‘This place is making me more depressed’: The organisation of care for suicide attempters in a South African hospital

2016 ◽  
Vol 22 (11) ◽  
pp. 1434-1446 ◽  
Author(s):  
Jason Bantjes ◽  
Annemi Nel ◽  
Kerry-Ann Louw ◽  
Louise Frenkel ◽  
Ereshia Benjamin ◽  
...  
Keyword(s):  
South Africa ◽  
Suicide Prevention ◽  
Ethnographic Study ◽  
Optimal Care ◽  
Large Hospital ◽  
Suicide Attempters ◽  
Targeted Interventions ◽  
Organisation Of Care ◽  
Prevention Interventions ◽  
The Impact

People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.

scholarly journals HIV Risks in Sexual Networks of Heterosexual Men in South Africa

2019 ◽  
Vol 11 (13) ◽  
pp. 146
Author(s):  
Nonzwakazi P Ntombela ◽  
Tivani P Mashamba-Thompson ◽  
Andile N Mtshali ◽  
Desmond Kuupiel ◽  
Ayesha BM Kharsany
Keyword(s):  
South Africa ◽  
Hiv Infection ◽  
South African ◽  
Heterosexual Men ◽  
Sexual Networks ◽  
Design Development ◽  
Sexual Partnerships ◽  
Hiv Risks ◽  
Prevention Interventions ◽  
The Impact

BACKGROUND: The interaction of HIV risks in sexual networks remains unclear in South Africa. We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review. METHODS & ANALYSIS: Literature searches were conducted on seven online databases. Two reviewers independently screened articles against the inclusion criteria and performed a Kappa coefficient test to evaluate the degree of agreement on article selection. Thematic content analysis and a Mixed Method Appraisal Tool version 2018 were used to present the narrative account of the outcomes and to assess the risk of bias on included studies. RESULTS: Of the 1356 records identified, six studies reported on the dynamics of HIV infection in heterosexual men in sexual networks. All studies that were included were published between 2006 and 2016. The participants were aged 13 years and above and comprised of sero-discordant couples, HIV patients, and male and female in the general population. These studies were conducted in multiple diverse regions including South Africa, Senegal, Uganda, Malawi, Kenya, Tanzania, Botswana and Zambia. Evidence showed that age and sexual partnerships were most commonly identified attributes to either HIV infection and/or transmission risks in men. While other biological and behavioral data were reported, the results were not specific to men. DISCUSSION: The impact of age and sexual partnerships are poorly understood and the data available limit inferences to South African men. Limited empiric evidence of HIV risk among men impacts on the design, development and tailoring of HIV prevention interventions to alter the trajectory.

Young men in post-apartheid South Africa talk about masculinity and suicide prevention

2016 ◽  
Vol 47 (2) ◽  
pp. 233-245 ◽  
Author(s):  
Jason Bantjes ◽  
Ashraf Kagee ◽  
Birte Meissner
Keyword(s):  
South Africa ◽  
Suicide Prevention ◽  
Young Men ◽  
Relationship Building ◽  
Political Transformation ◽  
Structured Interviews ◽  
Gender Regime ◽  
Prevention Interventions ◽  
Racially Mixed ◽  
To Receive

We explored the experiences of a racially mixed group of young men in post-apartheid South Africa to investigate how they conceptualised suicide and document their suggestions for suicide prevention. Data were collected via in-depth semi-structured interviews and analysed using thematic content analysis. Findings suggest that in spite of socio-political transformation, young men in South Africa may not feel liberated to deviate from traditional gender norms. Participants described restrictive heteronormative gender roles that are akin to hegemonic masculinity and that create a rigid gender regime that prevents authentic relating, disconnects young men from each other, and makes it difficult to receive emotional support. Participants attributed suicidal behaviour to feelings of disconnectedness, thwarted belonging, pressure to conform to the gender regime, and feelings of shame when unable to achieve masculine ideals. They suggested that suicide prevention should be aimed at fostering connectedness, relationship building, and disrupting the gender regime. Furthermore, they suggested that in cyberspace, the gender regime was less rigid and stated that they felt more liberated online to express distress and access support, which has implications for suicide prevention interventions.

scholarly journals Recession, recovery and suicide in mental health patients in England: time trend analysis

2019 ◽  
Vol 215 (04) ◽  
pp. 608-614 ◽  
Author(s):  
Saied Ibrahim ◽  
Isabelle M. Hunt ◽  
Mohammad S. Rahman ◽  
Jenny Shaw ◽  
Louis Appleby ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Suicide Prevention ◽  
Care Quality ◽  
Data Set ◽  
Targeted Interventions ◽  
Number Of Patients ◽  
Mental Health Patients ◽  
Male Patients ◽  
The Impact

BackgroundThe 2008 economic recession was associated with an increase in suicide internationally. Studies have focused on the impact in the general population with little consideration of the effect on people with a mental illness.AimsTo investigate suicide trends related to the recession in mental health patients in England.MethodUsing regression models, we studied suicide trends in mental health patients in England before, during and after the recession and examined the demographic and clinical characteristics of the patients. We used data from the National Confidential Inquiry into Suicide and Safety in Mental Health, a national data-set of all suicide deaths in the UK that includes detailed clinical information on those seen by services in the last 12 months before death.ResultsBetween 2000 and 2016, there were 21 224 suicide deaths by patients aged 16 or over. For male patients, following a steady fall of 0.5% per quarter before the recession (quarterly percent change (QPC) 2000–2009 –0.46%, 95% CI –0.66 to –0.27), suicide rates showed an upward trend during the recession (QPC 2009–2011 2.37%, 95% CI –0.22 to 5.04). Recession-related rises in suicide were found in men aged 45–54 years, those who were unemployed or had a diagnosis of substance dependence/misuse. Between 2012 and 2016 there was a decrease in suicide in male patients despite an increasing number of patients treated. No significant recession-related trends were found in women.ConclusionsRecession-associated increases in suicide were seen in male mental health patients as well as the male general population, with those in mid-life at particular risk. Support and targeted interventions for patients with financial difficulties may help reduce the risk at times of economic hardship. Factors such as drug and alcohol misuse also need to be considered. Recent decreases in suicide may be related to an improved economic context or better mental healthcare.Declaration of interestN.K. is supported by Greater Manchester Mental Health NHS Foundation Trust. L.A. chairs the National Suicide Prevention Strategy Advisory Group at the Department of Health (of which N.K. is also a member) and is a non-executive Director for the Care Quality Commission. N.K. chairs the National Institute for Health and Care Excellence (NICE) depression in adults guideline and was a topic expert member for the NICE suicide prevention guideline.

scholarly journals Targeting interventions for HIV testing and treatment uptake: An attitudinal and behavioural segmentation of men aged 20–34 in KwaZulu-Natal and Mpumalanga, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247483
Author(s):  
James Bell ◽  
Sunny Sharma ◽  
Shawn Malone ◽  
Melissa Levy ◽  
Jemma Reast ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Gender Equity ◽  
Young Men ◽  
Lifestyle Changes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Kwazulu Natal ◽  
The Impact

Despite recent improvements, men still have worse HIV outcomes than women in South Africa. This study describes how young men form distinct behavioural and attitudinal subgroups, and is intended to inform the design of targeted interventions to encourage HIV testing and initiation on antiretroviral therapy. Data were collected using a cross-sectional survey with questions on men’s attitudes, beliefs and behaviours around HIV/AIDS. A total of 2,019 men were randomly sampled from eight district municipalities in KwaZulu-Natal and Mpumalanga provinces between October 2018 and January 2019. Men were eligible to participate if they were aged 20–34, Black African, had an education level below university graduation, were aware of HIV and were willing to disclose whether they had tested for HIV. Each participant responded to a questionnaire asking about their demographic characteristics, reported sexual behaviour, engagement with HIV testing and treatment services, alcohol consumption, HIV knowledge, attitudes to gender equity and reported level of depressive symptoms. Data were analysed using canonical correlation, hierarchical clustering and factor analysis techniques to produce five groups of men. The results were synthesised using Human Centred Design principles to suggests areas for potential intervention for each segment. The results showed that men vary based on their attitudes to gender and masculinity, use of alcohol, testing and treatment behaviour, HIV-related fears and preferences for testing modalities. Segment 1 (21%) avoids the topic of HIV, perhaps fearful of the impact on his life. Segment 2 (23%) is well connected to his community and has social concerns about HIV. Segment 3 (15%) struggles with more distal determinants of HIV acquisition such as unemployment and poor mental health. Segment 4 (25%) has concerns about the lifestyle changes that would be required if he were HIV positive. Segment 5 (16%) has a strong traditional mindset and is fearful of the ramifications of HIV in his community. The results will be used to design targeted interventions to increase HIV testing and treatment rates among young men in South Africa. Further research is required to understand the impact of interventions designed in this way.

scholarly journals Is prevention of suicide worth less? A comparison of the value per statistical life

2021 ◽  
Author(s):  
Vimefall Elin ◽  
Persson Mattias ◽  
Olofsson Sara ◽  
Hultkrantz Lars
Keyword(s):  
Suicide Prevention ◽  
Traffic Safety ◽  
Traffic Fatalities ◽  
Statistical Life ◽  
Prevention Interventions ◽  
Contingent Valuation Survey ◽  
The Impact ◽  
Risk Reducing ◽  
Web Questionnaire ◽  
Value Per Statistical Life

AbstractThis paper compares the value per statistical life (VSL) in the context of suicide prevention to that of prevention of traffic fatalities. We conducted a contingent valuation survey with questions on willingness to pay (WTP) in both contexts by administering a web questionnaire to 1038 individuals aged 18 to 80. We conjectured that WTP for a given impact on the number of fatalities would be lower for suicide prevention because suicide, at least to some degree, is the result of individuals’ own decisions. However, this hypothesis was not supported by the within- or between-sample estimates of WTP or by responses to direct questions. Hence, no support is provided for the use of a lower valuation of the impact of suicide prevention than for risk-reducing programs in other fields, such as traffic safety. This implies that the same VSL should be used for evaluating suicide prevention interventions and for risk-reducing programs in other policy areas and funds for the prevention of fatalities should be directed to the area with the lowest cost per life saved.

The Impact of Universal Suicide-Prevention Programs on the Help-Seeking Attitudes and Behaviors of Youths

Crisis ◽  
2013 ◽  
Vol 34 (2) ◽  
pp. 82-97 ◽  
Author(s):  
Bonnie Klimes-Dougan ◽  
David A. Klingbeil ◽  
Sarah J. Meller
Keyword(s):  
Suicide Prevention ◽  
Help Seeking ◽  
Prevention Programs ◽  
Universal Prevention ◽  
Help Seeking Attitudes ◽  
Attitudes And Behaviors ◽  
Seeking Behavior ◽  
And Behaviors ◽  
Suicide Prevention Programs ◽  
The Impact

Background: While the ultimate goal of adolescent suicide-prevention efforts is to decrease the incidence of death by suicide, a critical intermediary goal is directing youths toward effective sources of assistance. Aim: To comprehensively review the universal prevention literature and examine the effects of universal prevention programs on student’s attitudes and behaviors related to help-seeking. Method: We systematically reviewed studies that assessed help-seeking outcomes including prevention efforts utilizing (1) psychoeducational curricula, (2) gatekeeper training, and (3) public service messaging directed at youths. Of the studies reviewed, 17 studies evaluated the help-seeking outcomes. These studies were identified through a range of sources (e.g., searching online databases, examining references of published articles on suicide prevention). Results: The results of this review suggest that suicide-prevention programming has a limited impact on help-seeking behavior. Although there was some evidence that suicide-prevention programs had a positive impact on students’ help-seeking attitudes and behaviors, there was also evidence of no effects or iatrogenic effects. Sex and risk status were moderators of program effects on students help-seeking. Conclusions: Caution is warranted when considering which suicidal prevention interventions best optimize the intended goals. The impact on adolescents’ help-seeking behavior is a key concern for educators and mental-health professionals.

The Impact of a Highly Publicized Celebrity Suicide on Suicide-Related Online Information Seeking

Crisis ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 207-209 ◽  
Author(s):  
Florian Arendt ◽  
Sebastian Scherr
Keyword(s):  
Suicide Prevention ◽  
Information Seeking ◽  
The Internet ◽  
Online Information ◽  
Search Queries ◽  
Related Information ◽  
Search Terms ◽  
Celebrity Suicide ◽  
Online Information Seeking ◽  
The Impact

Abstract. Background: Research has already acknowledged the importance of the Internet in suicide prevention as search engines such as Google are increasingly used in seeking both helpful and harmful suicide-related information. Aims: We aimed to assess the impact of a highly publicized suicide by a Hollywood actor on suicide-related online information seeking. Method: We tested the impact of the highly publicized suicide of Robin Williams on volumes of suicide-related search queries. Results: Both harmful and helpful search terms increased immediately after the actor's suicide, with a substantial jump of harmful queries. Limitations: The study has limitations (e.g., possible validity threats of the query share measure, use of ambiguous search terms). Conclusion: Online suicide prevention efforts should try to increase online users' awareness of and motivation to seek help, for which Google's own helpline box could play an even more crucial role in the future.

Some Reflections on Reparation in Post-Apartheid South Africa, using a Couple Therapy Intervention as a Microcosm of South African Society

2011 ◽  
Vol 1 (2) ◽  
Author(s):  
Andrea Hill ◽  
Sylvia Poss
Keyword(s):  
South Africa ◽  
South African ◽  
Couple Therapy ◽  
South African Society ◽  
Depressive Position ◽  
Central Hypothesis ◽  
Transference And Countertransference ◽  
Constructive Engagement ◽  
The Impact ◽  
Therapy Intervention

The paper addresses the question of reparation in post-apartheid South Africa. The central hypothesis of the paper is that in South Africa current traumas or losses, such as the 2008 xenophobic attacks, may activate a ‘shared unconscious phantasy’ of irreparable damage inflicted by apartheid on the collective psyche of the South African nation which could block constructive engagement and healing. A brief couple therapy intervention by a white therapist with a black couple is used as a ‘microcosm’ to explore this question. The impact of an extreme current loss, when earlier losses have been sustained, is explored. Additionally, the impact of racial difference on the transference and countertransference between the therapist and the couple is explored to illustrate factors complicating the productive grieving and working through of the depressive position towards reparation.

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