Suicide 2.0 by Aashray

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INCREASE IN SUICIDE

A AMONGST YOUTH

AN ASSIGNMENT FOR FOUNDATION COURSE SEM-II INTERNALS


UNDER THE GUIDANCE OF
DR. P PODDAR
SIES COLLEGE OF ARTS, SCIENCE AND COMMERCE
PLOT 1 – C, SECTOR 5, NERUL, NAVI MUMBAI, 400706
INCREASE IN SUICIDE A
AMONGST YOUTH

AN ASSIGNMENT FOR FOUNDATION COURSE SEM-II INTERNALS


UNDER THE GUIDANCE OF
DR. P PODDAR

STUDENT’S NAME ROLL NUMBER SIGN


1. D.MAHESH 19

DR. P PODDAR
PROJECT GUIDE
ACKNOWLEDGEMENT

We would like to express our special thanks of gratitude to


our teacher Dr. P Poddar, who gave us the golden
opportunity to do this wonderful project of Foundation Course
II onRelationship between Impact of Life Style and Culture of
Consumers and Coffee Retail: A Case Study Made on the
“INCREASE IN SUICIDES AMONGST YOUTH” .She also helped
us in completing the project. We came to know about so
many new things. We are really thankful to them. Secondly
we would also like to thank our parents and friends who
helped us a lot in finalizing this project within the limited time
frame.
ABSTRACT

Suicidal behavior is a leading cause of injury and death worldwide.


Information about the epidemiology of such behavior is important for
policy-making and prevention. The authors reviewed government data on
suicide and suicidal behavior and conducted a systematic review of studies
on the epidemiology of suicide published from 1997 to 2007. The authors'
aims were to examine the prevalence of, trends in, and risk and protective
factors for suicidal behavior in the United States and cross-nationally. The
data revealed significant cross-national variability in the prevalence of
suicidal behavior but consistency in age of onset, transition probabilities,
and key risk factors. Suicide is more prevalent among men, whereas
nonfatal suicidal behaviors are more prevalent among women and persons
who are young, are unmarried, or have a psychiatric disorder. Despite an
increase in the treatment of suicidal persons over the past decade,
incidence rates of suicidal behavior have remained largely unchanged. Most
epidemiologic research on suicidal behavior has focused on patterns and
correlates of prevalence. The next generation of studies must examine
synergistic effects among modifiable risk and protective factors. New
studies must incorporate recent advances in survey methods and clinical
assessment. Results should be used in ongoing efforts to decrease the
significant loss of life caused by suicidal behavior.
SUMMARY ON FINDINGS
The past decade of research on the epidemiology of suicide has
yielded several key findings. First, global estimates suggest that
suicide continues to be a leading cause of death and disease burden
and that the number of suicide deaths will increase substantially over
the next several decades. Second, the significant cross-national
variability reported in rates of suicide and suicidal behaviour appears
to reflect the true nature of this behaviour and is not due to variation
in research methods. Third, there is cross-national consistency in the
early age of onset of suicide ideation, the rapid transition from
suicidal thoughts to suicidal behaviour, and the importance of several
key risk factors. Fourth, despite significant developments in treatment
research and increased use of health-care services among suicidal
persons in the United States, there appears to have been little change
in the rates of suicide or suicidal behaviour over the past decade.

The 11.1 percent decrease in the US suicide rate since 1990 is


encouraging. Enthusiasm is tempered, however, by knowledge of the
fact that the suicide rate is currently at approximately the same level
as in 1950 and even 1900, with periodic fluctuation between 10.0 per
100,000 and 19.0 per 100,000 over the past 100 years (4, 9,176 ).
Similar stable patterns have been observed in other countries (177).
Moreover, data on nonfatal self-injury show a 16.5 percent increase in
such behaviour in only the past 6 years, especially for youth. It is
possible that the decrease in youth suicide over this period coupled
with the increase in nonfatal self-injury treated in emergency
departments is the result of decreased lethality of youth suicidal
behaviour (perhaps due to safer medication and less access to
firearms). An alternative possibility is that the increase in nonfatal
self-injury is explained largely by increases in the occurrence of non
suicidal self-injury. More careful assessment of the intent behind self-
injury is needed to address this question. Regardless of the ultimate
answers to these questions, it is clear that major advances are needed
to enhance understanding of the causes of suicidal behaviour and to
further decrease the loss of life due to suicide.
INDEX
SR. TOPICS PAGE NO.
NO
1 Chapter 1: Introduction

2 Chapter 2:Literature Review

3 Chapter 3: Research Methodology

4 Chapter 4: Research Analysis


5 Chapter 5: Results

6 Chapter 6: Recommendations and


Suggestions
7 Chapter 7: Conclusion
CHAPTER 1
INTRODUCTION

Suicide 1‡ is among the top three causes of death among youth


worldwide. According to the WHO, every year, almost one million
people die from suicide and 20 times more people attempt suicide; a
global mortality rate of 16 per 100,000, or one death every 40
seconds and one attempt every 3 seconds, on average. Suicide
worldwide was estimated to represent 1.8% of the total global burden
of disease in 1998; in 2020, this figure is projected to be 2.4% in
countries with market and former socialist economies. According to
the most recent World Health Organization (WHO) data that was
available as of 2011, the rates of suicide range from 0.7/100,000 in
the Maldives to 63.3/100,000 in Belarus. India ranks 43 rd in
descending order of rates of suicide with a rate of 10.6/100,000
reported in 2009 (WHO suicide rates). The rates of suicide have
greatly increased among youth, and youth are now the group at
highest risk in one-third of the developed and developing countries.
The emerging phenomenon of "cyber-suicide" in the internet era is a
further cause for concern; also because the use of new methods of
suicide are associated with epidemic increases in overall suicide
rates. Suicide is nevertheless a private and personal act and a wide
disparity exists in the rates of suicide across different countries. A
greater understanding of region-specific factors related to suicide
would enable prevention strategies to be more culturally sensitive.
This focus is also highlighted in the September 10, 2012 World
Suicide Prevention Day theme "Suicide Prevention across the Globe:
Strengthening Protective Factors and Instilling Hope". [5] This
qualitative review explores the historical and epidemiological aspects
of suicide in with a special focus on India. We hope that exposure of
the problem will facilitate primary prevention planning.

OBJECTIVES

1. Integrate and coordinate suicide prevention activities across

multiple sectors and settings.

2. Implement research-informed communication efforts designed

to prevent suicide by changing knowledge, attitudes, and


behaviors.

3. Increase knowledge of the factors that offer protection from

suicidal behaviors and that promote wellness and recovery.


CHAPTER 2
LITERATURE REVIEW
CHAPTER 3
RESEARCH METHODOLOGY

OBJECTIVES

1. 1. Integrate and coordinate suicide prevention activities across

multiple sectors and settings.

2. Implement research-informed communication efforts designed

to prevent suicide by changing knowledge, attitudes, and


behaviors.

3. Increase knowledge of the factors that offer protection from

suicidal behaviors and that promote wellness and recovery.

RESEARCH METHODOLOGY

SOURCES OF DATA COLLECTION:

Secondary Sources of Data Collection

Secondary data refers to data which is collected by someone who is someone other
than the user. Secondary data analysis can save time that would otherwise be spent
collecting data and particularly in the case of quantitative data.

Secondary data can be obtained from different sources:

1. Information collected through censuses or government departments like


housing, social security, tax records
2. Internet searches or libraries
3. Progress reports
4. Articles
5. Magazines
6. Newspapers

Data analysis is achieved through the perceptions and objectively evaluated


knowledge of the researcher.
CHAPTER 4
RESEARCH ANALYSIS

We begin with some basic facts about suicide, to set the stage for our later
analysis. While some of the facts are well known, others are not. 1. Since 1950,
suicide has tripled among youths and fallen among older adults and the
elderly. Figure 1, noted above, shows the change in suicide rates by age from
1950 to 1990. Suicide rates for youths tripled between 1950 and 1990, rising
from 4.5 per 100,000 to 13.8 per 100,000. In contrast, suicide among adults
has fallen by 10 percent and suicide among the elderly has fallen by half. To
highlight the differing trends by age, Figure 2 shows suicide rates by age at
decadal intervals over the 20th century. Suicide rates first peaked about 1910.
Suicide rates for adults and particularly the elderly rose again in the Great
Depression and have fallen substantially since then. Total suicide rates in 1997
are the same as they were in 1950. Suicide rates for youth, in contrast,
declined by 2.5 percent per year from their peak in 1908 through their trough
in 1955, and since then have risen by 2.4 percent per year. There is an increase
in youth suicide rate for every single year of age, as shown in Figure 3.
Between 1970 and 1980, the percentage increase was roughly the same for all
ages. Since 1980, suicide rates increased most rapidly among teenagers aged
15-19. One possible explanation for the rise in teen suicides is that teen deaths
might have been coded as accidents in previous years. While this is certainly
true to some extent, it does not change our findings materially. Figure 4 shows
the suicide rate, the gun accidental death rate, and the combined suicide and
gun accident rate for youths over time. Unfortunately, we cannot include
motor vehicle fatalities since motor vehicle deaths change for so many other
reasons over time (such as changes in car safety and legal driving speeds). The
gun accident rate declined over 8 time, but by nowhere near as much as the
suicide rate increased. Thus, the rise in suicide and gun accident deaths mirrors
the rise in suicide alone. The fact that suicide rates trend differently for young
adults, older adults, and the elderly suggests that different factors may be at
work for the three groups in the population. This is true cross-sectionally as
well. The correlation across states between youth and adult (elderly) suicide
rates is only .46 (.49), while the correlation between adult and elderly suicide
rates is .89. 2. Suicide is the third leading cause of death among youths. US
Vital Statistics records indicate that the annual suicide rate for youths (15-24)
is about 13 per 100,000, or .01 percent per year. Over the course of 10 years,
therefore, about .1 percent of youths will commit suicide. The leading cause of
death for youths is accidents (an annual rate of 38.5 per 100,000 in 1995),
followed by homicide (an annual rate of 20.3 per 100,000). 3. There are about
200 to 400 suicide attempts among youths for every completed suicide. There
are no national surveillance figures in the United States for suicide attempts;
estimates therefore come from a few national surveys, and from local
surveillance. As with suicide deaths, there is ambiguity in measuring suicide
attempts. There is wide variation in the lethality of intent; thus, the definition
of a “suicide attempt” varies considerably from one study to another. The term
“parasuicide” is sometimes used to refer to self-injury with low likelihood of
lethal outcome (for example, superficial cutting, minor overdoses), and
“deliberate self-harm” is sometimes used to refer collectively to self-injuries
across the full spectrum of lethality of intent. Our data on suicide attempts
come from the Adolescent Health Survey (AddHealth). Suicide attempts in
AddHealth (described in more detail below) are based on self-reports, and
leave the definition of “suicide attempt” open to the responding interviewee.
Table 1 shows data from AddHealth on suicide thoughts and attempts and
from Vital Statistics on successful suicides. About 14 percent of youths report
thinking of suicide in the past year, and 4 percent report attempting suicide.
About 1 percent of youths reported being seen medically for a suicide 9
attempt. Other data from the National Hospital Discharge Survey indicate that
about 0.2 percent of youths are hospitalized for self-injury each year. As shown
in the last column, these numbers are substantially greater than the fatal
suicide rate. There are about 300 self-reported suicide attempts, about 100
“medically seen” suicide attempts, and about 16 medically hospitalized suicide
attempts for every completed suicide. These numbers in themselves suggest
that not all teen suicide attempts are truly youths who wish to die. Many
youths may instead be engaged in ‘strategic’ suicide attempts – suicide
attempts of varying severity, designed to get attention, to punish parents or
other role models for perceived mistreatment, or to embarrass parents or
other family members. Indeed, common sense suggests that succeeding at
suicide is not all that difficult. After all, either tall buildings or rope are often
available, half of all households own a gun, and medications such as aspirin or
acetomenophen are even easier to find, and less frightening to use. As such,
unsuccessful attempts must usually be thought of as actions which are, for the
most part, designed to elicit a response other than one’s own death. Successful
attempts, on the contrary, most probably reflect a desire to actually end one’s
life. As such, we will discuss the theories of successful suicides and suicide
attempts separately. 4. Girls attempt suicide more often than boys; boys
commit suicide more often than girls. Table 1 shows suicide rates for various
demographic groups. The rate of suicide attempts is twice as high for girls as
for boys, but the rate of successful suicides is 6 times higher for boys than for
girls. Differences in suicide rates are evident throughout the life cycle. Figure 5
shows suicide rates by age and gender. Male suicide rates are roughly 3 times
female rates for adults, before increasing dramatically after age 65. Female
rates, in contrast, have a relative peak in late middle-age. 5. Suicide attempts
decrease with age after adolescence. Table 2 shows suicide attempts by single
year of age for youths (from AddHealth) and adults (from Crosby et al., 1999).3
The peak age for suicide attempts is 15; attempt rates for 18 year- 3 These
data are from a recent telephone survey of a nationally representative sample
of adults. 10 olds are 15 percent below the rate for 15 year-olds.4 Suicidal
thoughts decline in frequency from middle adolescence into adulthood and
older years. 6. Rates of suicide and homicide are positively correlated in the
national data. Figure 6 shows suicide and homicide rates over time. There is a
clear positive correlation between the two. Both rates rose substantially from
1910 through 1930 and then fell through 1960. In both cases, rates rose again
through 1975. Total suicide rates began to fall again in the mid-1980’s, while
homicide rates fell in the early 1980s, rose in the late 80’s and early 90’s, and
then have again fallen since 1994. The association between suicide and
homicide is even stronger for youths, as shown in Figure 7. Both rates rose
from 1910 through 1933, fell over the next 20 to 30 years, and then began a
prolonged increase, with a recent fall in both beginning in 1994. 7. Rural,
western states have the highest youth suicide rates and the fastest rate of
increase. Figure 8 shows the geographic dispersion in youth suicide rates in
1950 and 1990. Table 3 shows the states with the highest and lowest suicide
rates. Because Alaska and Hawaii were not states in 1950, they are not
included in the figure. Suicide rates in 1990 are above those in 1950 for all
states. But there is substantial dispersion in changes in suicide rates over time.
In 1950, suicide rates averaged 4.6 per 100,000, with a standard deviation of
2.0 (1.3 without Nevada). In 1990, the average rate was 15.3 with a standard
deviation of 5.4. Most surprisingly, suicide rates in 1990 are highest in rural,
Mountain states and lowest in urban, Northeastern and Mid-Atlantic states.
The highest suicide rates in 1990 are in Alaska, Wyoming, Montana, New
Mexico, and South Dakota. This pattern became particularly pronounced
between 1950 and 1990. Montana, New Mexico, and Wyoming were high in
1950, but not as far above average; South Dakota was actually below average.
These states replaced states that were relatively rural in 1950 but became
more urban over the time period: California, Utah, and Arizona. 4 A peak at
around age 15 is also found for suicide attempts among girls in Oregon. 11 The
states with the lowest suicide rates also changed. In 1950, the lowest suicide
rates were generally in Southern states (Alabama, Tennessee, Mississippi, and
Arkansas). By 1990, the lowest suicide states were the District of Columbia,
New Jersey, Delaware, Massachusetts, and New York. The high rate of suicide
in Mountain states does not appear to result from coding differences between
accidents and suicides. The correlation between teen suicide rates and teen
accidental death rates in 1990 is .50. 8. Blacks attempt and complete fewer
suicides than whites. Table 1 shows racial differences in suicide attempts and
completions. Blacks attempt suicide about one-quarter less frequently than do
whites, and complete suicides about one-third less. The lower rate of suicide
for blacks than whites suggests that youth suicides are not just a result of poor
economic prospects. By any measure, whites have much greater economic
prospects than do blacks. This ethnic difference also argues against some
family composition explanations, such as the hypothesis that the lack of a
father in the household leads to more youth suicides. However, during the
1980's, suicide rates increased most rapidly among young black males, so some
changing factors are clearly important in this relationship. 9. Economic
differences are moderately correlated with suicide rates. The last rows of Table
1 show suicide thoughts and completions in urban and rural areas, and
between richer and poorer families.5 Suicidal thoughts are moderately higher
in urban areas, although suicide rates are higher in rural areas. Youths in
poorer families are more likely to attempt and complete suicide than youths in
richer families. These economic differences are not overwhelmingly large; the
difference between rich and poor areas, for example, is much smaller than the
difference in suicide between blacks and whites, and between boys and girls. 5
In the last rows, the suicide rate is based on whether the county had median
income above or below average. 12 10. Teen suicide is primarily accomplished
with guns. Table 4 shows the methods that youths use to commit suicides in
1950 and 1990. In both years, the overwhelmingly large share of deaths results
from guns. Guns were 50 percent of deaths in 1950 and 64 percent in 1990.
Hanging is second most important in 1990, followed by poison. Suicide rates by
all methods except poison have increased over time. The increase is
particularly pronounced for gun deaths. The predominance of guns in teen
suicides and the association between rural, mountainous states and suicide
initially inclines one towards a means theory of higher suicide rates: the
availability of guns has increased youth suicides. The cross-state evidence
suggests otherwise, however: if anything, we would expect that guns were
relatively more available in rural, mountainous states in 1950 than in 1990. In
contrast to successful suicides, suicide attempts almost never use guns. Poison
is used in over 80 percent of suicide attempts (for example, drug overdoses).
CHAPTER 5
RESULTS
Learning that a loved one has died by suicide can absolutely be traumatic. In
addition to all the feelings that anyone would feel about the death of a loved one,
when the death is a suicide, there are additional feelings like:

 Extreme guilt for not preventing the suicide


 Failure because a person they loved felt unloved and committed suicide

 Anger or resentment at the person who chose to take his or her own life
 Confusion
 Distress over unresolved issues (many of which often exist in families where
one person has a mental illness, which is common in people who die by
suicide)

Suicide Effects on the Mental Health of Family and


Friends
Unfortunately, friends and family of those who have committed suicide experience
impacts on their own mental health. In a Canadian study, parents who lost a child to
suicide typically have higher rates of depression, physical problems and low income
(often even before the child's suicide). Anxiety and divorce are very common effects
on parents after a child's suicide.
Another study showed that children of parents who committed suicide are at a
significantly increased risk for committing suicide themselves. The younger the child
at the time of the parent's suicide, the greater the risk of his or her own suicide.
Stigma and the Effects of Suicide in Family and Friends
When a person dies, societally, others generally offer empathy and compassion, but
when a person dies by suicide, there is stigma around that death and people often
treat the loved ones of the person who committed suicide differently. Loved ones
can be very afraid to talk about the suicide for fear of judgement and condemnation
– being blamed for the suicide of their family member or friend. Because of this, one
effect of suicide on family and friends can be extreme isolation.

Suicide Support for Families and Friends


While losing a loved one to suicide can have very detrimental effects on your life and
health, you can deal with this extremely difficult situation by getting suicide survivor
support.
CHAPTER 6
RECOMMENDATIONS AND PREVENTIONS

Screening
The U.S. Surgeon General has suggested that screening to detect those
at risk of suicide may be one of the most effective means of preventing
suicide in children and adolescents. There are various screening tools in
the form of self-report questionnaires to help identify those at risk such
as the Beck Hopelessness Scale and Is Path Warm?. A number of these
self-report questionnaires have been tested and found to be effective for
use among adolescents and young adults.] There is however a high rate
of false-positive identification and those deemed to be at risk should
ideally have a follow-up clinical interview The predictive quality of these
screening questionnaires has not been conclusively validated so it is not
possible to determine if those identified at risk of suicide will actually
commit suicide Asking about or screening for suicide does not create or
increase the risk.
In approximately 75 percent of completed suicides, the individuals had
seen a physician within the year before their death, including 45 to 66
percent within the prior month. Approximately 33 to 41 percent of those
who completed suicide had contact with mental health services in the
prior year, including 20 percent within the prior month. These studies
suggest an increased need for effective screening. Many suicide risk
assessment measures are not sufficiently validated, and do not include
all three core sociality attributes (i.e., suicidal affect, behaviour, and
cognition). A study published by the University of New South Wales has
concluded that asking about suicidal thoughts cannot be used as a
reliable predictor of suicide risk.
Underlying condition
The conservative estimate is that 10% of individuals with psychiatric
disorders may have an undiagnosed medical condition causing their
symptoms,] upwards of 50% may have an undiagnosed medical
condition which if not causing is exacerbating their psychiatric
symptoms Illegal drugs and prescribed medications may also produce
psychiatric symptoms Effective diagnosis and if necessary medical
testing which may include neuroimaging to diagnose and treat any such
medical conditions or medication side effects may reduce the risk of
suicidal ideation as a result of psychiatric symptoms, most often
including depression, which are present in up to 90–95% of cases.
Interventions
A photo illustration produced by the Defense Media Agency on suicide
prevention
Many methods have been developed in an effort to prevent suicide. The
general methods include: direct talks, screening for risks, lethal means
reduction and social intervention. The medication lithium may be useful
in certain situations to reduce the risk of suicide. Talk therapiesincluding
phone delivery of services may also help.
Direct talks

National Suicide Prevention Lifeline, a nationwide crisis line in the United


States also available in Canada
An effective way to assess suicidal thoughts is to talk with the person
directly, to ask about depression, and assess suicide plans as to how
and when it might be attempted.] Contrary to popular misconceptions,
talking with people about suicide does not plant the idea in their heads.[
However, such discussions and questions should be asked with care,
concern and compassionThe tactic is to reduce sadness and provide
assurance that other people care. The WHO advises to not say
everything will be all right nor make the problem seem trivial, nor give
false assurances about serious issues. The discussions should be
gradual and specifically executed when the person is comfortable about
discussing his or her feelings. ICARE (Identify the thought, Connect with
it, Assess evidences for it, Restructure the thought in positive light,
Express or provide room for expressing feelings from the restructured
thought) is a model of approach used here.
Lethal means reduction[
Means reduction, reducing the odds that a suicide attempter will use
highly lethal means, is an important component of suicide prevention.
This practice is also called "means restriction".
Researchers and health policy planners have theorized and
demonstrated that restricting lethal means can help reduce suicide rates,
as delaying action until depression passes. In general, strong evidence
supports the effectiveness of means restriction in preventing
suicidesThere is also strong evidence that restricted access at so-called
suicide hotspots, such as bridges and cliffs, reduces suicides, whereas
other interventions such as placing signs or increasing surveillance at
these sites appears less effective. One of the most famous historical
examples, of means reduction, is that of coal gas in the United Kingdom.
Until the 1950s, the most common means of suicide in the UK was
poisoning by gas inhalation. In 1958, natural gas (virtually free of carbon
monoxide) was introduced, and over the next decade, comprised over
50% of gas used. As carbon monoxide in gas decreased, suicides also
decreased. The decrease was driven entirely by dramatic decreases in
the number of suicides by carbon monoxide poisoning.
In the United States, numerous studies have concluded that firearm
access is associated with increased suicide completion.] "About 85% of
attempts with a firearm are fatal: that's a much higher case fatality rate
than for nearly every other method. Many of the most widely used
suicide attempt methods have case fatality rates below 5%."Although
restrictions on access to firearms have reduced firearm suicide rates in
other countries, such restrictions are not feasible in the United States
because the Second Amendment to the United States
Constitution guarantees the right to own firearms, prohibiting large scale
restrictions on weapons.
Social intervention

A telephone connected to a crisis hotline at Niagara Falls State Park


National Strategy for Suicide Prevention promotes and sponsors various
specific suicide prevention endeavours:
 Developing groups led by professionally trained individuals for broad-
based support for suicide prevention.
 Promoting community-based suicide prevention programs.
 Screening and reducing at-risk behavior through psychological
resilience programs that promotes optimism and connectedness.
 Education about suicide, including risk factors, warning signs, stigma
related issues and the availability of help through social campaigns.
 Increasing the proficiency of health and welfare services at
responding to people in need. e.g., sponsored training for helping
professionals, Increased access to community linkages,
employing crisis counseling organizations.
 Reducing domestic violence and substance abuse through legal and
empowerment means are long-term strategies.
 Reducing access to convenient means of suicide and methods of
self-harm. e.g., toxic substances, poisons, handguns.
 Reducing the quantity of dosages supplied in packages of non-
prescription medicines e.g., aspirin.
 School-based competency promoting and skill enhancing programs.
 Interventions and usage of ethical surveillance systems targeted
at high-risk groups.
 Improving reporting and portrayals of negative behavior, suicidal
behavior, mental illness and substance abuse in the entertainment
and news media.
 Research on protective factors & development of effective clinical and
professional practices.
It has also been suggested by NSSP that media should prevent
romanticising of negative emotions and coping strategies which can lead
to vicarious traumatisation. The Centres for Disease Control and
Prevention (from a 1994 workshop) and the American Foundation for
Suicide Prevention (1999) have suggested that TV shows and news
media can help prevent suicide by linking suicide with negative
outcomes such as pain for the suicide and their survivors, conveying that
the majority of people choose something other than suicide in order to
solve their problems, avoiding mentioning suicide epidemics, and
avoiding presenting authorities or sympathetic, ordinary people as
spokespersons for the reasonableness of suicide
Postvention[
Postvention is for people affected by an individual's suicide; this
intervention facilitates grieving, guides to reduce guilt, anxiety, and
depression and to decrease the effects of trauma. Bereavement is ruled
out and promoted for catharsis and supporting their adaptive capacities
before intervening depression and any psychiatric disorders. Postvention
is also provided to intervene to minimize the risk of imitative or copycat
suicides, but there is a lack of evidence based standard protocol. But the
general goal of the mental health practitioner is to decrease the
likelihood of others identifying with the suicidal behavior of the deceased
as a coping strategy in dealing with adversity.[40]
Medication[
Recent research has shown that lithium has been effective with lowering
the risk of suicide in those with bipolar disorder to the same levels as the
general population. Lithium has also proven effective in lowering the
suicide risk in those with unipolar depression as well.[42]
Counseling
There are multiple evidence-based psychotherapeutic talk therapies
available to reduce suicidal ideation such as dialectical behavior
therapy (DBT) for which multiple studies have reported varying degrees
of clinical effectiveness in reducing suicidality. Benefits include a
reduction in self-harm behaviours and suicidal ideations. Cognitive
Behavior Therapy for Suicide Prevention (CBT-SP) is a form of DBT
adapted for adolescents at high risk for repeated suicide attempts.[45][46]
The World Health Organization recommends "specific skills should be
available in the education system to prevent bullying and violence in and
around the school premises in order to create a safe environment free
of intolerance".
CHAPTER 7
CONCLUSION

299 men completed screening and were eligible to participate. Of these,


251 men completed all or part of the survey (an 84% participation rate).
Data reported below are from these 251 men. Participants had a mean
age of 36.9 (SD 11.6). One-third (34%) were married or in a de facto
relationship, 59% were in paid employment, one-quarter (24%) of
participants were unemployed or unable to work, and one-quarter (26%)
had completed a university degree. The mean PHQ-9 score was 14.4
(SD 10.4) (moderate range), and the mean GAD-7 was 7.0 (SD 5.9)
(mild range). Seventy per cent rated their general health as good, very
good or excellent, and 30% as fair or poor. Fifty per cent were currently
receiving treatment for depression, 36% for anxiety and 19% for stress,
while 24% were receiving no treatment. Overall, two-thirds of
participants were receiving treatment for at least one condition and more
than half of the participants (54%) were receiving treatment for two or
more conditions. Sixty-one per cent had previously received treatment
for depression, 47% for anxiety and 28% for stress. Fifty-five per cent
endorsed ‘thoughts that you would be better off dead or of hurting
yourself’ in the past fortnight, as per PHQ-9 item
REFERENCES

WEBLIOGRAPHY

 http://pestleanalysis.com
 http://www.scribd.com
 http://www.researchgate.net
 http://en.m.wikipedia.org
 http://panmore.com
 http://studymoose.com

BIBLIOGRAPHY

The contributions of adolescent and parent perspectives to ethical


planning of survey research on youth drug use and suicide
behaviors are highlighted through an empirical examination of 322
7th-12th graders' and 160 parents' opinions on questions related
to 4 ethical dimensions of survey research practice: evaluating
research risks and benefits, establishing guardian permission
requirements, developing confidentiality and disclosure policies,
and using cash incentives for recruitment.

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