality. However, in some studies, the multivariate analyses, adjusting for confounding factors, found the association to be mediated by other factors such as mental health or feelings of entrapment. Limitations: Our searches were limited to English language. Conclusions: There is limited research regarding the association between eco-emotions and suicidality. Our review suggests an association between eco-emotions and suicidality, which might be mediated by other factors. Caution needs to be exercised in the interpretation of these results considering the design limitations of the studies. In keeping with advancing climate change research, our review emphasizes an urgent need for high level research.

Introduction: Although there have been assumptions about the link between eco-emotions and suicidality, there is currently no systematic evidence. Therefore, the aim of this review is to systematically examine empirical literature analysing the link between eco-emotions and suicidal ideation and behaviours, both fatal and non-fatal. Methods: The review protocol was pre-registered in PROSPERO [CRD42022352379] and the PRISMA checklist was followed. Searches were conducted in six electronic databases (Scopus (Elsevier), Medline (PubMed), Web of Science, ProQuest, CINAHL and Embase) for peer-reviewed English language literature published from 1 January 2000 until 16 September 2023. Screening of titles, abstracts and full texts was conducted independently by two reviewers and any discrepancies were resolved in consultation with a senior researcher. The Johanna Briggs Institute’s quality appraisal tools were used for quality assessment. Results: Search results revealed 559 records. After removal of duplicates, 424 articles were screened. After title and abstract screening, 28 articles were included for full text screening. Only one paper satisfied the inclusion criteria. A cross-sectional online knowledge, attitudes, and practice (KAP) survey among practicing mental health professionals across the State of Minnesota analysed the impact of climate change on their work and clients. Although the study did not specifically focus on suicidality, it reported that 22% of practicing mental health professionals had seen evidence of suicidal ideation or attempts in their clients as an outcome of climate change. Conclusion: There is a lack of research on the association between eco-emotions and suicidality. Considering advancing climate change research, our review emphasizes an urgent need to conduct high level research to analyse the association between eco-emotions and suicidality and consider its potential implications. What is already known on this topic?: There’s a recognized and growing concern about the impact of climate change on mental health, particularly the emergence of eco-emotions such as eco-anxiety, eco-grief, and solastalgia. While studies have linked higher temperatures and natural disasters to suicidality, research specifically examining the association between eco-emotions and suicidal ideation and behaviours is lacking. What this study adds?: This systematic literature review revealed a stark scarcity of research connecting eco-emotions with suicidal ideation and behaviours. Only one paper met the inclusion criteria of the review. This scarcity underscores the urgent need for more comprehensive studies exploring the potential connection between eco-emotions and suicidality at an individual level. How this study might affect research, practice, or policy?: The limited findings from this review highlight the pressing need for more in-depth research to determine and understand the association between eco-emotions and suicidal ideation and behaviours. It emphasizes the necessity for interdisciplinary research for a multi-faceted approach addressing mental health impacts of climate change and its underlying causes, calling for informed engagement, mental health support, and policy actions to mitigate eco-grief and anxiety related to climate change impacts.

Background According to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices. Objectives This article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study. The overarching aim is to contribute to the evidence base related to the recruitment, engagement and implementation strategies of applied mental health interventions in the workplace. Method The Mental Health Promotion and Intervention in Occupational Settings (MENTUPP) intervention was pilot tested in 25 SMEs in three work sectors and nine countries. The evaluation strategy of the pilot test relied on a mixed-methods approach combining qualitative and quantitative research methods. The process evaluation was inspired by the RE-AIM framework and the taxonomy of implementation outcomes suggested by Proctor and colleagues and focused on seven dimensions: reach, adoption, implementation, acceptability, appropriateness, feasibility and maintenance. Results Factors facilitating implementation included the variety of the provided materials, the support provided by the research officers (ROs) and the existence of a structured plan for implementation, among others. Main barriers to implementation were the difficulty of talking about mental health, familiarisation with technology, difficulty in fitting the intervention into the daily routine and restrictions caused by COVID-19. Conclusions The results will be used to optimise the MENTUPP intervention and the theoretical framework that we developed to evaluate the causal mechanisms underlying MENTUPP. Conducting this systematic and comprehensive process evaluation contributes to the enhancement of the evidence base related to mental health interventions in the workplace and it can be used as a guide to overcome their contextual complexity. Trial registration number ISRCTN14582090.

Objectives Increasing access to mental health support is a key factor for treating mental disorders, however, important barriers complicate help-seeking, among them, mental health related stigma being most prominent. We aimed to systematically review the current evidence for interventions focusing on reducing stigma related to mental health problems in small and medium enterprises (SMEs). Design Systematic review with a focus on interventions targeting mental health related stigma in the workplace in accordance with PRISMA guidelines. The methodological quality of included articles was assessed using the Quality Assessment Tool for Quantitative Studies Scale. Data sources PubMed, Ovid Medline, PsycINFO, Scopus, and Cochrane databases and Google Scholar were searched from January 2010 until November 2022. Eligibility criteria for selecting studies We included experimental or quasi-experimental studies about workplace interventions aiming to reduce stigma, where the outcomes were measured in terms of stigmatisation against depression, anxiety and/or other mental health problems. Data extraction and synthesis Records were screened by two independent reviewers after inspecting titles and abstracts and a full-text read of the articles to assess whether they meet inclusion criteria. The results were synthesised narratively. Results We identified 22 intervention studies, 3 with high quality, 13 with moderate quality and 6 with weak quality. Only 2 studies included SMEs, but no study focused on SMEs exclusively . The mode of delivery of the intervention was face to face in 15 studies, online in 4 studies and mixed in 3 studies. We found a significant reduction in stigmatising attitudes in almost all studies (20/22), using 10 different instruments/scales. Effects seemed to be independent of company size. Online interventions were found to be shorter, but seemed to be as effective as face-to-face interventions. Conclusions Although we did not find interventions focusing exclusively on SMEs, it is likely that antistigma interventions also will work in smaller workplaces. Trial registration PROSPERO: ID: CRD42020191307

Individuals bereaved by suicide experience substantial emotional distress and are at risk for poorer mental health, substance use concerns, and suicidal behaviors. This study aimed to explore whether those bereaved by suicide reported different coping styles compared to those bereaved by sudden death in the first six months. It also aimed to determine whether a previous mental health diagnosis (PMHD) and experiencing stigma and/or shame impacted the utilization of adaptive and maladaptive coping. The sample was constituted by individuals bereaved by suicide (n = 142) compared to those bereaved by sudden death (n = 63), six months after loss. The study included immediate family members who were 18 years or older and understood the English language. After controlling for demographics there were no significant differences in coping styles between bereavement types. Regardless of bereavement type, having a PMHD was associated with increased avoidant and problem-focused coping, and stigma and shame were each associated with increased avoidant coping. Women were also more likely to report using adaptive coping. Findings demonstrate no difference by bereavement type and have implications for the tailoring of grief/postvention supports that are sensitive to perceived stigma/shame to better facilitate utilization of adaptive emotion-focused coping, particularly for men and those with pre-existing mental health problems.

Objectives Working in high-stress and male-dominated occupations is associated with an elevated risk of suicide. The current study sought to conduct the first systematic literature review and meta-analysis aimed at determining suicide risk across the diverse, high pressure and male-dominated transport industry (commercial aviation, merchant seafaring, transit/driving) as compared to the general/employed population. Methods Searches of PubMed/Medline, Scopus and PsycINFO databases were conducted without date restriction until March 2021. Studies were included if they were written in English, were peer reviewed, and presented primary observational research data. Studies referring exclusively to suicidal ideation, suicide attempts, self-harm, and/or accidents were excluded. Results Following deletion of duplicates and non-English titles, a total of 4201 titles/abstracts were screened and 92 full-texts were read against inclusion/exclusion criteria. The final included sample consisted of 23 articles (16 used for meta-analysis). Results from the meta-analysis indicated that transport workers had a significantly elevated risk for suicide as compared to the general/employed population. Results were consistent across sensitivity analyses, and there was some variation across subgroup analyses. Conclusions Overall, we found transport workers had a significantly higher risk for suicide than the general/employed population, and this appeared to be driven by the association for those working in merchant seafaring/maritime occupations. The findings are discussed in relation to an identified need for the development, implementation, and evaluation of tailored workplace suicide prevention strategies for transport industry workers.

It has been argued that effective action towards addressing a complex concern such as suicide requires a combination of evidence-based strategies. While these complex public health approaches have recently gained importance, little is known about their characteristics and what contributes to their complexity. The use of interchangeable terms such as multilevel, multicomponent, community based, and inconsistent definitions of these approaches creates confusion around what it is and what it is not. In practice, this disorder is reflected in a substantial variation in the design, implementation, and evaluation of complex approaches in suicide research. While it is impossible to resolve all existing inconsistencies in terminology, this review explores a range of terms and definitions to connote complex interventions. It aims to unpack multiple meanings of these terms and their diverse usage in suicide literature. The potential implications of this fluidity and plausible pathways to make sense of this complexity for suicide research are also discussed. With a shared understanding of what constitutes a complex intervention, we can expect to see an improved representation of the real-world complexities in our efforts to address suicide. This common language can also contribute toward quality implementation and dissemination and thereby advance our understanding of complex interventions.