An evaluation of factors underlying suicide attempts in patients presenting at George Hospital emergency centre

Abstract

RESEARCHBackground: Roughly 130 patients are seen daily in the emergency centre (EC) at George Provincial Hospital (GPH), of whom one or two will have attempted suicide. GPH serves the population of Eden and Central Karoo Districts. Little is known about the circumstances surrounding these suicide attempts. We examined this pattern and formulated a protocol for managing these patients. Method: All patients attending the EC after attempting suicide between December 2010 and April 2011 were identified from the EC register. Thirty nine patients gave consent and completed a questionnaire. The data were analysed in Excel®. Additional information was obtained from five members of a focus group. Results: Patients who attempted suicide had often attempted suicide previously. They came from a community with high levels of longstanding financial and domestic stress, violence, dysfunctional family relationships, alcohol abuse and poor coping skills. Suicide attempts generally involved impulsively taking prescription medication following an argument with a family member. Patients felt abandoned or alone, were physically or mentally abused, were subjected to alcohol abuse, or had underlying anxiety or depression. Conclusion: Patients who attempt suicide and attend GPH EC come from a chronically stressed community with dysfunctional family patterns and alcohol abuse and lack coping skills. A psychological support team has introduced a suicide-attempt protocol in the EC offering patients an opportunity to deal with their distress and learn better coping skills.

A review of patients presenting to accident and emergency department with deliberate self-harm, KwaZulu-Natal, South Africa

“…11 Although the mean age of admission in this study was slightly older than that of the WHO report, the findings from this study support other Southern African studies, which have documented that the majority of DSH occurs in the 20–30-years age group. 28 , 30 However, these data may require further investigation, as other South African literature demonstrate that the frequency of DSH increases with increasing age. 31 There was a significant association between gender and type of DSH ( p < 0.01), with more women than men recorded as parasuicide and attempted suicide cases, which is consistent with other South African studies.…”

“… 27 More women than men presented with DSH, and this finding is in keeping with those of other studies on DSH in South Africa. 28 …”

“…Marriage was found to be protective, with less suicide and attempted suicide among those who were married, which is similar to the findings of other studies. 28 , 31 However, with the small number of patients admitted following suicide and attempted suicide, these figures must be treated with caution. In addition, it is also difficult to comment on the frequency of DSH and race, as there are proportionately more Africans attending this hospital than Whites or Indians because of its location and the population accessing health care here.…”

“…This study supports a common finding that being employed generally protects against DSH and suicide. 28 , 31 Religious belief also seems to be important when assessing DSH. South African literature reports that historically Roman Catholics had lower suicide rates compared with other religious groups such as Protestants or Jews.…”

“… 34 , 35 The most common reason recorded for DSH was around relationship challenges, and this is congruent with other South African studies. 28 , 32 …”