Junior research group leader:
Prof. Dr Nathalie Oexle, Department of Psychiatry and Psychotherapy II, University of Ulm, Section Public Mental Health

Co-operation partner:

• Junior Prof. Dr Miriam Rassenhofer & Prof. Dr Jörg Fegert, Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy
• Dr Daniel Buschek, University of Bayreuth, Faculty of Mathematics, Physics and Computer Science
• Prof. Dr Nicolas Rüsch, Prof. Dr Thomas Becker & Prof. Dr Reinhold Killian, Department of Psychiatry and Psychotherapy II at the University of Ulm
• Prof Dr Ulrich Reininghaus, ZI Mannheim, Department of Public Mental Health
• Prof Dr Benjamin Mayer, University of Ulm, Institute for Epidemiology and Medical Biometry

Ulm University staff:
Nadine Bayer
Matthias Lühr
Sophie Rudolf

Funding: BMBF (junior research groups in health services research)

Duration: 10/2022 - 09/2027

Summary:
Suicide is a leading cause of death among adolescents and it is estimated that about one third of adolescents in Germany experience suicidal thoughts, while about 6-9% attempt suicide. The treatment of acute suicide risk among adolescents usually takes place in the context of an inpatient hospital stay, but a particularly high risk of suicidal behaviour can be observed in the days and weeks following discharge. An integral part of current measures to reduce this increased risk of suicide is safety planning. This includes a personalised action plan with so-called "skills" (e.g. distraction, seeking help), which, when applied in a possible suicidal crisis, should reduce the patient's risk of suicide. An important limitation that could severely limit the effectiveness of traditional safety planning is its dependence on the availability and self-application of a paper-based action plan in everyday situations of high emotional stress. An innovative further development of safety planning is its implementation as a personalised smartphone app. However, here too there is the limitation of dependence on self-application in situations of high emotional stress. A significant increase in effectiveness could be achieved with an automatic trigger that automatically starts interventions in suicidal crises. The aim of EMIRA is therefore to develop and evaluate an automatic safety planning smartphone app to reduce the risk of suicide in adolescents aged 14-21 following inpatient treatment in a child and adolescent psychiatric clinic.

Project Leads

Prof. Dr. Nathalie Oexle, Department of Psychiatry and Psychotherapy II, Ulm University, Section of Public Mental Health
Junior Professor Dr. Vera Clemens, Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy
Junior Professor Dr. Miriam Rassenhofer, Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy
PD Dr. Eva Rothermund, Ulm University Hospital, Department of Psychosomatic Medicine and Psychotherapy

Coordination of Technical and Content Integration: Dr. Ulrike Hoffmann, Working Group "Knowledge Transfer, Dissemination, and E-Leanring", Ulm University Hospital, Department of Child and Adolescent Pyschiatry/Psychotherapy Jugendpsychiatrie/Psychotherapie

Research Staff, Ulm University

Dr. biol. hum. Lea Mayer
Pauline Meyer
Stefanie Johler

Funding: German Federal Ministry of Health

Duration: 07/2023 – 12/2025

Summary:

The stigmatization of people with mental illnesses has not decreased in Germany over recent decades. The consequences for affected individuals are severe and range from loss of social status and difficulties in housing, employment, or education to social isolation, poorer illness trajectories, suicidality, and reduced life expectancy. These consequences are partly driven by the so-called “treatment gap,” referring to the insufficient provision of care for people with mental illnesses, which is also clearly evident in Germany.

In Germany, mental illnesses are the second most common cause of sick leave and account for 29% of early retirement cases among men and 45% among women, making them a major socioeconomic factor. Early intervention in the course of illness — as well as earlier intervention within an individual’s life course — improves the likelihood of a favorable prognosis. However, depending on illness severity, only 10–50% of affected individuals in Germany receive adequate treatment.

Project Lead:
Prof. Dr. Nathalie Oexle, Klinik für Psychiatrie und Psychotherapie II der Universität Ulm, Sektion Public Mental Health

Projekt Coordination:
Franziska Marek

Cooperation Partner:
Prof. Dr. Thomas Niederkrotenthaler, Medizinische Universität Wien

Project Staff:
Dr. biol. hum. Maja Stiawa

Funding: German Research Foundation (DFG)

Summary:
Existing research on assisted suicide primarily focuses on philosophical and ethical questions, the needs of individuals seeking assisted suicide, and the attitudes of healthcare providers and the general population. One group that plays a crucial role in the context of assisted suicide, yet is often overlooked in research, healthcare, and policy, is the relatives and close contacts of individuals who die by assisted suicide.

Previous findings indicate that relatives may experience some aspects of a loss through assisted suicide positively, but may also face negative health consequences. These experiences and outcomes are likely influenced by a range of structural and legal factors, societal aspects, as well as interpersonal and intrapersonal factors, which have so far received little research attention.

The SELYAS research project addresses this gap by examining the experiences of relatives before, during, and after a loss through assisted suicide, and by identifying their specific support needs.

Project management:
Jun.-Prof. Dr Nathalie Oexle, Department of Psychiatry and Psychotherapy II, University of Ulm, Section Public Mental Health

Project partner:
AGUS e.V.

Ulm University staff:
Franziska Marek

Funding: German Research Foundation (DFG)

Duration: 10/2021 - 09/2024

Summary:
Social support is essential for coping with traumatic life events such as loss by suicide. However, people who have lost a loved one to suicide often report too little social support, with negative consequences for the grieving process. Social support is a complex phenomenon that fundamentally depends both on the personal willingness to seek and accept support and on the willingness of others to provide support. In order to increase social support after loss by suicide in the context of interventions, an understanding of the barriers and facilitating factors among those affected and potential supporters (e.g. friends, neighbours, work colleagues) is essential. DE-LOSS aims to close this knowledge gap.

Project management:
Jun.-Prof. Dr Nathalie Oexle, Department of Psychiatry and Psychotherapy II, University of Ulm, Section Public Mental Health

Ulm University staff:
Franziska Marek
Sophie Rudolf

Funding: Baden-Württemberg Foundation (elite programme for postdoctoral researchers)

Duration: 03/2021 - 09/2023

Summary:
Every year, around 10,000 people die by suicide in Germany, and the number of suicide attempts is estimated to be 10 times higher. Despite this high number of people affected, the topic is highly taboo. A lack of knowledge about suicide and negative attitudes towards people who experience suicidal behaviour have a number of negative consequences that make suicide prevention more difficult. For fear of rejection, negative reactions and out of shame, many of those affected keep their suicidal thoughts to themselves - as a result of which they receive no support or treatment. Many relatives also feel left alone in their grief due to the prejudices of others. At the same time, however, there are also indications that liberal social attitudes towards suicide, i.e. a normalisation of the topic, can encourage suicidal behaviour. The question therefore arises as to whether, and if so, how, knowledge and attitudes towards suicide can be improved without undesirable side effects. The project "Beneficial and harmful effects of reducing public suicide stigma" aims to answer this question. To this end, four potential interventions to increase knowledge and reduce stigma have been developed and their effectiveness and undesirable side effects are being tested in a web-based RCT.

Project management:

• Junior Professor Dr Nathalie Oexle, Department of Psychiatry and Psychotherapy II at the University of Ulm, Section of Public Mental Health
• Junior Professor Dr Vera Clemens, Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy
• Jun.-Prof. Dr Miriam Rassenhofer, Ulm University Hospital, Department of Child and Adolescent Psychiatry/Psychotherapy
• PD Dr Eva Rothermund, Ulm University Hospital, Psychosomatic Medicine and Psychotherapy

Project partners:

• Prof Dr Anne Barzel, Ulm University Hospital, Institute of General Medicine
• Competence Network for Continuing Education in General Practice Ulm

Ulm University staff:
Dr Katharina Grau
Maria Haun
Natalie Lamp
Beatriz Lloret
Lea Mayer

Funding: Ministry of Science, Research and the Arts Baden-Württemberg

Duration: 06/2021 - 12/2022

Summary:
Psychosocial problems such as financial difficulties, problems at work, loneliness and intra-family violence are often accompanied by psychological stress and even suicidal behaviour and are associated with consultations in GP surgeries. However, due to social taboos, these are often not disclosed and not sufficiently taken into account in the diagnosis and treatment plan. Primary care practitioners have a key role to play here. The prerequisites for this are recognising people at risk and an open attitude combined with the ability to act. The aim of the project is therefore to develop and evaluate an e-learning curriculum for primary care practitioners (_BASEPro) and medical students (_BASEStud) focussing on the above-mentioned topics. The aim is to increase awareness, self-efficacy and action competence in the target groups.