Selvmord og psykiske lidelser

Hjelmeland, Heidi; Dieserud, Gudrun; Dyregrov, Kari; Knizek, Birthe Loa; Rasmussen, Mette

doi:10.4045/tidsskr.14.0549

Cited by 11 publications

(9 citation statements)

References 10 publications

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“…In our data, symptoms of depression were a better predictor of non-fatal suicidal behaviour than any of the wide variety of poverty-related variables we considered. This finding is significant in the light of literature which contests the importance of psychiatric factors in the aetiology of suicide [ 15 – 18 ]. In spite of claims made in the critical suicidology literature (often without empirical evidence) about the primacy of socio-economic and cultural factors over psychiatric factors in the aetiology of suicide in LMICs [ 18 ], our data highlight the importance for policy makers to focus on psychiatric issues, like depression, in public health suicide prevention programmes, especially amongst those living in low-resource communities.…”

Section: Discussionmentioning

confidence: 64%

“…There is, however, a growing body of literature, building on Durkheim’s work, which asserts that socio-cultural and economic contexts are also significant factors in the aetiology of suicidal behaviour, and that it is important to expand our understanding beyond the psychiatric determinants of this behaviour [ 15 – 17 ]. Critical suicidologists [ 18 ] have gone so far as to assert that “suicide is about far more than mental disorders, and may be about something quite different” (p. 1370), although it is not entirely clear what the empirical evidence is to support such claims.…”

Section: Introductionmentioning

confidence: 99%

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Non-fatal suicidal behaviour, depression and poverty among young men living in low-resource communities in South Africa

et al. 2018

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BackgroundSuicide is a serious public health problem in low- and middle-income countries. Understanding the context- and gender-specific risk factors for non-fatal suicidal behaviour is the cornerstone of evidence-based public health interventions to reduce suicide. Poverty and symptoms of depression are well established risk factors for suicidal behaviour. However, little is understood about how proximal economic factors (such as losing one’s job, or food insecurity) may confound the effects of symptoms of depression to increase the risk of non-fatal suicidal behaviour in vulnerable populations, such as young men living under conditions of endemic poverty. The aim of this study was to explore the extent to which a wide range of poverty-related variables account for non-fatal suicidal behaviour independent of, or in addition to, symptoms of depression among young men living in low-resource communities in South Africa (SA).MethodsData were collected from a clustered sample of 647 young men living in low-resource communities in the Western Cape province of SA. Multivariate regressions were used to identify the associations between poverty-related measures, symptoms of depression, and past-month prevalence of non-fatal suicidal behaviour.ResultsNon-fatal suicidal behaviour in the last month was reported by 47 (6.13%) participants: suicidal ideation (n = 43; 5.97%); suicide plan (n = 5; 0.77%); suicide attempt (n = 4; 0.62%), and deliberate self-harm without intent to die (n = 4; 0.62%). Past-month prevalence of non-fatal suicidal behaviour was significantly associated with particular dimensions of poverty (living in a home without a toilet on the premises, having previously been fired, and food insecurity), but not with other dimensions of poverty (such as prolonged unemployment and low levels of income). However, symptoms of depression were a more significant predictor of non-fatal suicidal behaviour than any measure of poverty (aOR=1.093, 95% CI=1.058-1.129, p < .000).ConclusionsDepressive symptoms are more strongly associated with non-fatal suicidal behaviour than a range of proximal and distal economic factors among young men living under conditions of endemic poverty in South Africa. This has important public health implications and highlights the importance of increasing young men’s access to psychiatric services and targeting depression as an integral component of suicide prevention in low resource communities.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6104-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Non-fatal suicidal behaviour, depression and poverty among young men living in low-resource communities in South Africa

et al. 2018

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“…In a recent systematic review, Jakobsen et al (2017) concluded that the potentially limited beneficial effects of antidepressants (SSRIs) appear to be outweighed by harmful effects. Critical voices have been raised against diagnostic practices and the potential adverse effects of psychiatric medication (Gøtzsche, 2013; Whitaker, 2010), and several authors have questioned the overreliance on biomedical models with regard to how we understand and manage suicidality (Cutcliffe & Santos, 2012; Hjelmeland, Dieserud, Dyregrov, Knizek, & Rasmussen, 2014; Marsh, 2016; Webb, 2010). Even the assumption that 90% of all suicides are associated with mental disorders (Cavanagh, Carson, Sharpe, & Lawrie, 2003) is strongly challenged by researchers who argue that there is no valid evidence for this 90% statistic (Hjelmeland, Dieserud, Dyregrov, Knizek, & Leenaars, 2012).…”

Section: Discussionmentioning

confidence: 99%

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

Hagen

Knizek

Hjelmeland

2018

International Journal of Qualitative Studies on Health and Well

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Purpose: The purpose of this study is to explore how former suicidal inpatients experienced treatment and care in psychiatric wards in Norway following the implementation of the National guidelines for prevention of suicide in mental health care. The focus of the analysis was on aspects of treatment and care with potential for improvement. Method: We interviewed five former inpatients and analysed the data by means of Interpretative Phenomenological Analysis. Results: Experiencing a sense of companionship with the staff and receiving individualized treatment and care was important for the participants. This involved establishing trusting connections with mental health workers who treated them with respect, made them feel valued, and who recognized their suffering and needs. The formerly suicidal patients experienced being in a recovery process, which was promoted by the support of mental health workers. Although the participants reported mostly positive experiences, there were examples of insufficient care. Sometimes, they felt that their suffering and suicidality were not sufficiently recognized. Conclusion: Our study indicates that although there has been increased focus on suicidality in the mental health services, among other through clinical guidelines, some mental health workers still lack competence and should focus more fully on how to provide individualized care for suicidal inpatients.

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“…Critical suicidologists have pointed out the problems of focusing solely on psychiatric risk factors while failing to consider the socio-cultural context within which suicidal behaviours occur ( Hjelmeland et al, 2014 ). These critiques have spurned a number of studies which have attempted to examine more broadly the role of contextual factors in the aetiology of suicide.…”

Section: Literature Reviewmentioning

confidence: 99%

“…This renewed interest in socio-cultural context has led some authors to question the role of mental illness in precipitating suicidal behaviour. Hjelmeland et al (2014) have gone so far as to assert that ‘suicide is about far more than mental disorders, and may be about something quite different’ (p. 1370). There are good reasons to consider a wide range of contextual, socio-cultural and economic factors when planning suicide prevention interventions, particularly in low-resource environments.…”

Section: Literature Reviewmentioning

confidence: 99%

‘Don’t push me aside, Doctor’: Suicide attempters talk about their support needs, service delivery and suicide prevention in South Africa

Bantjes

2017

Health Psychology Open

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Few studies have explored the expressed support needs of suicide attempters in developing countries. Data, collected via in-depth interviews with suicide attempters admitted to a South African hospital, were analysed using thematic content analysis. Participants explicitly asked for integrated psycho-social services at a primary health care level and say they require assistance with alleviating psychiatric symptoms, establishing connectedness, interpersonal conflict and solving socio-economic problems. Findings highlight the importance for suicide prevention of (1) considering interpersonal and contextual socio-economic factors in addition to the psychiatric causes of suicidal behaviour; and (2) multilevel strategies, intersectoral collaboration and integrated person-centred primary health care.

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Selvmord og psykiske lidelser

Cited by 11 publications

References 10 publications

Non-fatal suicidal behaviour, depression and poverty among young men living in low-resource communities in South Africa

Non-fatal suicidal behaviour, depression and poverty among young men living in low-resource communities in South Africa

Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

‘Don’t push me aside, Doctor’: Suicide attempters talk about their support needs, service delivery and suicide prevention in South Africa

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