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Høilo Granheim IP, Kvernmo S, Silviken A, Lytken Larsen CV. The association between suicidal behaviour and violence, sexual abuse, and parental substance abuse among Sami and Greenlandic adolescents: the WBYG study and the NAAHS. Scand J Child Adolesc Psychiatr Psychol 2023; 11:10-26. [PMID: 37082430 PMCID: PMC10111208 DOI: 10.2478/sjcapp-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health and societal concerns. More knowledge is needed, as suicidal behaviour predicts later death by suicide. The aim of this study was to investigate associations between suicidal thoughts and suicide attempts and negative life events, including violence, sexual abuse, and parental substance abuse, in Sami and Greenlandic adolescents, within and between groups and gender. Method Working samples included 442 Sami and 399 Greenlandic Inuit (15-16-year-olds), in The Norwegian Arctic Adolescent Health Study (NAAHS) and the Well-Being among Youth in Greenland (WBYG) study. Multivariable logistic regression explored associations between suicidal behaviour and violence, sexual abuse, and parental substance abuse. Results Across Indigenous groups, suicidal thoughts and attempts were significantly associated with violence and sexual abuse. The association between suicidal behaviour; especially suicidal thoughts, and sexual abuse was significant and strong among Sami females. Sami and Inuit adolescents with a history of childhood violence reported significantly more suicide attempts; the strongest association was found among Sami males. Conclusion To Sami and Greenlandic Inuit, the experiences of negative life events, such as violence or sexual abuse are significant risk factors for suicidal behaviour. Public health programmes and prevention strategies targeting youth mental health and suicide should be culturally sensitive and sensitive to gender differences in the association between negative life events and suicidal behaviour.
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Affiliation(s)
- Ida Pauline Høilo Granheim
- Department of clinical medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Siv Kvernmo
- Department of clinical medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Silviken
- Centre for Sami Health Research, Faculty of Health Sciences, UiT The Arctic University of Norway, Karasjok, Norway
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2
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Crossin R. Exploring the link between adolescent inhalant misuse and suicidal behaviour: a behavioural toxicology perspective. Neurotoxicol Teratol 2021; 88:107038. [PMID: 34678460 DOI: 10.1016/j.ntt.2021.107038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
Adolescent inhalant misuse has a known association with suicidal thoughts and behaviour. This association persists even after inhalant misuse has ceased. Previous studies have hypothesised that this association may derive from socioeconomic disadvantage or vulnerability, and potentially mediated by impulsivity. This association may also be due to the central nervous system depressant effects of inhalants. This review takes a behavioural toxicology perspective, focussed particularly on the serotonergic system and the Hypothalamic-Pituitary-Adrenal (HPA) axis, as potential links between adolescent inhalant misuse and suicidal behaviour. The challenges of bridging the pre-clinical and clinical literature in this area are discussed, along with promising avenues for future research; ultimately aimed at reducing suicide risk in a vulnerable adolescent population group.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago (Christchurch), Christchurch 8140, New Zealand.
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3
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Lamoureux-Tremblay V, Muckle G, Maheu F, Jacobson SW, Jacobson JL, Ayotte P, Bélanger RE, Saint-Amour D. Risk factors associated with developing anxiety in Inuit adolescents from Nunavik. Neurotoxicol Teratol 2020; 81:106903. [PMID: 32512128 DOI: 10.1016/j.ntt.2020.106903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 01/05/2023]
Abstract
This study aimed to examine the relation between anxiety among the at-risk population of Inuit adolescents and diverse developmental risk factors including exposure to environmental chemicals, a subject of concern in Nunavik. Anxiety was assessed in 89 Inuit participants (mean age = 18.4 years; range = 16.2-21.9) with the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the State-Trait Anxiety Inventory (STAI). Potential risk factors for anxiety were documented at birth, 11 years of age and 18 years of age, including blood levels of chemicals (mercury, lead, PCBs) and nutrients, as well as age, sex, estimated IQ, drug and alcohol use, bullying, exposure to domestic violence, food insecurity, crowding and socio-economic status. Results showed that participants scored high on both measures of anxiety, particularly the SCARED, for which the mean score was above the clinical threshold. Multiple regression results show that significant risk predictors obtained from the SCARED scores were female sex (β = 0.32), higher current blood mercury concentration (β = 0.26), food insecurity (β = 0.26) and bullying experiences in the last year (β = 0.21). The significant predictors for the STAI trait anxiety were food insecurity (β = 0.25) and lower estimated IQ (β = -0.31), whereas food insecurity (β = 0.21), lower blood levels of vitamin E (β = -0.25) and higher cord blood mercury concentrations (β = 0.25) were found for STAI situational anxiety. Further regression analyses suggested that the adolescent-related variables were the most important risk factors. Our findings show that Inuit adolescents are at risk for anxiety via multiple contributing factors, particularly current exposure to mercury, food insecurity and female sex.
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Affiliation(s)
| | - Gina Muckle
- École de Psychologie, Université Laval, 2325, rue des Bibliothèques, Québec, Québec G1V 0A6, Canada
| | - Françoise Maheu
- Université de Montréal, 90 Avenue Vincent-D'Indy, Outremont, Montréal, Québec H2V 2S9, Canada
| | - Sandra W Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Drive, Detroit 48201, United States
| | - Joseph L Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Drive, Detroit 48201, United States
| | - Pierre Ayotte
- Département de Médecine Sociale et Préventive, Faculté de Médecine, 1050, Avenue de la Médecine, Pavillon Ferdinand-Vandry, Université Laval, Québec, Québec G1V 0A6, Canada
| | - Richard E Bélanger
- Département de Pédiatrie, Université Laval, Centre mère-enfant Soleil du CHU de Québec, 2705, Boulevard Laurier, Québec, Québec G1V 4G2, Canada
| | - Dave Saint-Amour
- Université du Québec à Montréal, 320 Sainte-Catherine Est, Pavillon J.A. De Sève, Montréal, Québec H2X 1L7, Canada..
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Suicide amongst the Inuit of Nunavut: An Exploration of Life Trajectories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061812. [PMID: 32168793 PMCID: PMC7143601 DOI: 10.3390/ijerph17061812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022]
Abstract
This article reports results of the life trajectories from 92 Inuit who died by suicide, matched for age and gender with 92 living-controls. A proxy-based procedure and semi-structured interviews with informants were conducted to obtain trajectories of developmental events occurring over the life course for suicide and community-matched controls. Results from this research indicate two different trajectories that differentiate the control-group from the suicide-group throughout the life course. Even though the number of suicide attempts are similar between both groups, the suicide-group had a more important burden of adversity, which seemed to create a cascading effect, leading to suicide.
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5
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Lim KS, Wong CH, McIntyre RS, Wang J, Zhang Z, Tran BX, Tan W, Ho CS, Ho RC. Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224581. [PMID: 31752375 PMCID: PMC6888476 DOI: 10.3390/ijerph16224581] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/03/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. METHODS A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.
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Affiliation(s)
- Kim-San Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (K.-S.L.); (R.C.H.)
| | - Celine H. Wong
- Division of Child and Adolescent Psychiatry, Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON M5T 1R8, Canada;
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Jiayun Wang
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
- Correspondence:
| | - Zhisong Zhang
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
| | - Bach X. Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Vietnam Young Physicians’ Association, Hanoi 100000, Vietnam
| | - Wanqiu Tan
- The China-Singapore (Chongqing) Demonstration Initiative on Strategic Connectivity Think Tank, Chongqing 400043, China;
| | - Cyrus S. Ho
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Roger C. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (K.-S.L.); (R.C.H.)
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
- Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119228, Singapore
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
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Cianconi P, Lesmana CBJ, Ventriglio A, Janiri L. Mental health issues among indigenous communities and the role of traditional medicine. Int J Soc Psychiatry 2019; 65:289-299. [PMID: 30977417 DOI: 10.1177/0020764019840060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population. METHODS We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities. RESULTS The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations' health needs. CONCLUSION This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).
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Affiliation(s)
| | | | - Antonio Ventriglio
- 3 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Lys C. Exploring coping strategies and mental health support systems among female youth in the Northwest Territories using body mapping. Int J Circumpolar Health 2019; 77:1466604. [PMID: 29697022 PMCID: PMC5917895 DOI: 10.1080/22423982.2018.1466604] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The mental health of young women in the Northwest Territories (NWT), Canada, is a critical public health concern; however, there is a dearth of research that examines how this population manages mental health challenges. This study explores the self-identified strategies that female youth in the NWT use to cope with mental health issues. The arts-based qualitative method of body mapping and a trauma-informed, strengths-based approach grounded in social ecological theory was used to collect data during in-depth semi-structured interviews. Forty-one participants (aged 13–17 years) attended FOXY body mapping workshops in six NWT communities in 2013 then completed interviews regarding the content of their body maps. Thematic analysis was used to identify five themes related to coping strategies: grounding via nature, strength through Indigenous cultures, connection with God and Christian beliefs, expression using the arts, and relationships with social supports. These results can be used to develop culturally relevant, strengths-based, trauma informed interventions that improve coping and resiliency among Northern youth.
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Affiliation(s)
- Candice Lys
- a University of Toronto , Dalla Lana School of Public Health , Toronto , Ontario , Canada.,b Fostering Open eXpression among Youth (FOXY) , Yellowknife , Northwest Territories , Canada
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8
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Fraser SL, Parent V, Dupéré V. Communities being well for family well-being: Exploring the socio-ecological determinants of well-being in an Inuit community of Northern Quebec. Transcult Psychiatry 2018; 55:120-146. [PMID: 29299979 DOI: 10.1177/1363461517748814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Inuit communities of Canada experience many disparities in health and psychosocial context. Research in community psychology has shown associations between such socio-ecological factors and individual well-being. The objective of the study was to explore how community-level determinants of well-being influence family well-being in a northern community of Nunavik, Quebec. A total of 14 participants were interviewed. A thematic inductive analysis was conducted to extract community determinants of family well-being from the data. A system science approach was used to explore the associations between determinants and larger psychosocial dynamics. A community workshop was held to discuss the results and their meaning. A total of 25 determinants were coded, 16 of which were community-level. Community-level stressors were highly interrelated, whereas community supports were generally disconnected and superimposed on narratives of stressors. Participants spoke of desired supports. In their narratives, these supports were connected to a variety of determinants of well-being, suggesting the need to connect, redefine and support existing resources rather than simply add on new ones. We discuss intricate links between family and community well-being in small and geographically isolated communities.
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9
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Beaudoin V, Séguin M, Chawky N, Affleck W, Chachamovich E, Turecki G. Protective Factors in the Inuit Population of Nunavut: A Comparative Study of People Who Died by Suicide, People Who Attempted Suicide, and People Who Never Attempted Suicide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010144. [PMID: 29337928 PMCID: PMC5800243 DOI: 10.3390/ijerph15010144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 12/05/2022]
Abstract
Epidemiological data shows an alarming prevalence of suicide in Aboriginal populations around the world. In Canada, the highest rates are found in Inuit communities. In this article, we present the findings of a secondary analysis conducted with data previously collected as part of a larger study of psychological autopsies conducted in Nunavut, Canada. The objective of this secondary analysis was to identify protective factors in the Inuit population of Nunavut by comparing people who died by suicide, people from the general population who attempted suicide, and people from the general population who never attempted suicide. This case-control study included 90 participants, with 30 participants in each group who were paired by birth date, sex, and community. Content analysis was first conducted on the clinical vignettes from the initial study in order to codify the presence of protective variables. Then, inferential analyses were conducted to highlight differences between each group in regards to protection. Findings demonstrated that (a) people with no suicide attempt have more protective variables throughout their lifespan than people who died by suicide and those with suicide attempts within the environmental, social, and individual dimensions; (b) people with suicide attempts significantly differ from the two other groups in regards to the use of services; and (c) protective factors that stem from the environmental dimension show the greatest difference between the three groups, being significantly more present in the group with no suicide attempt. Considering these findings, interventions could focus on enhancing environmental stability in Inuit communities as a suicide prevention strategy.
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Affiliation(s)
- Véronique Beaudoin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Monique Séguin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - Nadia Chawky
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - William Affleck
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Eduardo Chachamovich
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
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10
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Fraser S, Rouillard R, Nadeau L, D’Ostie Racine L, Mickpegak R. Collaborating to improve child and youth mental health in Nunavik. ACTA ACUST UNITED AC 2017. [DOI: 10.7202/1040143ar] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Following various reports highlighting the lack of mental health services for children and youth in Nunavik (Quebec, Canada), high rates of child placements under youth protection, and gaps in the coordination of services, the Regional Partnership Committee of Nunavik decided to prioritize collaborative, community-based approaches to the health and wellbeing of children, youth, and their families. It is in this context that the regional project Ilagiinut (‘For families’) was initiated and is being piloted in Kuujjuaraapik. In mental health care, collaborative practices are highly valued, and various models are flourishing. However, collaborative care models are not necessarily easy to implement and involve a variety of ingredients, including trust, strong partnerships, clarity of roles, and power dynamics, all of which are influenced by culture and context. In this study, we conducted a total of 54 interviews with administrators, clinicians, and Inuit family members to explore their everyday expectations for and experiences with child and youth mental health services and collaboration between people involved in care. In our analysis we explore how context influences expectations, beliefs, and experiences, and ultimately how these factors impact the nature of services offered to children, youth, and families. The aim is to shed light on obstacles to and facilitators of collaboration in child and youth mental health in order to inform individuals, communities, and organizations that are trying to change policy and practice.
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Affiliation(s)
- Sarah Fraser
- École de psychoéducation, Université de Montréal, Pavillon Marie-Victorin, C.P. 6128 succursale Centre-Ville, Montreal, Quebec H3C 3J7, Canada
| | - Rémy Rouillard
- École de psychoéducation, Université de Montréal, Pavillon Marie-Victorin, C.P. 6128 succursale Centre-Ville, Montreal, Quebec H3C 3J7, Canada
| | - Lucie Nadeau
- Division of Social and Cultural Psychiatry, McGill University. Mailing address: Inuulitsivik Health Centre, CLSC Parc Extension, 7085 Hutchison, salle 204.10, Montreal, Quebec H3N 1Y9, Canada
| | - Léna D’Ostie Racine
- École de psychoéducation, Université de Montréal, Pavillon Marie-Victorin, C.P. 6128 succursale Centre-Ville, Montreal, Quebec H3C 3J7, Canada
| | - Raymond Mickpegak
- Tasiurvik Family House, 403 Katimavik Avenue, P.O. Box 519, Kuujjuaraapik, Quebec J0M 1G0, Canada
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Kvernmo S, Rosenvinge JH. Self-mutilation and suicidal behaviour in Sami and Norwegian adolescents: prevalence and correlates. Int J Circumpolar Health 2016; 68:235-48. [DOI: 10.3402/ijch.v68i3.18331] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Kral MJ. Suicide and Suicide Prevention among Inuit in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:688-695. [PMID: 27738249 PMCID: PMC5066555 DOI: 10.1177/0706743716661329] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Inuit in Canada have among the highest suicide rates in the world, and it is primarily among their youth. Risk factors include known ones such as depression, substance use, a history of abuse, and knowing others who have made attempts or have killed themselves, however of importance are the negative effects of colonialism. This took place for Inuit primarily during the government era starting in the 1950s, when Inuit were moved from their family-based land camps to crowded settlements run by white men, and children were removed from their parents and placed into residential or day schools. This caused more disorganization than reorganization. The most negative effect of this colonialism/imperialism for Inuit has been on their family and sexual relationships. Many Inuit youth feel alone and rejected. Suicide prevention has been taking place, the most successful being community-driven programs developed and run by Inuit. Mental health factors for Indigenous peoples are often cultural. It is recommended that practitioners work with the community and with Inuit organizations. Empowered communities can be healing.
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Petrasek MacDonald J, Cunsolo Willox A, Ford JD, Shiwak I, Wood M. Protective factors for mental health and well-being in a changing climate: Perspectives from Inuit youth in Nunatsiavut, Labrador. Soc Sci Med 2015; 141:133-41. [PMID: 26275362 DOI: 10.1016/j.socscimed.2015.07.017] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 04/23/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022]
Abstract
The Canadian Arctic is experiencing rapid changes in climatic conditions, with implications for Inuit communities widely documented. Youth have been identified as an at-risk population, with likely impacts on mental health and well-being. This study identifies and characterizes youth-specific protective factors that enhance well-being in light of a rapidly changing climate, and examines how climatic and environmental change challenges these. In-depth conversational interviews were conducted with youth aged 15-25 from the five communities of the Nunatsiavut region of Labrador, Canada: Nain, Hopedale, Postville, Makkovik, and Rigolet. Five key protective factors were identified as enhancing their mental health and well-being: being on the land; connecting to Inuit culture; strong communities; relationships with family and friends; and staying busy. Changing sea ice and weather conditions were widely reported to be compromising these protective factors by reducing access to the land, and increasing the danger of land-based activities. This study contributes to existing work on Northern climate change adaptation by identifying factors that enhance youth resilience and, if incorporated into adaptation strategies, may contribute to creating successful and effective adaptation responses.
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Affiliation(s)
| | - Ashlee Cunsolo Willox
- Cape Breton University, Depts. of Nursing & Indigenous Studies, 1250 Grand Lake Rd., Sydney NS B1P 6L2, Canada.
| | - James D Ford
- McGill University, Dept. of Geography, 805 Sherbrooke St. W., Montreal QC H3A 0B9, Canada
| | - Inez Shiwak
- 'My Word': Storytelling & Digital Media Lab, Rigolet Inuit Community Government, Rigolet, Nunatsiavut, Labrador, A0P 1P0, Canada
| | - Michele Wood
- Nunatsiavut Government, Department of Health & Social Development, 200 Kelland Drive, P.O. Box 496, Station C, Happy Valley-Goose Bay, NL A0P 1C0, Canada
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Fraser SL, Geoffroy D, Chachamovich E, Kirmayer LJ. Changing rates of suicide ideation and attempts among Inuit youth: a gender-based analysis of risk and protective factors. Suicide Life Threat Behav 2015; 45:141-56. [PMID: 25255825 DOI: 10.1111/sltb.12122] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/16/2014] [Indexed: 11/30/2022]
Abstract
Inuit in Canada currently suffer from one of the highest rates of suicide in the world. The objective of this study was to explore the prevalence of suicide ideations and attempts among 15-24 year olds living in Nunavik, Québec, and to explore risk and protective factors of suicide attempts as a function of gender. A cross-sectional survey was conducted in 2004 across Nunavik. Univariate and multivariate logistic regressions were conducted. A total of 22% of young males and 39% of females adults reported past suicidal attempts. Gender differences were observed in relation to associated risk and protective factors as well as degree of exposure to risk factors. Suicide prevention must include alcohol and drug prevention programs and rehabilitation services, interventions to reduce physical and sexual violence and their long-term impacts on Inuit youth, as well as exposure to culturally meaningful activities.
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Affiliation(s)
- Sarah L Fraser
- Psychoéducation, Université de Montréal, Montreal, QC, Canada
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Young TK, Revich B, Soininen L. Suicide in circumpolar regions: an introduction and overview. Int J Circumpolar Health 2015; 74:27349. [PMID: 25742881 PMCID: PMC4351303 DOI: 10.3402/ijch.v74.27349] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 11/21/2022] Open
Abstract
This extended editorial introduces the Special Issue on Suicide and Resilience in Circumpolar Regions, the results of the knowledge synthesis project by an international research team funded by the Canadian Institutes of Health Research and endorsed by the Arctic Council. It focuses on the extent and magnitude of the problem of suicidal behaviours and thoughts from a circumpolar perspective – the variation across Arctic States and their northern regions, the excess risk among some indigenous groups and their demographic characteristics. Much remains to be learned about the design and implementation of youth-focused intervention programmes, especially in a circumpolar comparative framework.
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Affiliation(s)
- T Kue Young
- School of Public Health, University of Alberta, Edmonton, AB, Canada;
| | - Boris Revich
- Laboratory of Environmental Health, Institute for Forecasting, Russian Academy of Science, Moscow, Russian Federation
| | - Leena Soininen
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
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Abstract
Between 48 million and 500 million people are thought to experience suicide bereavement every year. Over the past decade, increased policy attention has been directed towards suicide bereavement, but with little evidence to describe the effect of exposure or to provide appropriate responses. We used a systematic approach to carry out a narrative review of studies of the effect of suicide bereavement on mortality, mental health, and social functioning, and compared them with effects from other bereavements. We found 57 studies that satisfied strict inclusion criteria. Results from these studies suggested that exposure to suicide of a close contact is associated with several negative health and social outcomes, depending on an individual's relationship to the deceased. These effects included an increased risk of suicide in partners bereaved by suicide, increased risk of required admission to psychiatric care for parents bereaved by the suicide of an offspring, increased risk of suicide in mothers bereaved by an adult child's suicide, and increased risk of depression in offspring bereaved by the suicide of a parent. Some evidence was shown for increased rejection and shame in people bereaved by suicide across a range of kinship groups when data were compared with reports of relatives bereaved by other violent deaths. Policy recommendations for support services after suicide bereavement heavily rely on the voluntary sector with little input from psychiatric services to address described risks. Policymakers should consider how to strengthen health and social care resources for people who have been bereaved by suicide to prevent avoidable mortality and distress.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, University College London, London, UK.
| | - David Osborn
- UCL Division of Psychiatry, University College London, London, UK
| | - Michael King
- UCL Division of Psychiatry, University College London, London, UK
| | - Annette Erlangsen
- Suicide Prevention Research, Research Unit, Mental Health Centre Copenhagen, Denmark; Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Luke JN, Anderson IP, Gee GJ, Thorpe R, Rowley KG, Reilly RE, Thorpe A, Stewart PJ. Suicide ideation and attempt in a community cohort of urban Aboriginal youth: a cross-sectional study. CRISIS 2014; 34:251-61. [PMID: 23357216 DOI: 10.1027/0227-5910/a000187] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. AIMS To examine the prevalence of suicide ideation and attempt and the associated factors for a community1 cohort of Koori2 (Aboriginal) youth. METHOD Data were obtained from the Victorian Aboriginal Health Service (VAHS) Young People's Project (YPP), a community initiated cross-sectional data set. In 1997/1998, self-reported data were collected for 172 Koori youth aged 12-26 years living in Melbourne, Australia. The data were analyzed to assess the prevalence of current suicide ideation and lifetime suicide attempt. Principal components analysis (PCA) was used to identify closely associated social, emotional, behavioral, and cultural variables at baseline and Cox regression modeling was then used to identify associations between PCA components and suicide ideation and attempt. RESULTS Ideation and attempt were reported at 23.3% and 24.4%, respectively. PCA yielded five components: (1) emotional distress, (2) social distress A, (3) social distress B, (4) cultural connection, (5) behavioral. All were positively and independently associated with suicide ideation and attempt, while cultural connection showed a negative association. CONCLUSIONS Suicide ideation and attempt were common in this cross-section of indigenous youth with an unfavorable profile for the emotional, social, cultural, and behavioral factors.
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Affiliation(s)
- Joanne N Luke
- Victorian Aboriginal Health Service, Fitzroy, Melbourne, Australia.
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MacDonald JP, Ford JD, Willox AC, Ross NA. A review of protective factors and causal mechanisms that enhance the mental health of Indigenous Circumpolar youth. Int J Circumpolar Health 2013; 72:21775. [PMID: 24350066 PMCID: PMC3860333 DOI: 10.3402/ijch.v72i0.21775] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/24/2013] [Accepted: 10/24/2013] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To review the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. STUDY DESIGN A systematic literature review of peer-reviewed English-language research was conducted to systematically examine the protective factors and causal mechanisms which promote and enhance Indigenous youth mental health in the Circumpolar North. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with elements of a realist review. From 160 records identified in the initial search of 3 databases, 15 met the inclusion criteria and were retained for full review. Data were extracted using a codebook to organize and synthesize relevant information from the articles. RESULTS More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. More than 40 protective factors at the individual, family, and community levels were identified as enhancing Indigenous youth mental health. These included practicing and holding traditional knowledge and skills, the desire to be useful and to contribute meaningfully to one's community, having positive role models, and believing in one's self. Broadly, protective factors at the family and community levels were identified as positively creating and impacting one's social environment, which interacts with factors at the individual level to enhance resilience. An emphasis on the roles of cultural and land-based activities, history, and language, as well as on the importance of social and family supports, also emerged throughout the literature. CONCLUSIONS Healthy communities and families foster and support youth who are resilient to mental health challenges and able to adapt and cope with multiple stressors, be they social, economic, or environmental. Creating opportunities and environments where youth can successfully navigate challenges and enhance their resilience can in turn contribute to fostering healthy Circumpolar communities. Looking at the role of new social media in the way youth communicate and interact is one way of understanding how to create such opportunities. Youth perspectives of mental health programmes are crucial to developing appropriate mental health support and meaningful engagement of youth can inform locally appropriate and culturally relevant mental health resources, programmes and community resilience strategies.
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Affiliation(s)
| | - James D. Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - Ashlee Cunsolo Willox
- Departments of Nursing and Indigenous Studies, Cape Breton University, Sydney, Nova Scotia, Canada
| | - Nancy A. Ross
- Department of Geography, McGill University, Montreal, Quebec, Canada
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Kulkarni RR, Rao KN, Begum S. Comorbidity of psychiatric and personality disorders in first suicide attempters: a case-control study. Asian J Psychiatr 2013; 6:410-6. [PMID: 24011689 DOI: 10.1016/j.ajp.2013.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 05/02/2013] [Accepted: 05/12/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Comorbid psychiatric and personality disorders in suicide attempters pose greater estimated risk of suicide than psychiatric disorders alone. The current study aimed to evaluate prevalence and pattern of psychiatric and/or personality morbidity and comorbidity in first-time suicide attempters in comparison to the age and sex matched community sample. METHODS Socio-demographic variables, family background, psychiatric morbidity and comorbidity in survivors of first suicide attempt were compared to age and sex matched community controls. Structured (Mini International Neuropsychiatric Interview plus) and semi-structured (International Personality Disorder Examination) clinical interviews were utilized to evaluate for axis-I and axis-II (personality) diagnosis. Risk-rescue rating was administered to assess medical seriousness of suicide attempt. RESULTS Individuals who made a first suicide attempt showed significantly lower educational achievement (P<0.0001; OR 1.56; 95% CI 0.89-2.74), but no significant difference in other socio-demographic variables compared to the controls. Cases had high family history of psychiatric illnesses (31% vs. 7%; P<0.0001; OR 5.97; 95% CI 2.48-14.35); high prevalence of psychiatric disorders (89% vs. 25%; P<0.0001; OR 24.27 95% CI 11.21-52.57), personality disorders (52% vs. 24%; P<0.0001; OR 3.43; 95% CI 1.88-6.28), comorbidity of psychiatric and personality disorders (51.6% vs. 19.5%; P=0.022; OR 3.01; 95% CI 1.14-7.92), and high overall prevalence of any axis-I and/or axis-II (personality) morbidity (93% vs. 41%; P<0.0001; OR 19.12; 95% CI 8.05-45.43), compared to controls. CONCLUSION Survivors of first suicide attempt are at nineteen times increased odds of having psychiatric morbidity and/or comorbidity, especially with personality disorders. Personality evaluation and management in such individuals may result in better comprehensive approach to health care.
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Affiliation(s)
- Ranganath R Kulkarni
- Department of Psychiatry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India.
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Bloch LH, Drachmann GH, Pedersen ML. High prevalence of medicine-induced attempted suicides among females in Nuuk, Greenland, 2008-2009. Int J Circumpolar Health 2013; 72:21687. [PMID: 23967416 PMCID: PMC3748457 DOI: 10.3402/ijch.v72i0.21687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The suicide rate in Greenland, especially among men, is among the highest in the world. Attempted suicide rates may be high also. However, the rates of attempted suicide are unknown. Objective We aimed to estimate the age- and gender-specific incidence of attempted suicide using medicine in Nuuk in 2008–2009. Design An observational retrospective study of consecutive medical records on patients admitted to Dronning Ingrids Hospital in Nuuk in 2008–2009 with possible medicine intoxication. Results Seventy-four (60 females and 14 men) cases of attempted suicide using medicine were included. Of those, 43 used paracetamol alone or in combination with other medicine. The incidence of attempted suicide using medicine was higher among females than males (p<0.001). The highest incidence of attempted suicide with paracetamol was found among women aged 20–24 years (0.84%). The highest incidence of suicide with medication (1.31 per 100 inhabitants per year) was among women aged 15–19 years. Conclusions The incidence of attempted suicide using medicine was high in Nuuk, Greenland, especially among women. The highest incidence of suicide attempts with medication was observed among women in the age group 15–19 years (1.31%). This may reflect psychosocial vulnerability among young people in Greenland. Initiatives to improve living conditions for children and adolescents are highly recommended to be initiated immediately.
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Chachamovich E, Haggarty J, Cargo M, Hicks J, Kirmayer LJ, Turecki G. A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability. Int J Circumpolar Health 2013; 72:20078. [PMID: 23539438 PMCID: PMC3609997 DOI: 10.3402/ijch.v72i0.20078] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/21/2013] [Accepted: 01/22/2013] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country. OBJECTIVE This article presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (Learning from lives that have been lived) is a large case-control study, including all 120 cases of suicide by Inuit that occurred in Nunavut between 1 January 2003 and 31 December 2006. The article describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues; data collection procedures; and the acceptability, reliability and validity of the method. METHOD A retrospective case-control study using the psychological autopsy approach was carried out in 22 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed. RESULTS The psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations.
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Affiliation(s)
- Eduardo Chachamovich
- Department of Psychiatry, McGill Group for Suicide Studies, McGill University, Montreal, Quebec, Canada.
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22
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Saudny H, Leggee D, Egeland G. Design and methods of the Adult Inuit Health Survey 2007-2008. Int J Circumpolar Health 2012; 71:19752. [PMID: 23166895 PMCID: PMC3500824 DOI: 10.3402/ijch.v71i0.19752] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 10/19/2012] [Accepted: 10/19/2012] [Indexed: 11/14/2022] Open
Abstract
Background The Canadian International Polar Year (IPY) program made it possible to undertake much needed health research in 3 jurisdictions within the Canadian Inuit Nunangat (homeland) over a 2-year period: Inuvialuit Settlement Region (ISR), Nunavut Territory, and Nunatsiavut. Design The Adult Inuit Health Survey (IHS) was a cross-sectional survey and provides baseline data upon which future comparisons can be made for prospectively assessing factors leading to the progression of chronic diseases among Canadian Inuit. With the help of the Canadian Coast Guard Ship Amundsen, which was equipped with research and laboratory facilities, 33 coastal communities were visited; land survey teams visited 3 inland communities. Results The Adult IHS succeeded in obtaining important baseline information concerning the health status and living conditions of 2,595 adults living in ISR, Nunavut and Nunatsiavut. Conclusion Information from this survey will be useful for future comparisons and the opportunity to link with the International Inuit Cohort, a follow-up evaluation, and for the development of future health policies and public health interventions.
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Affiliation(s)
- Helga Saudny
- School of Dietetics and Human Nutrition/Centre for Indigenous Peoples' Nutrition and Environment-CINE, McGill University, Ste Anne de Bellevue, Canada.
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24
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Abstract
The practice of petrol sniffing is a unique and poorly understood phenomenon that is associated with substantial morbidity, mortality and social devastation in affected remote Indigenous communities. For these groups and for the wider community, much mystery has surrounded the practice and its effects. Here we introduce the epidemiology of petrol sniffing among Indigenous groups internationally, review its impact on the brain, behaviour and social functions and summarise related interventions.
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Affiliation(s)
- Sheree Cairney
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia.
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25
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Greening L, Stoppelbein L, Luebbe A, Fite PJ. Aggression and the risk for suicidal behaviors among children. Suicide Life Threat Behav 2010; 40:337-45. [PMID: 20822360 DOI: 10.1521/suli.2010.40.4.337] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two subtypes of aggression--reactive and proactive--were examined to see how they relate to suicidal behaviors among young children admitted for acute psychiatric inpatient care. The children and their parents completed self-report questionnaires/interviews. Regression analyses revealed that depressed girls who scored higher on reactive aggression reported more suicidal behaviors; whereas proactive aggression did not relate to suicidal behaviors for either boys or girls.
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Affiliation(s)
- Leilani Greening
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Abstract
OBJECTIVE The aim of the present study was to characterize suicide in the Northern Territory (NT) for the 6 year period 1 January 2001-31 December 2006. METHOD Suicide death rates by area (Australia, NT), sex, and Indigenous status for the period of 2001-2006 were obtained from the National Coroners Information System through the Victorian Institute of Forensic Medicine. Population figures were obtained from the Australian Bureau of Statistics. RESULTS For this period the suicide rate of NT (21.6 per 100 000) was double the national rate ( 11 ), and the rate for NT Indigenous people (36.7) was significantly higher (p < 0.001) than that of NT non-Indigenous people (14.7). There was a decline in the suicide rate for Australia of -8.6%; for NT, -6.3%; for NT non-Indigenous, -3.3%; and for NT Indigenous, -9.0%. The sex difference was significant (p < 0.001) for both Australia and the NT with male subjects having a higher suicide rate than female subjects. With respect to age group, some evidence suggested an earlier peak for NT Indigenous compared to NT non-Indigenous people. Hanging was more common in NT than in the rest of the country and accounted for 87% of Indigenous suicide. CONCLUSION Suicide is more common in NT than in Australia generally, and more common in NT Indigenous than NT non-Indigenous people. There is evidence of a decline in suicide rates across the board.
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Affiliation(s)
- Saxby Pridmore
- Centre for Remote Health, Flinders University and Charles Darwin University, Alice Springs, NT 0871, Australia.
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Lehti V, Niemelä S, Hoven C, Mandell D, Sourander A. Mental health, substance use and suicidal behaviour among young indigenous people in the Arctic: a systematic review. Soc Sci Med 2009; 69:1194-203. [PMID: 19700231 DOI: 10.1016/j.socscimed.2009.07.045] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Indexed: 11/15/2022]
Abstract
The Arctic has been a subject to various socio-cultural changes; indigenous people living in the region have experienced injustice and oppression in different forms. Furthermore, there are currently various new social, political and environmental challenges. It has been assumed that the continuous socio-cultural transition has an influence on indigenous people's wellbeing. We conducted a systematic literature review with regard to epidemiological mental health research on Arctic indigenous children and adolescents. The aim was to describe the nature and scope of research conducted and to explore for possible regional and ethnic differences in mental health. It was found that current epidemiological knowledge is based mainly on cross-sectional studies from selected regions and limited to substance use and suicidal behaviour. Youth suicide rates are alarmingly high in many parts of the Arctic, particularly in Greenland and Alaska. Differences between indigenous and non-indigenous groups are also most evident and uniform across suicide studies, with rates being systematically higher among indigenous youth. Substance use is common throughout the Arctic, however, regional and ethnic differences in usage vary considerably. Other psychosocial problems remain largely unexplored. In addition, very little is known about the causes of mental health problems in general and the impact of rapid socio-cultural changes in particular. There are several methodological limitations in the studies included here, many related to the validity of research instruments in different cultural contexts. There is a need for longitudinal comparative studies from the entire Arctic with culturally relevant instruments addressing mental health in early childhood as well.
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Affiliation(s)
- Venla Lehti
- Department of Child Psychiatry, University of Turku, Turku, Finland.
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Abstract
In this Review we delve into the underlying causes of health disparities between Indigenous and non-Indigenous people and provide an Indigenous perspective to understanding these inequalities. We are able to present only a snapshot of the many research publications about Indigenous health. Our aim is to provide clinicians with a framework to better understand such matters. Applying this lens, placed in context for each patient, will promote more culturally appropriate ways to interact with, to assess, and to treat Indigenous peoples. The topics covered include Indigenous notions of health and identity; mental health and addictions; urbanisation and environmental stresses; whole health and healing; and reconciliation.
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Affiliation(s)
- Malcolm King
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.
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Laliberté A, Tousignant M. Alcohol and Other Contextual Factors of Suicide in Four Aboriginal Communities of Quebec, Canada. CRISIS 2009; 30:215-21. [DOI: 10.1027/0227-5910.30.4.215] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Aboriginal populations worldwide face increasing rates of suicide. Despite this recurring observation, little research has emerged from Aboriginal settings. Aims: This paper describes the psychosocial and behavioral characteristics of 30 consecutive adult suicides from four First-Nations communities in Quebec, Canada. Method: Psychological autopsies guided by the LEDS with family members of the deceased. Results: Suicide among this group is overrepresented by young single men. Alcohol intoxication at the time of death was reported for 22 cases in association with rapid acting out after the precipitating event for 20. All but two cases had a history of alcohol abuse, and drug use was also present in 23 cases. In 16 cases there had been a previous suicide attempt, 14 of which occurred during the previous year. The main socio-demographic characteristics of the communities were overcrowded living arrangements and no job status (90%). Seven cases were incarcerated or locked up at the time of death. Clustering of suicide was observed within seven nuclear families including 16 suicides. Conclusion: This study shows that Aboriginal suicide is the result of a complex interweaving of individual, familial, and socio-historical variables. The impact of contemporary social stressors on individual well-being must be addressed to prevent suicide in this community.
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Affiliation(s)
- Arlene Laliberté
- Centre for Research and Intervention on Suicide and Euthanasia, Department of Psychology, University of Quebec at Montreal, Canada
- North Queensland Health Equalities Promotion Unit, University of Queensland, Australia
| | - Michel Tousignant
- Centre for Research and Intervention on Suicide and Euthanasia, Department of Psychology, University of Quebec at Montreal, Canada
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Haggarty JM, Cernovsky Z, Bedard M, Merskey H. Suicidality in a sample of Arctic households. Suicide Life Threat Behav 2008; 38:699-707. [PMID: 19152300 DOI: 10.1521/suli.2008.38.6.699] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We investigated the association of suicidal ideation and behavior with depression, anxiety, and alcohol abuse in a Canadian Arctic Inuit community. Inuit (N = 111) from a random sample of households completed assessments of anxiety and depression, alcohol abuse, and suicidality. High rates of suicidal ideation within the past week (43.6%), and suicide attempts within last 6 months (30%), were reported. Ideation was more frequent among younger persons, whereas those favoring local native language were less likely to report a wish to die. Higher overall suicidality scores were associated with higher anxiety, and alcohol abuse, but not with depression or gender. Implications for future research are discussed.
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Affiliation(s)
- John M Haggarty
- Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
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Lee HS, Kim S, Choi I, Lee KU. Prevalence and risk factors associated with suicide ideation and attempts in korean college students. Psychiatry Investig 2008; 5:86-93. [PMID: 20046350 PMCID: PMC2796021 DOI: 10.4306/pi.2008.5.2.86] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. METHODS Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki's suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. RESULTS The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. CONCLUSION Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.
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Affiliation(s)
- Hong-Seok Lee
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sukil Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Inyoung Choi
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyuong-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Freedenthal S, Vaughn MG, Jenson JM, Howard MO. Inhalant use and suicidality among incarcerated youth. Drug Alcohol Depend 2007; 90:81-8. [PMID: 17433572 PMCID: PMC2000484 DOI: 10.1016/j.drugalcdep.2007.02.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2007] [Revised: 02/28/2007] [Accepted: 02/28/2007] [Indexed: 11/17/2022]
Abstract
Studies consistently indicate that inhalant use is associated with increased mental health problems in adolescents, but few investigations have focused on the potential relationship of inhalant use to suicidality (ideation or attempt). This study examined how different levels of volatile solvent use relate to suicidal ideation and attempted suicide among 723 incarcerated youth (mean age=15.5, S.D.=1.2; 87% male) in Missouri, and whether any associations between solvent use and suicidality differ by gender. In bivariate analyses, severity of inhalant use was positively associated with histories of suicidal ideation and suicide attempt for both boys and girls. In multivariate analyses, inhalant use disorders remained significantly associated with suicidal ideation and suicide attempt histories even after adjusting for general level of psychiatric symptoms, prior trauma, other substance use, gender, and additional potential confounders. Inhalant use without abuse or dependence also significantly related to suicidal ideation in multivariate analyses, but an interaction between gender and inhalant use signified this relationship was stronger for girls. Inhalant use disorders in incarcerated youth, as well as inhalant use without abuse or dependence (particularly in girls), may signal elevated suicide risk. Suicide risk assessments should, therefore, include questions about inhalation of volatile solvents such as paint, gasoline, and household cleaners.
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Affiliation(s)
- Stacey Freedenthal
- University of Denver, Graduate School of Social Work, Denver, CO 80208, USA.
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Rodríguez AH, Caldera T, Kullgren G, Renberg ES. Suicidal expressions among young people in Nicaragua: a community-based study. Soc Psychiatry Psychiatr Epidemiol 2006; 41:692-7. [PMID: 16752049 DOI: 10.1007/s00127-006-0083-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Suicidal behaviour is a major public health problem among adolescents. In Nicaragua as well as in most other countries, young people aged 15-24 have the highest rate of attempted suicide according to hospital records. The aims of this study were to investigate self-reported life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts (i.e. suicidal expressions) among young men and women in the community and to identify factors associated with suicidal expressions. METHODS The sample was derived from an established study base in the city of León, Nicaragua. From 352 randomly selected subjects aged 15-24 years, 278 individuals (145 males and 133 females) were interviewed using the Attitudes Towards Suicide (ATTS) questionnaire, including questions on suicidal expressions. RESULTS The overall 1-year prevalence of any suicidal expression was 44.8% among males and 47.4% among females. A suicide attempt in the past year was reported by 2.1% of males and 1.5% of females. There was no significant gender difference in reporting of the separate types of suicidal expressions, except for death wishes, where females reported higher prevalence (33.8% vs. 20.7%). Exposure to suicidal expressions among significant others was significantly associated with own serious suicidal expressions. The study failed to identify any association between suicidal expressions and sociodemographic factors such as poverty or educational level. CONCLUSIONS The present study highlights that suicidal behaviour is a significant public health problem among young people in Nicaragua. The finding that suicidal behaviour among significant others appears to have a contagious effect on adolescents, needs to be addressed in the prevention of suicidal behaviour.
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Abstract
Inuit suicide is the most significant mental health issue in the newly created Nunavut Territory of Canada's eastern Arctic. Suicide rates in Nunavut are 6 times those of Canada's southern provinces. Consistent with other Canadian populations, males aged 15-29 years of age are most at risk. Various social constructions have been used to make sense of Inuit suicide, a phenomenon of historical interest to anthropologists, who popularized the idea of elderly Inuit voluntarily abandoning their lives to the elements so as not to burden their surviving relatives. An examination of the literature and research dealing with Inuit suicide suggests that three typologies have typically been used to explain the problem: organic or quasi-organic explanations, social explanations involving concepts of social change and social disruption, and socio-psychological models of two types; a risk assessment approach focusing on the circumstances surrounding the deceased or the person with suicidal thoughts and another dealing with norms, values, thought processes and relationships within Inuit culture. We argue that these approaches offer incomplete explanations of the current problem. Attempts to complete the picture by identifying risk factors have produced contradictory and unsatisfactory results. We conclude that the impact of colonial relations of ruling has much to do with the current problem and advocate an approach that combines narrative research and intergenerational communication with community action to address the problem. Low Inuit inuusittiaqarniq (self-esteem) is an important factor in Inuit suicide, but rather than a psychological problem, has its roots in a history of colonialism, paternalism and historical events.
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Affiliation(s)
- Frank James Tester
- School of Social Work and Family Studies, University of British Columbia, Vancouver, Canada.
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Gmitrowicz A, Szymczak W, Kotlicka-Antczak M, Rabe-Jabłońska J. Suicidal ideation and suicide attempt in Polish adolescents: is it a suicidal process? Int J Adolesc Med Health 2003; 15:113-24. [PMID: 12955813 DOI: 10.1515/ijamh.2003.15.2.113] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The objective of our study was to assess the prevalence and possible predictors of suicide attempts and ideation in the school population of adolescents in the city of Lodz. METHOD A self-administered anonymous questionnaire was distributed to a representative (random) sample of 1,663 students, aged 14 to 21 years. Adolescents reporting no suicide behaviour constitute the control group; characteristics of this group were compared to those of the group concerned, with exploration of the correlation between different variables in terms of relative risk, separately for suicidal ideation and suicide attempts. RESULTS About 31% of students reported suicidal ideation (SSI), and 8%--suicide attempts (SSA). Among the factors related to the highest relative risk of suicide attempts in the examined students and differentiated SSA and SSI, the most significant factor appeared to be previous psychiatric treatment and/or psychotherapy (OR = 9), run away from home (OR = 7), suicidal deaths among relatives and friends (OR = 6), drug abuse (OR = 5), and "fascination with death" (OR = 4). CONCLUSIONS There are separate predictors of suicide attempt and suicidal ideation in Polish adolescents. Suicidal ideation as a common phenomenon (occurring in every third pupil) probably should be included into the specificity of the puberty process and considered as a separate phenomenon from suicide attempt. The presence of previous psychiatric diagnosis is most strongly related to the occurrence of suicide attempts (including those repeated), but is not related to suicidal ideation.
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Affiliation(s)
- Agnieszka Gmitrowicz
- Department of Psychiatry, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland.
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Bjerregaard P, Curtis T. Cultural change and mental health in Greenland: the association of childhood conditions, language, and urbanization with mental health and suicidal thoughts among the Inuit of Greenland. Soc Sci Med 2002; 54:33-48. [PMID: 11820680 DOI: 10.1016/s0277-9536(01)00005-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In Greenland, the rapid sociocultural change of the last 50 years has been paralleled by an epidemiological transition characterized by a reduction in infectious diseases, an increase in cancer and cardiovascular diseases, and an increased prevalence of mental health problems. During 1993-94 and 1997-98, two health interview surveys were conducted among Inuit in Greenland and Inuit migrants in Denmark. The response rates were 71 and 55%. Information on mental health was obtained from 1388 and 1769 adults. As indicators of mental health, the prevalence of potential psychiatric cases according to the General Health Questionnaire (GHQ-12) and the prevalence of suicidal thoughts were studied in relation to childhood residence and father's occupation, current residence, and language. The statistical methods included logistic regression and graphical independence models. The results indicated a U-shaped association in Greenland of GHQ-cases with age and a high prevalence of suicidal thoughts among young people; a low prevalence of GHQ-cases among those who were bilingual or spoke only Danish; and a high prevalence of suicidal thoughts among migrants who grew up in Denmark and among residents of the capital of Greenland. In Greenland, women were more often GHQ-cases and had suicidal thoughts more often than men. The association between language and GHQ-cases is presumed to operate through socioeconomic factors. It is necessary to modify the common notion that rapid societal development is in itself a cause of poor mental health: as a result of successful integration into the modern Greenlandic society, some population groups have better mental health compared to other groups.
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Affiliation(s)
- Peter Bjerregaard
- Section for Research in Greenland, National Institute of Public Health, Copenhagen, Denmark.
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Kirmayer LJ, Brass GM, Tait CL. The mental health of Aboriginal peoples: transformations of identity and community. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2000; 45:607-16. [PMID: 11056823 DOI: 10.1177/070674370004500702] [Citation(s) in RCA: 281] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper reviews some recent research on the mental health of the First Nations, Inuit, and Métis of Canada. We summarize evidence for the social origins of mental health problems and illustrate the ongoing responses of individuals and communities to the legacy of colonization. Cultural discontinuity and oppression have been linked to high rates of depression, alcoholism, suicide, and violence in many communities, with the greatest impact on youth. Despite these challenges, many communities have done well, and research is needed to identify the factors that promote wellness. Cultural psychiatry can contribute to rethinking mental health services and health promotion for indigenous populations and communities.
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Affiliation(s)
- L J Kirmayer
- Division of Social and Transcultural Psychiatry, McGill University.
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Yuen NY, Nahulu LB, Hishinuma ES, Miyamoto RH. Cultural identification and attempted suicide in Native Hawaiian adolescents. J Am Acad Child Adolesc Psychiatry 2000; 39:360-7. [PMID: 10714057 DOI: 10.1097/00004583-200003000-00019] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To determine rates of lifetime suicide attempts in a community sample of Native Hawaiian adolescents and determine the contribution of Hawaiian cultural affiliation, socioeconomic status, and psychiatric symptoms as risk factors for suicide. METHOD High school students were surveyed in the state of Hawaii for lifetime suicide attempts, Hawaiian cultural affiliation, socioeconomic status, and symptoms of depression, substance abuse, aggression, and anxiety. Multiple logistic regressions were used on 3,094 subjects to develop prediction models for lifetime suicide attempts. RESULTS Native Hawaiian adolescents had significantly higher rates of suicide attempts (12.9%) than other adolescents in Hawaii (9.6%). Hawaiian cultural affiliation rather than ethnicity was uniquely predictive of suicide attempts. Logistic regression indicated that depression, substance abuse, grade level, Hawaiian cultural affiliation, and main wage earner's education best predicted suicide attempts in Native Hawaiian adolescents, while depression, substance abuse, and aggression predicted suicide attempts in non-Hawaiians. CONCLUSIONS Native Hawaiian adolescents have higher rates of attempted suicide than non-Hawaiian adolescents. Strong Hawaiian cultural affiliation rather than ethnicity is a risk factor for attempted suicide.
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Affiliation(s)
- N Y Yuen
- Native Hawaiian Mental Health Research Development Program, Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu 96813, USA.
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Ponizovsky AM, Ritsner MS, Modai I. Suicidal ideation and suicide attempts among immigrant adolescents from the former Soviet Union to Israel. J Am Acad Child Adolesc Psychiatry 1999; 38:1433-41. [PMID: 10560231 DOI: 10.1097/00004583-199911000-00019] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A community survey was conducted to examine suicidal ideation and suicide attempts, behavior problems, psychological distress, social support, and adjustment difficulties in a sample of adolescents. METHOD Four hundred six Russian-born Jewish immigrants to Israel, aged 11 to 18 years, were selected to match the age and sex distribution of the total immigrant adolescent population. Two indigenous samples of Jewish adolescents in Russia (n = 203) and in Israel (n = 104) were matched with immigrants for comparison. Parameters of interest were measured with self-administered questionnaires. RESULTS The 6-month prevalence rate of suicidal ideation in the immigrant sample (10.9%) was significantly higher than that for Russian controls (3.5%) but not for Israeli natives (8.7%). There were few gender differences in suicidal ideation and suicide attempts. Older adolescents reported suicidal ideation 2 times more frequently than their younger counterparts. Suicide ideators scored significantly higher than nonideators on all scales of psychological distress and behavior problems. They rated higher sources of immigration difficulties concerning language, physical health, personality characteristics, and family problems but had less socioeconomic and intercultural problems of migration and lower social support from the family but not from other sources. CONCLUSIONS Results clearly support the migration-convergence hypothesis of suicide risk among adolescents.
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Affiliation(s)
- A M Ponizovsky
- Psychiatric Epidemiology Research Unit, Talbieh Mental Health Center, Jerusalem, Israel.
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Kirmayer LJ, Boothroyd LJ, Hodgins S. Attempted suicide among Inuit youth: psychosocial correlates and implications for prevention. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 1998; 43:816-22. [PMID: 9806088 DOI: 10.1177/070674379804300806] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To identify potential risk and protective factors associated with attempted suicide among Inuit youth, a population known to have a high rate of both attempted and completed suicide in recent years. METHOD A secondary analysis of data on 203 Inuit youth (aged 15 to 24 years) from a random community survey conducted by Santé Québec in 1992. Factors previously identified in the literature and in clinical consultation and ethnographic research were tested with bivariate statistics and logistic regression models for each gender. RESULTS At the bivariate level, positive correlates included substance use (solvents, cannabis, cocaine), recent alcohol abuse, evidence of a psychiatric problem, and a greater number of life events in the last year. Regular church attendance was negatively associated with attempted suicide. Multivariate analysis indicated that a psychiatric problem, recent alcohol abuse, and cocaine or crack use were the strongest correlates of attempted suicide for females, while solvent use and number of recent life events were the strongest correlates for males. CONCLUSIONS Suicide prevention programs can be targeted at youth who are using substances, particularly solvents, cocaine, and alcohol, have psychiatric illness, and have experienced recent negative life events. Involvement in church or other community activities may reduce the risk for suicide. Consideration of gender differences may allow more precise identification of those at risk for attempted suicide.
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Affiliation(s)
- L J Kirmayer
- Department of Psychiatry, Sir Mortimer B Davis-Jewish General Hospital, Montreal, Quebec.
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