Community based studies to investigate risk factors and to develop a Nursing Intervention to reduce suicide

Abstract

Suicide is a major public health problem in many developing countries. Suicide is not only a medical issue but it also has economic, social, moral and political dimensions. Consequently, the prevention of suicide has medical, social, psychological, economic and political implications. The community based studies were carried out in Kaniyambadi block of Vellore district, Tamil Nadu, Southern India. The Department of community health, Christian Medical College, Vellore has been operating, a community health programme in this block for the past five decades. The qualitative study employed focus group discussion to elicit local perspectives about suicide in a diverse group of individuals. The psychological autopsy study is the first community based study from India to use verbal autopsies for all deaths as part of an ongoing community surveillance programme. It also employed the standard psychological autopsy procedure and used a standard structured interview schedule for diagnosis. The intervention study was a structured educational intervention for school students to enhance their knowledge and attitude regarding suicide. The qualitative study revealed that many people in the local community perceived suicide as an option to get over interpersonal, family and financial stress among normal individuals as well as among those with mental illness. The psychological autopsy study documented severe mental disorder only in a minority of subjects who killed themselves. The psychological autopsy study also reported that psychosocial stress and social isolation are risk factors for suicide in the region. The intervention study demonstrated the effectiveness of a structured educational programme about suicide in improving knowledge and attitude among students who received the education. Suicide remains as a distinct global public health problem and the reduction of rates continues to be major concern of many countries. Knowledge of risk and protective factors can be a guide for support and prevention of suicide.