Men in despair: A qualitative psychological autopsy study of suicide in Northern Uganda

Abstract

The psychosocial circumstances surrounding men's suicide in postconflict Central Northern Uganda were investigated using qualitative psychological autopsy interviews. Records of 17 men who died by suicide were identified through police and local leaders in Internally Displaced Peoples' camps of Amuru and Gulu Districts. Two to five significant others were interviewed around each case. Data were analyzed by interpretative phenomenological analysis (IPA). Lost dignity and social value, lack of hope for the family's future, overwhelming family responsibility, and mental illness were circumstances found to have preceded the suicides. The protracted war in the Northern region of Uganda left men in rural communities feeling disempowered and disenfranchised. This may have contributed to suicidal behavior in some of them. Suicide prevention in this area needs to be multidisciplinary with an emphasis on helping both men and women understand and deal with the many social changes that have evolved over time and affected their traditional roles and responsibilities.

Suicidal behaviour across the African continent: a review of the literature

“…In post-conflict Northern Uganda, Kizza et al [59,60] conducted a qualitative psychological autopsy study among men and women in Internally Displaced Peoples’ camps. In this context, suicide in both sexes was found to be connected to men’s “loss of masculinity”.…”

“…In this context, suicide in both sexes was found to be connected to men’s “loss of masculinity”. In order to understand what this means it is necessary to understand how the gender roles in this community had been before the war and how the war had changed these roles and responsibilities in a way that contributed to suicide for both men and women, albeit in very different ways [59,60]. …”

“…The type of risk factors that are identified and their relative importance is likely to vary across different regions and population groups. The importance of taking into consideration the socio-cultural context has been highlighted by qualitative studies [59-61]. Such studies are crucial in order to build locally relevant suicide theory and to understand how, when, where and for whom risk factors may be connected to suicidal behaviour [57,58].…”

An overview of mental health care system in Kilifi, Kenya: results from an initial assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems

“…This could be due to under-reporting of suicide cases, probably because of the stigma and isolation that family members of people who die by suicide face in many African communities. Indeed a study by Kizza et al [15] from Uganda indicated that suicidality was associated with “loss of masculinity” and such stereotypes may interfere with reporting of suicide cases, leading to gross under-estimation of these cases. Also, the preponderance of male suicides in our report is consistent with other studies [15, 16].…”

Ruptures of War: Shame and Symbolic Violence in Post-Conflict Acholiland

“…Other studies (e.g. Dolan 2009, 191-218;Kizza et al 2012) indicate that this impairment of masculine identity is systemic in Acholiland, and the subsequent loss of dignity has in fact compelled many Acholi men to commit suicide.…”