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Characteristics of attempted suicides seen in emergency-care settings of general hospitals in eight low- and middle-income countries

Published online by Cambridge University Press:  22 July 2005

ALEXANDRA FLEISCHMANN
Affiliation:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
JOSÉ M. BERTOLOTE
Affiliation:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
DIEGO De LEO
Affiliation:
Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Queensland, Australia
NEURY BOTEGA
Affiliation:
Department of Psychiatry, FCM – UNICAMP, Campinas, Brazil
MICHAEL PHILLIPS
Affiliation:
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, People's Republic of China
MERIKE SISASK
Affiliation:
Estonian-Swedish Mental Health and Suicidology Institute, Estonian Center of Behavioral and Health Sciences, Tallinn, Estonia
LAKSHMI VIJAYAKUMAR
Affiliation:
Department of Psychiatry, Voluntary Health Services & SNEHA, Kotturpuram, Chennai, India
KAZEM MALAKOUTI
Affiliation:
Tehran Psychiatric Institute, Mental Health Research Centre, Tehran, Islamic Republic of Iran
LOURENS SCHLEBUSCH
Affiliation:
Department of Behavioural Medicine, School of Family and Public Health Medicine, Faculty of Health Sciences, Nelson R. Mandela School of Medicine, University of KwaZulu–Natal, Durban, South Africa
DAMANI DE SILVA
Affiliation:
Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
VAN TUONG NGUYEN
Affiliation:
Hanoi Medical University, Hanoi, Viet Nam
DANUTA WASSERMAN
Affiliation:
National and Stockholm County Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Public Health Sciences, Karolinska Institute and Swedish National Institute of Psychosocial Medicine, Stockholm, Sweden

Abstract

Background. The objective was to describe patients presenting themselves at emergency-care settings following a suicide attempt in eight culturally different sites [Campinas (Brazil), Chennai (India), Colombo (Sri Lanka), Durban (South Africa), Hanoi (Viet Nam), Karaj (Iran), Tallinn (Estonia), and Yuncheng, (China)].

Method. Subjects seen for suicide attempts, as identified by the medical staff in the emergency units of 18 collaborating hospitals were asked to participate in a 45-minute structured interview administered by trained health personnel after the patient was medically stable.

Results. Self-poisoning was the main method of attempting suicide in all eight sites. Self-poisoning by pesticides played a particularly important role in Yuncheng (71·6% females, 61·5% males), in Colombo (43·2% males, 19·6% females), and in Chennai (33·8% males, 23·8% females). The suicide attempt resulted in danger to life in the majority of patients in Yuncheng and in Chennai (over 65%). In four of the eight sites less than one-third of subjects received any type of referral for follow-up evaluation or care.

Conclusions. Action for the prevention of suicide attempts can be started immediately in the sites investigated by addressing the one most important method of attempted suicide, namely self-poisoning. Regulations for the access to drugs, medicaments, pesticides, and other toxic substances need to be improved and revised regulations must be implemented by integrating the efforts of different sectors, such as health, agriculture, education, and justice. The care of patients who attempt suicide needs to include routine psychiatric and psychosocial assessment and systematic referral to professional services after discharge.

Type
Original Article
Copyright
© 2005 Cambridge University Press

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