Psychological autopsy review on mental health crises and suicide among youth in Pakistan

Abstract

Introduction Ascertaining putative sociodemographic and clinical causes for death by probable suicide can potentially help implement region‐specific strategies to reduce suicide rates. In this study, we wanted to investigate methods utilized and the psychosocial and mental health characteristics of youths (aged 12‐26 y) who died by probable suicide. Method We examined data from mental health clinical files and forensic reports and performed qualitative psychological autopsy interview from more than multiple sources for each youth who died by probable suicide between 1 May and 31 December 2015 in the Khyber Pakhtunkhwa Province of Pakistan. Results The two most common methods of probable suicide were by firearm use and self‐poisoning utilizing pesticides that were significantly associated with male and female gender, respectively. The most common mental health difficulties were major depressive disorder and harmful use of psychoactive substances. Other clinical features particularly evident included thoughts of self‐harm, irritability and aggression, low self‐esteem, treatment nonadherence, family dispute, and financial distress. Conclusion Efforts to reduce the ease of access to firearms and pesticides may potentially have a beneficial effect in reducing the suicide rate in this region of Pakistan.

Suicide by poisoning in Pakistan: review of regional trends, toxicity and management of commonly used agents in the past three decades

“…[5][6][7][8] Mirroring global studies, the three most common methods for suicides in Pakistan are poisoning, firearms and hanging. 9,10 Pakistan Pakistan is the fifth most populous country in the world. 11 It is predominantly an agricultural country and, according to the 2017 National Census, around 64% of its population of 207 million is considered rural.…”

“… 5 – 8 Mirroring global studies, the three most common methods for suicides in Pakistan are poisoning, firearms and hanging. 9 , 10 …”

Psychological autopsy study and risk factors for suicide in Muslim countries

“…32 Overall, two studies were rated as high‐quality and 29 , 30 four as moderate‐quality 27 , 31 , 32 , 34 ; two others could not be assessed on six of the eight items due to the lack of a control group, and hence, the overall quality cannot be commented upon. 31 , 33 …”

Perceptions of stakeholders about the role of health system in suicide prevention in Ghizer, Gilgit-Baltistan, Pakistan

“…The study also showed rates in men as 7.06 per 100,0000 and women as 3.08 per 100,000 in the Sindh province [8]. A recent psychological autopsy study from KP province identified major depression, use of harmful substances, lack of treatment compliance, financial issues, aggression, low self-confidence, family disputes and thoughts of self-harm as risk factors for suicide [9].…”

“…Over the last few years there have been anecdotal reports of increasing incidents of suicides, particularly of female suicides, in Gilgit-Baltistan (GB) in the Northern areas of Pakistan [10]. A study on female suicides in Ghizer district, GB showed crude rates as 14.89 per 100, 000 and an annual age-specific death rate for young females (15-24 years) as 61.07 per 100,000 for the years 2000 to 2004 [9]. An ethnographic study explored major factors associated with female suicides in GB and them as 1) Social factors including academic pressure, relationship problems, divorce and financial issues, 2) Cultural factors including lack of freedom, lack of decision making power and male child preference and 3) Psychological (mental illness and depression) [11].…”