The objective of this study was to understand the features of young suicide in order to contribute to suicide prevention efforts. In this article, the demographic, clinical, and suicide-related features of all cases of young suicide (aged 10-24 years) in Singapore for the years 2000-2004 are described. We also compared those who sought mental health services to those who did not. Overall, the suicide rate was 5.7 per 100, 000, with gender ratio of 1:1 and higher rates among ethnic Indians. Psychosocial stressors and suicide by jumping from height were common. Mental health service use was associated with unemployment, previous suicide attempts, family history of suicide, more use of lethal methods, lack of identifiable stressor, and less suicide notes. Suicide prevention efforts should promote awareness of suicide risks and access to mental health services.
BackgroundDeliberate self-harm (DSH) is a prominent mental health concern among adolescents. Few studies have examined adolescent DSH in non-Western countries. This study examines the prevalence, types and associated risk factors of DSH in a clinical sample of adolescents in Singapore.MethodsUsing a retrospective review of medical records, demographic and clinical data were obtained from 398 consecutive adolescent psychiatric outpatients (mean age = 17.5 ± 1.4 years, range = 13–19 years) who presented at Changi General Hospital from 2013 to 2015.Results23.1% (n = 92) of adolescents engaged in at least one type of DSH. Cutting was the most common type of DSH reported. Females were three times more likely to engage in DSH than males. DSH was positively associated with female gender (odds ratio [OR] 5.03), depressive disorders (OR 2.45), alcohol use (OR 3.49) and forensic history (OR 3.66), but not with smoking behaviour, living arrangement, parental marital status, past abuse or family history of psychiatric illness.ConclusionInterventions targeting adolescent DSH should also alleviate depressive symptoms, alcohol use and delinquent behaviours.
Background: The Supported Discharge Service (SDS) is a model of enhanced care in the community for adolescents after inpatient discharge. Methods: This study comprised the first 20 patients referred to SDS, largely those with delayed discharges. Service use and clinical outcomes were collected and predictors of total contact time were investigated. Results: Significant improvements had been made with SDS. Higher baseline Strengths and Difficulties Questionnaire (SDQ) conduct scores were associated with less contact time. Conclusions: SDS is a feasible model of care. Adolescents with conduct problems may benefit from engagement strategies. Further rigorous evaluation of the model is required.
Key Practitioner Message• Hospitalized youth with moderate to severe mental health problems may be cared for in the community by intensive step-down care using the Supported Discharge Service model • SDS is able to provide effective clinical care that both patients and families find useful and acceptable
DSH is a significant clinical problem that may be influenced by biological and clinical factors. Adolescents presenting with DSH should be examined for mood and alcohol use disorders.
Deliberate self-harm refers to an intentional act of causing physical injury to oneself without wanting to die. Deliberate self-harm behaviours most commonly include cutting (with a knife or razor), scratching or hitting oneself, and intentional drug overdose. They may also include limiting of food intake and other 'risk-taking' behaviours such as driving at high speeds and having unsafe sex.(1,2) Many individuals who self-harm use more than one method of self-injury. These acts are often gratifying and cause minor to moderate harm. Some individuals self-harm on a regular basis, while others do it only once or a few times. Although deliberate self-harm is done without lethal intent, it could lead to fatality.
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