OSPI-Europe WP 6 Hungary Miskolc Prof Mária Kopp

OSPI-Europe WP 6: Hungary Miskolc Prof. Mária Kopp András Székely Dr. Zoltán Cserháti Dr. Katalin Papp OSPI Europe is funded by the European Commission within the 7 th Framework Programme 18/03/2018 Slide no 1

1. WP 6: Level 1 • GP – CME training in October, 2010 - 11 GPs • 3 meetings of psychiatrists and GPs – 25, 10 • – Informational videos/DVDs for patients – available at the webpage – Educational videos/DVDs for GPs - available at the webpage Paediatricians – Primary care nurses/public health nurses • Course for district nurses in November, 2010 – 70 participants egyben vagy csoportban? • Primary care psychologists, social workers, etc – Course in the hospital – March 2011, 23 participants • • • Telephon helpline for GPs – Agreement with the hospital psychiatric department Further activities for the next 6 months – Meeting of the GPs, pdychiatrists and the Family Helping service in Miskolc Foreseeable (other) problems, risks or delays OSPI Europe is funded by the European Commission within the 7 th Framework Programme 18/03/2018 Slide no 2

2. WP 6: Level 2 • General public – Flyer 50. 000, Poster 3. 000 • Schools, pharmacies, hospitals, GPs offices, any available public spot – Problems in the schools – Cinema spot – October-March, twice per day (House of Arts) – Radio spot – since November – December, local radio stations – Media appearances • 2010. September 14. Miskolci Rádió: Dr. Tűzkő Judit, Szemán Edit, Dr. Papp Kata • 2010. September 27. Európa Rádió: Szemán Edit, Dr. Papp Kata • 2010. Oct. 12. Észak-Magyarország, daily newspaper: article about the suicide among adolescents. Szemán Edit, Dr. Ilona Sági • Diósgyőri Rádió: interview about OSPI, depression, suicide. Dr. Ilona Sági (60 minutes) • Miskolci Rádió: Morning program about health. Chat about OSPI and suicide prevention. Dr. Ilona Sági • Regional TV: Interview about OSPI, depression suicide (Dr. Ilona Sági, Edit Szemán, Béla Újvári • 2010 Nov. 08. Észak-Magyarország, daily newspaper: Ujvári Béla fireman, interview • 2010 Nov. 13. Diósgyőri Rádió: György Csutorás psychologist, OSPI program • Miskolci TV, teletext: flyer and poster since February • 2011. Feb. Miskolci TV, Erzsébet Molnár – the hot-line is not available from mobile phone OSPI Europe is funded by the European Commission within the 7 th Framework Programme 18/03/2018 Slide no 3

2. WP 6: Level 2 (cont. ) – Public informational events • • • 2010 Sep 25. Szabó Lőrinc Primary School Health Day 2010 Oct. 01. Herman High School Health Day (appr. 40) 2010 Oct. 02. Katica Infant Nursery Health Day (30) 2010 Sep. 26. Opening ceremony of a Protestant Center 2010 Nov. 12. Presentation of Prof. Kopp Mária, Philosophers Association in Miskolc (40) • 2010 Nov. 29 -30. Bp. Conference on suicide prevention • 2010 Jan. 27. „Society of Avas” – organization of institutions of the housing estate, presentation of OSPI – WEB-page: www. depihelp. info • Further activities for the next 6 months – Dissemination of materials in the geriatric care institutions, local government institutions – Connecting schools to present trainings/information lectures for parents – Negotiation about the campaign with the local transport company. • Foreseeable (other) problems, risks or delays – Main problem in the schools, refusal from teachers

3. WP 6: Level 3 • • • Pharmacists – 2010 Sept – CME course, 50 Priests – Protestant: 2010. Sept 18. – Catholic: 2010 Nov 12. Police – Continuous endeavour, but no success – Tried to replace them with firemen • • Regular courses for firemen, held by one of them Hotline professionals – Cooperation with the local professionals, active participation in media presentations, trainings • • • Psychotherapists – 3 meetings of psychiatrists and GPs – 25, 10 – Meeting of the psychiatry department and the Toxycology department Teachers, youth protection – 2010 Oct, 50 Schools – For parents, 15 – For teachers, 42 OSPI Europe is funded by the European Commission within the 7 th Framework Programme 18/03/2018 Slide no 5

3. WP 6: Level 3 (cont. ) • OSPI meetings – – 2010 Sept Community facilitators at the Fire Department (20) 2010 Oct Community facilitators at the Fire Department (16) 2010 Nov Community facilitators at the Fire Department (22) 2010 Dec 29 • Advisory meeting about the topic of the mental health center (Menta-house) – 2011 Feb. Focus-group (8) – 2011 March – network-building meeting (50) • Further activities for the next 6 months – Meeting with decision makers about the Menta-house proposal – Meeting of communitiy facilitators – Trainings for emergency service, firemen, teachers, students at the university • Foreseeable (other) problems, risks or delays

4. WP 6: Level 4 • Patients and their relatives – 2011. feb 22, 24. Extended care for children Dept Child Rehabilitation. : course for 25 children • • Planning to involve the parents too. Support for self-help groups for depression – Dept of Toxicology • Self-help group is just organized (Mónika Tóth) – Civil organizations • • • Hot-line – Cooperation with Blue Line Child Crisis Foundation, they are building an office in Miskolc – Planning to make an internet-point for youngsters Emergency cards for patients after suicide attempt – Flyers, cards, other materials, personal help is given at the Toxicology Dept. Further activities for the next 6 months – Trainings for peer counselors, mentors of minorities – Tried to reach the local governments competent department about the 6 youth suicide • • Facebook Foreseeable (other) problems, risks or delays – Problems with the hot-line service • No access from mobile phone OSPI Europe is funded by the European Commission within the 7 th Framework Programme 18/03/2018 Slide no 7

5. WP 6: planned activities • Level 5 (Core and Optional) • Identification of suicide hot spots – 20 levels building – no suicide in the last year, probably corridors or other equipments were placed – 90 per cent of suicides was committed in the house • During CME courses: warnings concerning TCA (especially larger packages) and other drugs with toxicity on overdose – Suicide hot-spots are mentioned and pointed out at the trainings • Further activities for the next 6 months • Foreseeable (other) problems, risks or delays OSPI Europe is funded by the European Commission within the 7 th Framework Programme 18/03/2018 Slide no 8

WP 6: Dept of Toxicology - snapshot • All committed suicide cases come here from the whole county They are responsible for the stroke and neurological outpatient service – 5 neurologists, 5 resident, 20 nurses • Main problems (by personal interviews with the employees) – Minorities • Aggression, physical insults • They report suicide attempt but there is no drug content in their stomach (proved by the stomach lavage) • They also report that they did not want to commit suicide – Some of them comes 20 -30(!) times pro year • Alcohol detoxication reported as suicide attempt • They claim for the tranquillizers – those can be sold at the black market • Appr. 45% of the so called patients at toxicology are these type of minority –romawomen – They need time – They increase the hostile attitudes towards depression and suicide attempters – Real patients • Need for psychologists, • Self-help groups are being organized • Civil helpers have to be involved due to the lack of professionals

WP 6: Menta-house • Planned to establish a community based mental health center for sustainability of the programme • Found a professional and devoted psychiatrists for the position • Developed a plan of the institution, how it links to the health care system, to the civil organizations • Proposed it to the local government

WP 6: Data collection • Data, Miskolc – County Hospital, Miskolc 1999 • TAJ szám megnevezése Születés dátuma Ápoló osztály neve Irányítószám Felvétel napja Családi állapot – Emergency service 1999 • Number of suicide – no information on cases – Police 1999 • Ssz • Nem Születési dátum Kor Lakhely Helyszín Családi áll végzettség előző kísérletek szomatikus pszichés Megjegyzés BL Mód Alkohol halál ideje (hó) Data, Szeged – Emergency service • Age, date, place of living, bno – Igazságügy • Suicides – BJK Nem születési idő Helyszín Alkohol (vér/víz) Toxi BL elkövetés Halál időp. – Hospital • Sex, date, age, bno Kor Lakhely Korábbi kísérlet Mód Egyéb

Conference presentations: • Kopp, MS et al: Gender differences in mediating role of depression between socioeconomic factors and premature mortality: Follow-up of the Hungarian Epidemiological Panel, Congress of Psychiatric Epidemiology, Bergen, June 16 -19, 2010. • Székely A, Kopp MS: OSPI-Europe Program, Optimized Suicide Prevention Programs and their Implementation in Europe, International Bálint Conference, Csikszereda, Jun 24 -26, 2010 • Maria S. Kopp, András Székely, Mária Bagi: The Hungarian Alliance against Depression, Strengthening social capital in the intervention region, Safety in Europe, 21 -24 September, London

Papers: • Dégi Cs. L, Balog P, Kopp M, Kállay É, Thsyer JF, Csikai EL (2010) Depressive symptoms, negative life events and incidence of lifetime treatment of cancer in the Hungarian population, J Cognitive and Behavioral Psychotherapies, 10, 1, 39 -57. • Hajnal Á, Susánszky É, Szántó Zs, Kopp M (2009) Öngyilkossági magatartás, az öngyilkossággal kapcsolatos lakossági ismeretek és attitüdök a Hungarostudy felmérések tükrében, (Suicidal behavior, attitudes and knowledge about suicide in the Hungarian population) Népegészségügy 87, 2, 5966. (in Hungarian) • Kopp MS, Konkoly Thege B, Balog P, Stauder A, Salavecz Gy, Rózsa S, Purebl Gy, Ádám Sz (2010) Measures of stress in epidemiological research, Journal of Psychosomatic Research 69, 211 -225. • Hajnal Á, Susánszky É, Kopp M (in press) Felismerhető-e az öngyilkossági szándék? (in Hungarian) (Realisation of suicide intentions) Új Pedagógiai Szemle

Papers: • Airi Värnik, Merike Sisask, Peeter Värnik, Jing Wu, Kairi Kõlves, Ella Arensman, Margareth Maxwell, Thomas Reisch, Ricardo Gusmão, Chantal van Audenhove, Gert Scheerder, Christina M. van der Feltz-Cornelis, Claire Coffey, Maria Kopp, Andras Szekely, Saska Roskar and Ulrich Hegerl (in press) Drug suicide: a gender-equal cause of death in 16 European countries Or Intentional drugs overdose kills men and women equally: a study of 16 European countries, BMC Public Health 2011, 11: 61 doi: 10. 1186/1471 -2458 -11 -61 • Peeter Va¨rnik, Merike Sisask, Airi Va¨rnik, Zrinka Laido, Ullrich Meise, Angela Ibelsha¨user, Chantal Van Audenhove, Alexandre Reynders, Ru¨ ya-Daniela Kocalevent, Maria Kopp, Agnes Dosa, Ella Arensman, Claire Coffey, Christina M. van der Feltz-Cornelis, Ricardo Gusma˜o, Ulrich Hegerl (2010), Suicide registration in eight European countries: A qualitative analysis of procedures and practices, Forensic Science International, 202, 86 -92. • Hegerl U, Arensman E, Aromaa E, Coyne J, Gusmao R, Kopp M, Maxwell M, Meise U, Pycha R, Pull C, Reisch T. Scheerder G, Sisask M, Perez SOla V, Tuulari J, van Audenhove C (2010): Improving teh care of depressed patients and preventing suicides – The European Alliance Against Depression, German Medical Journal (német-arab kiadás), 11, Digital edition /e. Book 3_2011, 74 -78.

Psychosocial Background Factors Associated with Self-Reported Suicide Attempts in the Hungarian Population Mária S. Kopp, András Székely, Szilvia Ádám • Methods: Survey respondents were 12, 527 subjects/individuals in 1995 and 12, 653 subjects/individuals in 2002, both representative samples of all Hungarians age 18 years and older according to sex, age and place of residence. • Conclusion: The various forms of suicidal behaviour have several background factors in common, yet the strength of the associated factors differs according to the severity of the suicidal behaviours.

Results: • • In 1995 4. 0% and in 2002 2. 9% answered that they had attempted suicide. In 1995 3. 3% and in 2002 1. 8% received subsequent medical care. In 1995 1. 1% and in 2002 0, 8% reported that they had attempted suicide two or more times in their lives. In 1995, suicide attempts were significantly more frequent among the unemployed, the divorced, separated, less educated, Lutherans and Jews. In 2002, the prevalence of suicide attempts was higher among the unemployed, the disabled, less educated, divorced and the Jews. The most important background factors of suicidal behaviour among Hungarians over the age of 18 were maladaptive coping strategies (excessive eating/drinking, drug -taking and risk-taking), suicide in the family, high levels of depressive symptomatology, hostile attitude (primarily within the family), low perceived social support from one’s partner, parents, children and co-workers.