Risk Factors for Suicidal Behavior Depend on Age for Veterans in the Pacific Islands

Characteristics, causality, and suicidal behavior: a qualitative study of family members with suicide history in Wonogiri, Indonesia

Objective

This study explored the characteristics, causality, and suicidal behavior among family members with suicide history in Wonogiri, Central Java, Indonesia.

Methods

Qualitative semistructured interviews were conducted with 15 family members who had made suicide attempts. The interviews directly explored the relationships among characteristics, causality, and suicidal behavior. The research data were analyzed using the Miles and Huberman approach.

Results

The results indicate that there are relationships among characteristics, causality, and suicidal behaviors. The characteristics contributing to suicide attempts were male gender, age (adolescence and old age), lack of religious activities, introvert nature, low economic status, chronic diseases, unemployment, and a history of family members with suicide attempts. The causality of suicide was joblessness, economic crisis, unemployment, family conditions, personality disorder, depression, sickness, and suicide ideation.

Conclusions

The findings highlight the relationships among characteristics, causality, and suicidal behaviors. Suicide occurs when individuals have some problems that they cannot solve because of the lack of family support. The causal factors were related to one another, which caused the suicidal behavior. One of the most effective suicide prevention strategies is educating the community on how to identify suicidal signs and increase social supports.

Suicide in a rural area of coastal Kenya

BACKGROUND

Suicide accounts for approximately 1.4% of deaths globally and is the 15th leading cause of death overall. There are no reliable data on the epidemiology of completed suicide in rural areas of many developing countries, yet suicide is an indicator of the sustainable development goals on health.

METHODS

Using data collected between 2008 and 2016 from the Kilifi Health and Demographic Surveillance System in rural Kenya, we retrospectively determined the incidence rate and risk factors for completed suicide.

RESULTS

During the period, 104 people died by suicide, contributing to 0.78% (95% CI = 0.74-1.10) of all deaths. The mean annual incidence rate of suicide was 4.61 (95% CI = 3.80-5.58) per 100,000 person years of observation (pyo). The annual incidence rate for men was higher than that of women (IRR = 3.05, 95% CI = 1.98-4.70, p < 0.001) and it increased with age (IRR = 2.73, 95% CI = 2.30-3.24, p < 0.001). People aged > 64 years had the highest mean incidence rate of 18.58 (95% CI = 11.99-28.80) per 100,000 pyo. Completed suicide was associated with age, being male, and living in a house whose wall is made of scrap material, which is a proxy marker of extreme poverty in this region (OR = 5.5, 95% CI = 4.0-7.0, p = 0.02). Most cases (76%) completed suicide by hanging themselves. Spatial heterogeneity of rates of suicides was observed across the enumeration zones of the KHDSS.

CONCLUSIONS

Suicide is common in this area, but the incidence of completed suicide in rural Kenya may be an underestimate of the true burden. Like in other studies, suicide was associated with older age, being male and poverty, but other medical and neuropsychiatric risk factors should be investigated in future studies.