Mental health implications of suicide rates in South Africa

Mental health challenges are a severe issue that could lead to suicide if not properly addressed.South Africa has a significant burden of mental health issues,which contributes to the soaring rate of suicide.Adequate mental health-care provision could reduce the high suicide rate in South Africa.Since the apartheid regime,the country has made a series of efforts to improve mental health.This study aimed to review and examine available literature on mental health and suicide issues in South Africa and demonstrate the policy implications.This study adopted a narrative review approach.Electronic databases(PubMed,Scilit,Google Scholar and Semantic Scholar)were used to identify published articles in the English language with crucial search terms that included mental health,South African mental health policy,South Africa,suicide and policy.Literature suggests that at the provincial level,there are no adequate mental health policies,and the implementation of the country’s mental health policy is faced with many challenges,such as a shortage of professionals and finances.The review also showed that task sharing and counselling have been pilot-tested and shown to be effective methods for the prevention of mental illness and promotion of positive mental health.This study concludes that the mental health treatment gap still exists in South Africa,and this needs to be tackled using effective,multi-level counselling interventions and policy initiatives.Adequate mental health-care provision and effective implementation of mental health policy could reduce the high rate of suicide in South Africa.

Mental Health, Religion and Suicide

Suicide is one of the most common yet serious concerns, and a worldwide subject that individuals have debated from the past to the present. Suicidal ideation affects and disrupts the functionality of a human being regardless of age, gender, ethnicity, or even religion. This article aims to discuss suicide in general and from an Islamic perspective in specific, as research has shown that an Islamically oriented approach and intervention works better with the Muslim population in general. The paper also aims to have a broader view of how Islam categorized suicide classically and its modern implications, which also lets us explore the similarities, and differences between the Islamic perspective and different religions about suicide and related mental health concerns. A collection of both classic and modern sources was used to extract information and provide a scope of definitions to clarify suicide and religiosity concerning the teachings and opinion of Islam about the meaning of life, afterlife, and soul. It was found that the Muslim population showed a lower rate of suicide in comparison to individuals from other religions, and religious individuals showed faster recovery from suicidal ideation. Yet, Muslims are not immune to mental health conditions that would result in suicide. Therefore, further studies and research need to be conducted to understand the huge stigma around Muslim about mental health and suicide in the Muslim communities, to compare the effectiveness among the religious and the non-religious Muslims, and lastly to fill the gap as to why the Muslim population tends to be hesitant in seeking help regarding their psychological problems.

Suicide Prevention in Mental Health Services—A Qualitative Study of a Web Based Program for Mental Health Care Staff

Background: Further strategies are needed to deal with the high losses to suicide. New modalities should be explored within the context of suicide prevention. Aim: The aim of the study was to evaluate participants’ experiences of a web based program for mental health care staff, including its potential clinical relevance. Methods: Nineteen participants participated in five focus groups. Data was analyzed using content analysis. Results: The analysis showed participants’ experiences of the program’s contents and format (“Web Based Modules”, “Discussion Groups”) and practical value (“Clinical Relevance and Use”, “Effects on Communication and Climate”). Conclusions: The program partly increased awareness about risk factors and the importance of inquiring about suicide ideation/plans and documenting suicide assessments. Experiences of the clinical value were varying and may be increased through potential enhancements.

The Potential of Simulation to Enhance Nursing Students’ Preparation for Suicide Risk Assessment: A Review

Suicide risk assessment is a critical skill in preventing suicide. Yet most nurses do not feel confident in assessing suicide risk. Development of this potentially life-saving skill needs to begin at the undergraduate nursing level. As simulation is an effective pedagogical tool utilised within nursing education, the aim of this paper was to explore the potential of simulation in preparing student nurses’ for suicide risk assessment. Literature was examined to identify what simulation modalities were employed within nursing education and the outcomes associated with these. The findings suggest that to varying degrees all simulation modalities have the potential to decrease student anxiety, and increase student confidence, knowledge and communication skills when working with people at risk of suicide. However the use of Standardised Patient (SP) simulation adds an authenticity to the experience and allows for the assessment of a wider range of human responses, including key nonverbal communication skills. The sense of realism provided by SP allows for more in-depth understanding into the person’s experiences, which is critical in the assessment of a person’s mental health needs and risk of suicide. The majority of simulations identified were located within a mental health setting. Given that student nurses may encounter a person who is suicidal in any clinical setting, further research is needed on simulation which integrates mental health assessments and suicide risk assessment into a variety of clinical areas.

Closing the Gap: Characterizing Key Factors Leading to the Disparity in Suicide Rates along the Urban-Rural Continuum

Suicide is a top ten cause of mortality in the United States.In previous literature the suicide rates in rural com-munities have been reported to be greater than those of more urban communities.Additionally,these studies have discussed many potential causes for the unfortunate disparity in rates.One cause often discussed is lack of mental health care providers in rural communities.The data for this study was gathered from the CDC’s WONDER data-base and the NPPES NPI Registry.The urban-rural categorization of counties used the 2013 NCHS Urban-Rural Scheme.Statistical analysis included chi-square tests,paired t-tests,and stepwise regression analyses.Results indi-cate that both the number of residents per provider(r=0.35,p≤0.005),and urbanization level(r=0.49,p≤0.001)were significantly related to suicide rate.Additionally,even after controlling for provider rates,each additional level of rurality predicted an increase of 1.2 suicides per 100,000 residents.Ultimately,the number of providers may play a major role in suicide rates,but extra effort must also be made in rural communities to combat the other contextual factors leading to increased suicide rates.

Newspaper Reporting of Suicide Impact on Rate of Suicide in the Contemporary Society in Sri Lanka

Suicide has been largely investigated by many researchers in a variety of perspectives. The objective of this study is to identify the relationship between the rate of suicide in contemporary society and how it can be affected by the way of suicide reporting at the same time. Qualitative method is used to analysis the data capturing from observation, interviews and textual analysis. Special attention has been paid to the news reporting in the suicide in Sri Lankan newspapers. Sinhala medium newspapers： Lankadeepa, Diwaina, Lakbima, Silumina, Dinamina, Rivira, were used as the major sample of this study. Time period is located from January 2000 to January 2010. In conclusion, Suicide has been reporting in Sri Lanka as a heroic and sensational action for the target of maximum selling and the financial benefit of media institutions. Use of Language in suicide reporting and the placement of the story in the newspaper have been two major factors that cause to glamorize the incident. Suicide reporting is highly sensational and rhetorically made by the ownership of the media and non-ethical consideration of the journalism in Sri Lanka. Victims and vulnerable are encouraged to get in to suicide and they are generally encouraged to their action for faith. Suicide should be reported in the newspaper as a problem of mental health and attention should be drawn to well inform the public on the issue. Human incidents should not be reported in media for cheap commercial purposes that indirectly chance to gain much financial profit through the highest selling and expansion. This study suggest to take necessary action to immediately make a frame of ethics of media reporting that avoids such unethical reporting in the practice of suicide reporting in Sri Lanka.

Suicide risk in systemic lupus erythematosus:A narrative review

Introduction:Despite the medical and scientific advances,the disease’s restrictions and the perception of personal and social losses related to its course reinforce fear and generate intense suffering in lupus patients.Psychiatric comorbidities,especially major depressive episodes,are highly prevalent during systemic lupus erythematosus.Among them,suicide is a behavior that is much more common than we believe.Objective:To perform a narrative review on suicidal behavior associated with systemic erythematosus lupus(SLE).Results:Studies have shown an increased risk of suicide among patients with chronic diseases and psychiatric disorders,especially depression.However,suicide cannot be attributed only to a higher prevalence of depression and other mental illnesses.Therefore,it is necessary to learn more about the suicide risk factors present in patients with lupus to work on secondary prevention and avoid the premature loss of lives and the additional suffering of families and surrounding communities.The coordination between the studies on suicidal behavior and its intricate network of individual and sociocultural factors and the studies on this multisystem autoimmune disease with a broad manifestation spectrum,lupus,creates new and essential field research.Conclusions:Non-psychiatrist office-based physicians,health clinics,or wards dedicated to the treatment of SLE should recognize and handle the suicide risk factors on their patients to reduce the suffering caused by this disease.

The relationship between child maltreatment and axis I mental disorders: A summary of the published literature from 2006 to 2010

Research has indicated that child maltreatment is associated with an increased likelihood of mental disorders and suicidal ideation and attempts that continues into adulthood. The purpose of this paper is to provide a synopsis of the recent published research from 2006 to 2010 on the association between child maltreatment and Axis I mental disorders and suicidal ideation and attempts. The databases MEDLINE and PsycINFO were searched for relevant and high quality citations up to October 2010. The results indicated that all types of child maltreatment examined are linked to reduced mental health. A general noted trend in the literature is that earlier age of onset of child maltreatment is associated with poorer mental health outcomes. Sex differences do exist with some disorders being more likely among males (e.g., anti-social behaviour) and other more likely among females (e.g., depression, PTSD, substance use disorders) following child maltreatment.

Self-Efficacy as a Suicidal Ideation Predictor: A Population Cohort Study in Rural Japan

Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.

Effects of Stress, Depression, and Problem Drinking on Suicidal Ideation among Korean Workers

The mental health of workers is an important issue that affects not only individuals and their families but also workplaces and communities.Therefore,it is necessary to regularly evaluate and analyze workers’mental health status,including levels of stress,depression,and addictive behaviors to apply thesefindings in creating mental health promotion programs.This study aims to provide basic data that would facilitate early intervention for workers’mental health problems by analyzing factors such as stress,depression,and problem drinking that can affect suicidal ideation.From April 15 to October 25,2019,a survey was conducted with 165 workers across six workplaces in a Korean city.Analysis was performed using descriptive statistics,correlation,and simple and multiple regression analyses using the R statistics program 4.0.3.There was no difference in suicidal ideation scores based on the participants’general characteristics,while there was a significant positive correlation among stress,depression,problem drinking,and suicidal ideation.In addition,severe depression,severe stress,and severe problem drinking had significant effects on suicidal ideation,and among the subitems of stress,somatic symptoms had an effect on suicidal ideation.In addition,severe stress,somatic symptoms,depression,and severe problem drinking had a significant effect on suicidal ideation in males but not in females.It is necessary to identify the effects of stress,depression,drinking problems,and suicide on workers’mental health,and evaluate their mental health systemati-cally and regularly to recognize whether active psychiatric treatment and nursing intervention are necessary as well as preventive management.In addition,it is meaningful to pay attention to the suicide ideation of adult workers and provide basic data to promote systematic public health policies on mental health.

The Association between Physical Education and Mental Health Indicators in Adolescents:A Cross-Sectional Study

Objective:To explore the associations between physical education attendance and mental health indicators.Methods:Using data from the Global Student Health Survey,the frequency of physical education attendance,suicidality-related indicators,loneliness,bullying,and anxiety were all assessed using a standardized self-reported questionnaire.Multivariable logistic regression was used to estimate the association between physical education attendance and mental health-related indicators.Results:The study included 276,169 participants from 71 coun-tries(47.3%males,aged 11–18 years old).After controlling for sex,age,food insecurity,close friends,physical activity,sedentary time,others’help,and parents’understanding,physical education attendance was not signifi-cantly associated with suicidal attempts,suicidal ideation,and anxiety.However,compared with no physical edu-cation attendance,individuals attending physical education for 1,2,as well as 5 or more days had significantly reduced odds/ratios of suicide;only 2 days of physical education attendance was associated with a lower odds ratio for suffering from loneliness.Even 1 day of physical education was associated with not being bullied by others.Conclusion:This study suggests that physical education attendance may not have an effective role in reducing mental health illnesses in children and adolescents.Future studies are encouraged to corroborate or negate our research discoveries by using better and further improved study designs.

An Evaluation of Suicidality and Its Predictors in Police Officers in Lagos, Nigeria

Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-dimensional, however, there are insufficient studies which have examined the burden and risk factors of suicidality in Nigerian police officers. Objective: To determine the prevalence and predictors of suicidality among police officers in Lagos, Nigeria. Methods: This was a cross-sectional study of 600 police officers who were selected using a non-probability sampling method. Questionnaires used were: Suicide Behaviour Questionnaire-Revised (SBQ-R), State-Trait Anxiety Inventory (STAI), and a Socio-Demographic Questionnaire. Results: Prevalence of suicidality was 14%, and the predictors of suicidality were: state anxiety (p 0.001), trait anxiety (p 0.001), substance use (p = 0.03), being unmarried (p = 0.03), and female gender (p = 0.02). Conclusion: Suicidality is prevalent among Nigerian police officers, with a higher risk in those who are vulnerable. The creation of government policies and infrastructure which promote mental health in police officers is necessary.

养老机构伴自杀意念失能老人心理弹性及相关因素研究

目的调查养老机构中伴有自杀意念失能老人的心理弹性并分析其相关因素。方法于2022年5月至10月便利抽取重庆市8所养老机构,采用中文版Beck自杀意念量表筛查出119名有自杀意念的失能老人,使用一般情况调查表、10条目简明心理弹性量表、纽芬兰纪念大学幸福感量表和医院抑郁量表对其进行问卷调查。结果伴自杀意念失能老人的心理弹性水平偏低,条目均分为(1.58±0.70)分。伴自杀意念失能老人的心理弹性在养老机构性质、失能程度、文化程度、入住时长、与亲属通讯频率、参加集体活动频率等方面的差异有统计学意义(P<0.05)。伴自杀意念失能老人的心理弹性与抑郁症状呈负相关(r_(1)=–0.631,P<0.001),与主观幸福感呈正相关(r_(2)=0.652,P<0.001)。文化程度和主观幸福感可正向预测伴自杀意念失能老人的心理弹性,抑郁症状负向预测其心理弹性(调整R^(2)=0.521,P<0.001)。结论养老机构伴自杀意念失能老人的心理弹性水平较低,应重点改善文化程度和主观幸福感较低、抑郁症状较突出的失能老人的心理弹性。

儿童青少年精神障碍患者家长自杀倾向及危险因素分析

目的探讨儿童青少年精神障碍患者家长自杀倾向及其危险因素,并构建自杀倾向的预测模型。方法采用横断面调查的方法,收集2022年8月至2023年7月就诊于安徽省内两所医院共299名儿童青少年精神障碍家长的社会人口学资料,并采用自杀相关的标准化问题、患者健康问卷-9(PHQ-9)以及多伦多述情障碍量表(TAS-20)分别评估调查对象自杀倾向、抑郁症状及述情障碍的程度。结果自杀倾向的总体检出率为15.4%,其中自杀意念、自杀计划和自杀未遂检出率分别为11.0%、3.3%和8.0%。Logistic回归分析结果显示,躯体疾病史、抑郁症状、述情障碍以及情感辨别不能因子与较高的自杀倾向风险有关(均P<0.05)。基于回归分析结果,构建预测患儿家长自杀倾向风险预测模型,并绘制受试者工作特征(ROC)曲线下面积(AUC)为0.80(95%CI:0.72~0.87,P<0.05)。结论儿童青少年精神障碍患者家长自杀倾向检出率较高,提示临床上在注重青少年精神障碍患者的同时,亦不能忽视患儿家长的心理健康,应加强对患儿和家长的护理,必要时应提供个体化的综合干预措施。

稳定期精神分裂症患者孤独感与被动自杀意念的相关性

目的:探讨稳定期精神分裂症患者的孤独感与被动自杀意念的相关性。方法:采用孤独感自评量表(UCLA Loneliness Scale,UCLA)、简明国际神经精神访谈中文版自杀分量表(The suicide subscale of the Chinese version of Mini-International Neuropsychiatric Interview,MINI)和自制的一般情况调查量表,对在某心理卫生医院确诊为精神分裂症的208例患者进行调查分析。结果:208名稳定期精神分裂症患者中175例被动自杀意念呈阳性(84.13%);单因素分析发病情况(t=-2.434,P<0.05)、病程(F=18.821,P<0.001)、累计住院年数(F=13.776,P<0.001)是稳定期精神分裂症患者被动自杀意念的影响因素;相关系数分析结果显示年龄与被动自杀意念呈现正相关(r=0.322,P<0.001)、孤独感与被动自杀意念呈现正相关(r=0.565,P<0.001);多元回归分析结果显示累计住院年数(β=1.620,P<0.05)和孤独感(β=0.408,P<0.001)是稳定期精神分裂症被动自杀意念的独立影响因素,差异具有统计学意义。结论:孤独感和累计住院年数是稳定期精神分裂症患者产生被动自杀意念的独立影响因素;稳定期精神分裂症患者孤独感越高,其被动自杀意念越强。

青少年非自杀性自伤体验质性研究的Meta整合

目的系统评价有关青少年非自杀性自伤真实体验与感受的质性研究,为制定个性化干预方案提供参考,帮助青少年回归家庭与社会。方法检索中英文数据库从建库到2023年6月1日有关青少年非自杀性自伤体验的质性研究,采用澳大利亚JBI循证卫生保健中心定性研究质量评价标准对纳入的研究进行评价,运用Meta整合方法进行结果整合。结果共纳入13项研究,包含226名青少年,提炼42个研究结果,整合成11个新类别,最终归纳为3个整合结果:非自杀性自伤的导火索,非自杀性自伤多维度体验,对治疗与帮助的看法。结论青少年非自杀性自伤的早期经历各异,身心体验复杂。应加强对青少年非自杀性自伤的重视,建立家庭-学校-医疗机构互助联络网,做到信息共享、早期预防、联合应对,促进青少年心理健康发展。

老年人自杀行为真实体验质性研究的Meta整合

目的系统评价老年人自杀行为的真实体验,为老年人自杀的预防与干预提供参考。方法计算机检索中英文数据库,并辅以人工检索,检索老年人自杀真实体验的质性研究,检索时限为建库至2023年7月。采用JBI循证卫生保健中心质性研究质量评价标准评价文献质量,以汇集性整合方法对结果进行整合。结果纳入11篇文献,提炼出37个研究结果,归纳出10个类别,最终整合得到3个整合结果,即老年人自杀行为影响因素的多元化,老年人面对自杀行为导致死亡结局的复杂心理,老年人自杀行为后的调节与应对。结论发生自杀行为的老年人存在复杂的心理体验。家庭、社区、养老机构及医疗机构相关人员应密切关注老年人身心健康及心理变化,根据个体差异性实施相应的干预方案。

精神障碍青少年非自杀性自伤研究进展

从青少年精神障碍病人非自杀性自伤行为的定义、分类、危害、测量工具、影响因素以及干预措施等方面进行综述,以期为青少年精神障碍病人非自杀性自伤行为的预防和管理提供参考。

心智化家庭疗法对抑郁症患者自我效能感、抑郁程度和自杀意念的影响

目的:探讨心智化家庭疗法对抑郁症患者自我效能感、抑郁程度和自杀意念的影响。方法:选取103例抑郁症患者,按照干预方法不同分为对照组(n=51)和观察组(n=52)。对照组予以常规干预;观察组予以心智化家庭疗法,两组患者均干预12周。比较两组患者干预前后自我效能感[情绪调节自我效能感量表(RESE)]、抑郁程度[汉密顿抑郁量表(HAMD)24项及抑郁自评量表(SDS)]、自杀意念[Beck自杀意念自评量表中文版(BSI-CV)]、应对方式[简易应对方式量表]及家庭功能[家庭亲密度与适应性量表(FACESII-CV)]的变化。结果:干预后,两组患者RESE量表各维度评分及总分均上升,且观察组高于对照组(P<0.05);两组患者HAMD及SDS量表评分均下降,且观察组低于对照组(P<0.05);两组患者BSI-CV量表各维度及总分均下降,且观察组低于对照组(P<0.05);两组患者积极应对方式维度评分均上升,且观察组高于对照组(P<0.05);两组患者消极应对方式维度评分均下降,且观察组低于对照组(P<0.05);两组患者FACESII-CV量表总分及各维度评分均上升,且观察组高于对照组(P<0.05)。结论:心智化家庭疗法可提升抑郁症患者自我效能感,改善抑郁程度,降低自杀意念,且有利于改善其应对方式,提升其家庭功能。