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Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey

Published online by Cambridge University Press:  22 July 2005

JOSÉ M. BERTOLOTE
Affiliation:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
ALEXANDRA FLEISCHMANN
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
JAFAR BOLHARI
Affiliation:
Tehran Psychiatric Institute, Mental Health Research Centre, Tehran, Islamic Republic of Iran
NEURY BOTEGA
Affiliation:
Department of Psychiatry, FCM – UNICAMP, Campinas, Brazil
DAMANI DE SILVA
Affiliation:
Department of Psychological Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
HUONG TRAN THI THANH
Affiliation:
Hanoi Medical University, Dong Da, Hanoi, Viet Nam
MICHAEL PHILLIPS
Affiliation:
Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, People's Republic of China
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
AIRI VÄRNIK
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
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 objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community.

Method. The community survey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys.

Results. Suicide attempts (0·4–4·2%), plans (1·1–15·6%), and ideation (2·6–25·4%) varied by a factor of 10–14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22% and 88% of the attempts.

Conclusions. The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed.

Type
Original Article
Copyright
© 2005 Cambridge University Press

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