Demographic profile of patients and risk factors associated with suicidal behaviour in a South African district hospital

Background

Suicidal behaviour comprises self-destructive thoughts coupled with attempts at suicide, which negatively impacts the patient, family, friends, and their community. There is a paucity of data on factors influencing suicidal thoughts and behaviour in South Africa. The aim of this study was to evaluate demographic profile and risk factors associated with suicidal behaviour.

Methods

In this retrospective descriptive and observational study, 282 medical records of patients with suicidal behaviour were studied. The risk factors and age at occurrence were tabulated. Descriptive analyses were undertaken to understand how they were distributed across key socio-demographic groups.

Results

Suicidal behaviour was particularly prominent amongst the female population. The suicidal ideation, plan and non-fatal suicide were reported by 48.6%, 29.1% and 36.5%, of patients respectively. The prevalence for suicidal ideation was significantly higher in females (54.5% vs. 31.5%; p < 0.0007) but not for suicidal plan (28.7% vs. 30.1%; p < 0.81) and suicidal attempt (37.3% vs. 34.2%; p = 0.63) as compared with males. Suicidal behaviour was positively associated with depression (r = 0.56, p < 0.001) and negatively associated with age (r = −0.16, p = 0.01). Multivariate logistic regression analysis revealed that suicidal behaviour was influenced by female gender, poor social support, depression and a family history of non-fatal suicide.

Conclusion

This research has confirmed an association between female sex and factors associated with a higher risk of suicidal behaviour.

Mapping Institutional Interventions to Mitigate Suicides: A Study of Causes and Prevention

Suicide is an extreme, tragic act and an important subject for social inquiry. It is the rising public health issue prevalent in the Himalayan range of Pakistan. The young and educated population is more prone to suicide instead of using this prime phase of age productively. Unfortunately, the suicide problem remains unaddressed, the causes remain undefined, solutions are not in the works, and in situations when others play a part in driving someone to commit suicide, no one is being held accountable. This study is aimed at uncovering the root causes of suicide and proposing some preventive measures to mitigate the problem. Our team studied three years’ worth of data (2017–2019) on suicides from the office of Human Rights Commission of Pakistan, Chitral. In addition, we conducted semi-structured interviews of different stakeholders, including family members, neighbors, lawyers, and police personnel. The findings revealed that extended family pressures, the power dynamic between sustainers and dependents, family conflicts, and inheritance cases were the major causes of the domestic violence that preceded suicide attempts. Mental health issues, forced marriages, academic competitions, and flawed litigation processes were also among the leading causes of suicide. Awareness through education and religious sermons, strengthening healthcare organizations, restructuring family systems, establishing police complaint centers, effective prosecution processes, and imparting lifesaving skills have been identified as measures to prevent suicide. This study has theoretical and practical implications, as it adds certain novel variables regarding the causes and solutions of suicide to the existing body of literature and guides public authorities to strengthen institutions to intervene effectively.

Trends in method-specific suicide in Brazil from 2000 to 2017

PURPOSE

Understanding long-term patterns of suicide methods can inform public health policy and prevention strategies. In Brazil, firearm-related policies may be one salient target for suicide prevention. This study describes trends in method-specific suicide at the national and state-levels in Brazil, with a particular focus on firearm-related suicides.

METHODS

Brazilian mortality data for suicide and undetermined intent among people aged 10 years and older between 2000 and 2017 were obtained from the National Mortality Information System. We examined national and state-level trends in age-standardised suicide rates for hanging, self-poisoning, firearms, jumping from a high place, other, and unspecified methods. We also compared total rates of mortality from suicide and undetermined intent over the period. Applying Joinpoint regression, we tested changes in trends of firearm-specific suicide rates.

RESULTS

The total suicide rate increased between 2000 and 2017. Rates of hanging, self-poisoning by drugs or alcohol and jumping from a high place showed the largest increases, while firearm-specific suicide rates decreased over the study period. Trends in methods of suicide varied by sex and state.

CONCLUSION

It is of public health concern that suicide rates in Brazil have risen this millennium. Restricting access to firearms might be an effective approach for reducing firearm-specific suicides, especially in states where firearm availability remains particularly high. Treatment and management of substance misuse may also be an important target for suicide prevention policies. More work is needed to understand the causes of rising suicide rates in Brazil and to improve the mental health of the population.

Prevalence of Suicide Thoughts and Behaviours among Female Garment Workers Who Survived the Rana Plaza Collapse: An In-Depth Inquiry

The Rana Plaza building collapse occurred on 24 April 2013 in Savar, near the capital city of Bangladesh, killing more than 1130 garment workers and injured about 2500, mostly females. Those who survived face ongoing challenges, including socio-cultural constraints, economic hardship, post-traumatic stress disorders (PTSD), depression, and critical health issues, which may lead to suicidal ideation and death. The aim of this article is to explore why and how female garment workers who survived the Rana Plaza collapse are now at risk of suicide thoughts and behaviours, and suicide death. Unstructured face-to-face interviews were held from April to July 2018 with 11 female garment workers who survived the Rana Plaza building collapse. Interviews continued until data saturation was reached. The interviews were tape-recorded and transcribed verbatim while simultaneously being translated into English from Bengali/Bangla. Transcripts were coded and thematically analysed. The study found that all participants were living with multiple risk factors of suicidal ideation (including low socio-economic status, poverty, social stigma, psychological distress, and trauma) which the participants directly linked to the collapse of the Rana Plaza building. Our analysis uses the three-step theory of suicide (3ST, Klonsky & May, 2015) to understand female Rana Plaza survivors' suicide risk. Female survivors' overall vulnerability requires urgent attention while taking the socio-cultural setting of Bangladesh into account. In addition, a lifelong caring system (combining financial security and free healthcare) needs to be initiated to accommodate the female survivors with mainstream society to avoid possible future suicides. They require long-term social and economic security and psychological support.

In-Law Relationships in Evolutionary Perspective: The Good, the Bad, and the Ugly

In-laws (relatives by marriage) are true kin because the descendants that they have in common make them "vehicles" of one another's inclusive fitness. From this shared interest flows cooperation and mutual valuation: the good side of in-law relationships. But there is also a bad side. Recent theoretical models err when they equate the inclusive fitness value of corresponding pairs of genetic and affinal (marital) relatives-brother and brother-in-law, daughter and daughter-in-law-partly because a genetic relative's reproduction always replicates ego's genes whereas reproduction by an affine may not, and partly because of distinct avenues for nepotism. Close genetic relatives compete, often fiercely, over familial property, but the main issues in conflict among marital relatives are different and diverse: fidelity and paternity, divorce and autonomy, and inclinations to invest in distinct natal kindreds. These conflicts can get ugly, even lethal. We present the results of a pilot study conducted in Bangladesh which suggests that heightened mortality arising from mother-in-law/daughter-in-law conflict may be a two-way street, and we urge others to replicate and extend these analyses.

Suicide and Attempted Suicide in Jhenaidah District, Bangladesh, 2010–2018

Abstract. Background: Suicide and attempted suicide are a serious but under-explored public health problem in Bangladesh. Survey estimates suggest that Jhenaidah District, one of the 64 districts that make up Bangladesh, is one of the highest suicide-prone regions in Bangladesh. Relatively little is known about the magnitude of suicide attempts in the district. Aims: This article describes the incidence of suicide and suicide attempts for Jhenaidah, Bangladesh for the period 2010–2018. Method: Primary descriptive analysis was performed on routine data collected by a Bangladesh-based nongovernment organization (NGO): Societies for Voluntary Activities (SOVA). Results: A total of 22,675 suicide attempts and 3,152 suicides occurred in the district. The rate of suicide attempts was found to be 136.35/100,000 and the suicide rate was found to be 20.6/100,000 in Jhenaidah. The subdistrict Sadar had the highest incidence of suicide attempt (38.09%) and suicide (33.47%). Poisoning was the most common method of suicide attempt for both males (77.07%) and females (77%). Limitations: Many cases of suicide attempts and suicide are unreported in Bangladesh owing to stigmatization; only reported cases form part of this investigation. Conclusion: Jhenaidah has very high rates of suicide and suicide attempts that surpass the global and Bangladesh averages. Although females demonstrate higher suicide rates, male suicide rates have gradually increased over the study period. Future studies are called for to better understand the local patterns and dynamics of fatal and nonfatal suicidal behaviors. Developing a sub-district-, district-, and national-level suicide prevention strategy ought to be considered a priority.