Perspectives on reasons for suicidal behaviour and recommendations for suicide prevention in Kenya: qualitative study

Suicidal behaviours and associated factors among residents of Jimma Town, Southwest Ethiopia: a community-based cross-sectional study

INTRODUCTION

Suicidal behaviour is a major public health concern in Africa and a cause of premature mortality. The availability of community epidemiological data in Ethiopia is limited. This study assessed the prevalence of suicidal behaviour and its associated factors in Jimma Town, Southwest Ethiopia.

METHODS

Using the Suicide Behaviour Questionnaire-Revised (SBQ-R), a community-based cross-sectional survey was conducted between September and November 2021. Multistage sampling was used to screen 636 participants for suicidal behaviour. The association between suicidal behaviour and other variables was explored using binary and multivariable logistic regression analyses.

RESULTS

The overall estimated prevalence of suicidal behaviour of the respondents in the study was 7.9% (95% CI 5.9% to 10.3%), using the SBQ-R score (>7). One-third of the individuals with lifetime attempts encountered stigma. Multivariable logistic regression models indicated that being female (AOR 2.81, 95% CI 1.48 to 5.31), having depression (AOR 6.9, 95% CI 1.98 to 24.57), family history of mental illness (AOR 4.11, 95% CI 1.38 to 12.19), poor social support (AOR 3.86, 95% CI 1.23 to 12.15) and good coping efficacy (AOR 0.91, 95% CI 0.88 to 0.94))were significantly associated for suicidal behaviour with p value less than 0.05.

CONCLUSION

The overall prevalence of suicidal behaviour was relatively higher in this population than in other studies done in Ethiopia. In addition, the current study indicates the presence of suicide stigma, which further influences poor health-seeking behaviours. The factors significantly associated with suicidal behaviour in this study included being female, having a family history of mental illness, poor social support, poor coping self-efficacy and depressive symptoms. Findings warrant the attention of policy-makers in early screening of depression, developing preventive measures targeting risk factors and enhancing access to mental healthcare services.

Is serum homocysteine level a biomarker of suicide attempts: A preliminary study

Suicide is a global public health concern, and understanding its multifaceted determinants is crucial for effective prevention. This study was designed to find an answer to the question of whether serum homocysteine level can be a biomarker of suicide attempts. This preliminary study involving 90 participants (45 suicide attempt cases and 45 controls) was conducted at Elazig Fethi Sekin City Hospital. Biochemical analyses were performed to assess serum homocysteine, vitamin B12, and folic acid levels. Statistical analyses, including t-tests, Mann-Whitney U tests, and ROC analysis, were employed to explore differences between groups and assess the diagnostic potential of homocysteine. Elevated homocysteine levels were found in individuals who attempted suicide compared to the control group (p= <0.001). Additionally, lower levels of vitamin B12 (p=<0.001) and folic acid (p=<0.001) were observed in the suicide attempt group. ROC analysis indicated a significant diagnostic potential for homocysteine in predicting suicide attempts (AUC = 0.845, sensitivity = 91%, specificity = 71%). This study establishes a significant association between high homocysteine levels and suicide attempts, accompanied by lower vitamin B12 and folic acid levels. The findings suggest a potential link between disturbances in homocysteine metabolism and suicidal tendencies, urging further research to establish causation and explore therapeutic implications. Consideration of the study's limitations and directions for future research are warranted.

Suicidal Ideation Among Kenyan Youth: A Qualitative Analysis of Online Life Stories

This study examines the experiences of suicidal ideation among Kenyan youth through a qualitative analysis of online narratives, a sample that comprised 15 young individuals aged 17-26 who shared their stories on online platforms. Employing Interpretative Phenomenological Analysis (IPA), the study highlights complex interactions of societal pressures, mental health challenges, and identity struggles that contribute to suicidal ideation. Key themes identified include the impact of cultural expectations, mental health stigma, isolation, and identity crises. By prioritizing the personal voices of the youth, the study sheds light on the deeply contextual nature of suicidal ideation and offers insights into the meanings individuals ascribe to their experiences. The findings advocate for culturally sensitive interventions and underscore the need to address mental health stigma, aiming to foster a supportive societal environment for Kenyan youth grappling with these issues.

Interventions for Self-Harm and Suicidal Ideation in Africa: A Systematic Review

BACKGROUND

Self-harm and suicidal ideation are increasing public health concerns globally and are paramount in Africa. Therefore, a review of suicidal ideation and self-harm interventions would be beneficial in identifying culturally appropriate interventions for the African context.

METHOD

The Population, phenomenon of Interest and Context (PICo) model was adopted to formulate the review strategy. Thus, the Population (Africans), phenomenon of Interest (intervention) and Context (self-harm and suicidal ideation). We used this PICo strategy which is a modified version of PICO for qualitative studies. Framework with Boolean operators (AND/OR/NOT) was further used to ensure rigor through search terms such as ("Suicide" OR "suicidal ideation") AND ("Intervention" OR "Treatment" OR "Therapy" OR "Psychological" OR "Psychosocial" OR "Culturally adapted") AND "Africa" OR "African countries." Six databases were searched (Embase, PsycINFO, ProQuest Central, Cochrane Controlled Trials Register, Medline, and Web of Science) for published articles between 2000 and March 2023. N = 12 studies met the inclusion criteria, and the relevant data extracted were synthesized and thematically analyzed. The review protocol was pre-registered on the PROSPERO Registry (no. CRD42021283795).

RESULTS

N = 12 studies met the inclusion criteria, and the following themes emerged from the synthesized literature and analyses of current African approaches to curbing self-harm and suicidal ideation: (a) Western medical and compassion-focused intervention (b) the helpful role of traditional healing and healers (c) psychoeducation and self-help techniques (d) use of technology and a nation-wide approach.

CONCLUSION

Self-harm and suicidal ideation are global health concerns. To address this health concern in Africa, the authors recommend culturally adapted psychological interventions to be tested via randomized control trials.

A qualitative study on perspectives of undergraduate professional students on suicide and recommendations for an effective suicide prevention program

Background

Suicide has become a leading cause of death among 15- to 39-year-olds. Recent data suggests that one student commits suicide every 60 seconds in India. One of the suicide preventive strategies adopted is the introduction of a crisis helpline for students but the effectiveness of this support in preventing suicide remains questionable. Our study aims to find out the perspectives of students on suicide and their recommendations for an effective suicide prevention program.

Method

A qualitative design with focus group discussions was used to collect data. A universal sampling technique was adopted and the data were analyzed using the framework method.

Results

A total of 830 students were divided into 70 groups with each group having 12 to 15 students participating in the focus group discussion. Several themes and subthemes emerged from the discussion. Overall, students had a poor understanding of people who attempt suicide, elaborated the factors instigating a person to make a suicidal attempt, barriers to access help and their views on effective crisis intervention service.

Conclusion

The study identified student perspectives on suicide and the challenges perceived by the students for the effective implementation of a crisis intervention program for suicide prevention.