Structuring Roles and Gender Identities Within Families Explaining Suicidal Behavior in South India

Suicide and suicide behavior: A qualitative study in Telangana, India

This study aimed to understand the perceptions and experiences of suicide attempters in order to suggest potential initiatives to reduce the suicide burden in rural India. The study is based on 46 in-depth interviews with suicide attempters and 4 focus group discussions with their family members. Interview content analysis revealed information related to four anticipated themes: the characteristics of a suicide attempt are complex; suicide attempters are taken to public hospitals for first aid and treatment; the consequences of suicide attempts are diverse; and quality of life improved after the suicide attempt. There were also two unanticipated themes: suicide attempters sought help from potential rescuers; and the underreporting of suicide attempts. Emergent themes from the focus group discussions were the vulnerable group for suicide; poverty, indebtedness, family conflicts and unemployment are the main reasons for suicide; non-violent methods are used to commit suicide; there were no behavioral changes before suicide; the devastating effects on the families of decedents; positive community support to suicide survivor families; and expectations of preventive measures from both the community and government. The article argues that to reduce the suicide burden, the government should adopt a two-pronged strategy of creating a secure livelihood all-year round and providing psychological counseling at both the household and community levels.

The mental health impact of caste and structural inequalities in higher education in India

This study aimed to identify how mental health practice and policy in India can better address the needs of Dalit women and men in Indian institutions of higher education. Left unexamined, psychiatric and mental health practices and policies have become complicit in a legal and political network that actively denies the reality of caste discrimination in modern India. Frequently, Dalit students who choose to end their lives are described as having personal problems and depression, which enables institutional authorities to circumvent legal justice against caste discrimination and violence. Using an anthropological methodology of close readings of Dalit biographies and a review of ethnographic research, government reports, and online documentaries on the experiences of Dalit men and women, this study suggests that mental health practice and policy can change confidentiality laws, decriminalize student support groups, and build networks of institutional and policy support for Dalit students.

Reassessing the Mental Health Treatment Gap: What Happens if We Include the Impact of Traditional Healing on Mental Illness?

In this Fresh Focus, we reassess what the mental health treatment gap may mean if we consider the role of traditional healing. Based on systematic reviews, patients can use traditional healers and qualitatively report improvement from general psychological distress and symptom reduction for common mental disorders. Given these clinical implications, some high-income countries have scaled up research into traditional healing practices, while at the same time in low-and middle-income countries, where the use of traditional healers is nearly ubiquitous, considerably less research funding has studied or capitalized on this phenomena. The World Health Organization 2003-2020 Mental Health Action Plan called for government health programs to include traditional and faith healers as treatment resources to combat the low- and middle-income country treatment gap. Reflection on the work which emerged during the course of this Mental Health Action Plan revealed areas for improvement. As we embark on the next Mental Health Action Plan, we offer lessons-learned for exploring potential relationships and collaborations between traditional healing and biomedicine.

Exploring the Family factors associated with Suicide Attempts among Adolescents and Young Adults: A Qualitative Study

BACKGROUND

Suicides are among the leading cause of death among adolescents and young adults worldwide, including India. Suicide attempts are about 20 times more common than completed suicides. Teenagers and youth who attempt suicide belong to a heterogeneous group. Various biological and psychosocial factors, including family factors, contribute to such behavior. Quality of family functioning and relationships may act as an important contextual factor in deciding suicidal behavior. Hence, this study was done to explore the family factors contributing to suicide attempts.

METHODS

Qualitative exploratory study design and purposive sampling were used. Data were collected from 22 adolescents and young adults using an in-depth interview method. All audio recordings were transcribed in Malayalam, and then translated to English. Codes were developed using the qualitative data analysis software. Thematic analysis was done. Themes and relationships were identified and synthesized to a framework that represents the summary of the data.

RESULTS

Most of the participants perceived the home environment as hostile. Problems within the family included parental conflicts and separation, conflict with a sibling or other members of the family, and marital disharmony. Most of them perceived low family support. Socioeconomic factors such as financial issues, superstitious beliefs, disturbing neighborhoods, interpersonal issues, and the stigma of having a mental illness, in a family member, were also noted.

CONCLUSION

Hostile family environment, faulty interactions between family members, and lack of perceived family support may contribute to suicidal behavior among adolescents and young adults. Hence, it is imperative to consider these factors while treating them or planning any suicide prevention program for them.

Does ethnicity matter in risk and protective factors for suicide attempts and suicide lethality?

This study explored ethnic differences in risk and protective factors for suicide attempts, for the major ethnic groups in Singapore, and ethnic differences in prediction of lethality. Three years of medical records related to suicide attempters (N = 666) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Of the sample, 69.2% were female, 30.8% male; 63.8% Chinese, 15.8% Indian, and 15.0% Malay. Indians were over-represented in this sample, as compared with the ethnic distribution in the general population. Ages ranged from 10 to 85 years old (M = 29.7, SD = 16.1). Ethnic differences were found in risk and protective factors, and perceived lethality of suicide attempts. All available variables were subjected to regression analyses for Chinese, Indian and Malay attempters to arrive at parsimonious models for prediction of perceived lethality. The findings were discussed in regards to implications in assessment of suicide risk and primary prevention for the multiethnic society in Singapore.