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      Events Prior to Completed Suicide: Perspectives of Family Survivors

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      Issues in Mental Health Nursing
      Informa UK Limited

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          Abstract

          Relatively little is known about the experiences of those bereaved by suicide, particularly in the weeks leading to the death of a loved one. This study used a qualitative methodology to explore the perspectives of close survivors of a completed suicide. Ten people who were bereaved by suicide participated in face-to-face interviews that were digitally recorded, transcribed verbatim, and thematically analysed. Analysis revealed the following three themes: He Tried to Hang Himself: Purposeful indications of the intent to end life; They Still Ignored It: Disappointment with health services; and Nobody Talked to Me: Exclusion of family members from treatment information. Prior to the suicide of their loved one, participants had identified that the loved one was at risk and perceived they were unable to acquire appropriate assistance from services. Rather, services were perceived by participants as unsupportive and inadequate. Health and social service professionals could benefit from further specialised education concerning suicide and its sequelae to ensure more effective and sensitive care delivery to suicide survivors.

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          The Wounded Storyteller

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            Prevalence and predictors of persistent suicide ideation, plans, and attempts during college.

            Suicide is the second-leading cause of death among college students in the U.S. and is preventable. Approximately 1100 college students die by suicide each year. This study examined the prevalence and predictors of one-time and persistent suicide ideation, plans, and attempts reported during college. Data were gathered prospectively over four years. Face-to-face interviews were conducted with 1253 first-year college students at one large mid-Atlantic university. Risk factors were measured in Year 1. An estimated 12%(wt) of individuals experienced suicide ideation at some point during college, and of those individuals, 25% had more than one episode of ideation (persistent ideation; 2.6%(wt) of the overall sample). Ten individuals had a plan or attempt during college (0.9%(wt) of the sample). Risk factors for persistent suicide ideation included low social support, childhood or adolescent exposure to domestic violence, maternal depression, and high self-reported depressive symptoms. Persistent ideators differed from one-time ideators only by higher levels of depression (p=.027). Persistent ideators were no more likely than one-time ideators to have made a suicide plan or attempt during college (8% vs. 9%, respectively). Although the sample size is large, only a small percentage of participants had persistent ideation, suicide plans or attempts during college. These results have implications for programs aimed at identifying college students at risk for suicide. The accurate identification of college students at risk for suicide is an important step toward suicide prevention. Copyright © 2010 Elsevier B.V. All rights reserved.
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              Is Open Access

              Service availability and utilization and treatment gap for schizophrenic disorders: a survey in 50 low- and middle-income countries

              OBJECTIVE: To outline mental health service accessibility, estimate the treatment gap and describe service utilization for people with schizophrenic disorders in 50 low- and middle-income countries. METHODS: The World Health Organization Assessment Instrument for Mental Health Systems was used to assess the accessibility of mental health services for schizophrenic disorders and their utilization. The treatment gap measurement was based on the number of cases treated per 100 000 persons with schizophrenic disorders, and it was compared with subregional estimates based on the Global burden of disease 2004 update report. Multivariate analysis using backward step-wise regression was performed to assess predictors of accessibility, treatment gap and service utilization. FINDINGS: The median annual rate of treatment for schizophrenic disorders in mental health services was 128 cases per 100 000 population. The median treatment gap was 69% and was higher in participating low-income countries (89%) than in lower-middle-income and upper-middle-income countries (69% and 63%, respectively). Of the people with schizophrenic disorders, 80% were treated in outpatient facilities. The availability of psychiatrists and nurses in mental health facilities was found to be a significant predictor of service accessibility and treatment gap. CONCLUSION: The treatment gap for schizophrenic disorders in the 50 low- and middle-income countries in this study is disconcertingly large and outpatient facilities bear the major burden of care. The significant predictors found suggest an avenue for improving care in these countries.
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                Author and article information

                Journal
                Issues in Mental Health Nursing
                Issues in Mental Health Nursing
                Informa UK Limited
                0161-2840
                1096-4673
                May 13 2013
                May 2013
                May 13 2013
                May 2013
                : 34
                : 5
                : 309-316
                Article
                10.3109/01612840.2012.751639
                23663017
                c8f7b029-d3b6-4bf4-97c5-ee56eafd579d
                © 2013
                History

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