Alexandra Clement on her EAAD internship

Internship with the EAAD

My name is Alexandra Clement, and I am a first year PhD student in the PhD Health Quality program at Queen’s University, which is in Ontario, Canada. The focus of my doctoral research is how youth suicide prevention can be supported through the early detection and treatment of depression and suicidal behaviours by primary care providers. Over the summer in 2021, I was incredibly fortunate to have the EAAD host my internship, with Prof. Dr. Ulrich Hegerl as my supervisor. During my internship I learned about the internationally recognized EAAD 4-level model for improving care for people with depression and preventing suicidal behaviour. I also had the opportunity to see how this approach is being implemented by 10 national partners as part of the EAAD-Best project. Finally, I worked with staff from the EAAD and Stiftung Deutsche Depressionshilfe (German Depression Foundation) on a project studying how suicide death registration procedures in German states have changed over time, and how these changes in procedure may have impacted the rate of suicide deaths.

Danke schön to Prof. Dr. Hegerl and the staff of the EAAD. I learned a great deal and enjoyed the entire internship experience.

Suicide registration data project

Researchers have shared that the number of suicide deaths reported by federal organizations are likely underestimated due to the misclassification of suicide deaths and methodological variations in death-registration procedures. This is problematic as the underreporting of suicide deaths can have negative implications for policy development, research funding, and the evaluation of suicide prevention programmes. The aim of our study is to increase the knowledge of changes in death-registration procedures within Germany over time, as well as suggest how these variations may have impacted the reporting of suicide deaths.

To do this, death registration and population data for the period of 1991 to 2019 was obtained through the Federal Health Monitoring website. Analyses are being conducted to calculate age-adjusted, standardized death rates, which are then compared across time (i.e., 1991 to 2019) to determine whether significant changes have occurred from year to year. Initial results suggest that multiple significant changes have influenced the rate of total mortality (overall deaths) and suicide deaths between 1991 and 2019, with a general decline in rates over the period of analysis. Our next steps will be to finish the analyses and then determine what significant procedural changes in suicide registration processes correspond to the observed changes over time.

Dr. Kahar Abula presented our preliminary results at the DGPPN Congress held in Berlin from November 24 to 27, 2021.