Suchergebnisse

This study identifies the cultural values affecting near-lethal suicide attempters' help-seeking behaviours. Six Chinese survivors of intentional near-lethal self-poisoning were interviewed and their medical records examined. Interviewees with strong suicidal intentions had less demand for healthcare services and were resistant to care. Non-contact with services was associated with perceived service irrelevance, unhelpfulness and personal need to maintain self-reliance and dignity. Service providers should be trained to be sensitive to these individual values to allow the delivery of a culturally-appropriate service for this population. Social work empowerment models that focus on users' self-reliance should be adopted in practice for this high-risk group.

Abstract. Background: A 45-month community-based suicide prevention program was launched in response to the emergence of a suicide cluster in 2010 in Hong Kong. Aims: This study aimed to evaluate the effectiveness of the program, document the implementation and outcomes of the project, and identify factors that contribute to the outcomes. Method: The program was delivered following the five key components of the public health approach: (a) community consensus building; (b) surveillance and monitoring; (c) development of coordinated action strategies; (d) interventions development and implementation at the universal, selective, and indicated levels; and (d) program evaluation. Results: A significant decreasing trend of suicide was found in the study site during the intervention period, whereas no changes were found in the three control sites. Spatial analysis also showed that the suicide cluster subsided after the intervention. Three impacts and one challenge of the program were identified from the qualitative feedback of the program stakeholders. Limitations: More investigations should be made to assess the sustainability of this community-based suicide prevention effort in the long run. Conclusion: A community-based suicide prevention program was successfully implemented to address the suicide cluster. A reduction in the suicide rate was observed after the intervention.

Background: Marked differences have been found in the characteristics of people dying by suicide in Western and Asian countries. However, there is less information available on possible differences for deliberate self-harm (DSH). Aims: To compare the characteristics of people presenting to hospital in Hong Kong and Oxford (UK) with DSH, and to assess the outcome of those persons in Hong Kong. Methods: A sample of DSH patients admitted to the accident and emergency (A&E) department of a regional hospital in Hong Kong was assessed and followed up 6 months later to assess the risk of repetition of DSH, and was then compared with such patients in Oxford. Results: The majority of patients in Hong Kong were female (male:female ratio of 1:2.4), young (59% were under 35), and had used self-poisoning (78%). Over one-third were single (37%) and one-fourth unemployed (26%). About half (49%) scored in the high or very high categories of the Beck's Suicide Intent Scale, considerably more so than in Oxford; 44.6% of patients defaulted psychiatric outpatient service during the 6-month follow-up period. The repetition rate within the following 6 months was 16.7%. The number of self-reported adverse life problems, history of childhood sexual and physical abuse, and repetitive self-mutilation were shown to be the factors most strongly correlated with the risk of re-attempt. Alcohol problems were much lower than in Oxford. Conclusions: The findings show that DSH patients in Hong Kong show some marked differences compared to those in Oxford. Implications for the prevention of repeated DSH in Hong Kong are discussed.

Abstract. Background: Studies have shown that postdischarge care for self-harm patients is effective in reducing repeated suicidal behaviors. Little is known about whether volunteer support can help reduce self-harm repetition and improve psychosocial well-being. Aim: This study investigated the efficacy of volunteer support in preventing repetition of self-harm. Method: This study used a quasi-experimental design by assigning self-harm patients admitted to the emergency departments to an intervention group with volunteer support and treatment as usual (TAU) for 9 months and to a control group of TAU. Outcome measures include repetition of self-harm, suicidal ideation, hopelessness, and level of depressive and anxiety symptoms. Results: A total of 74 cases were recruited (38 participants; 36 controls). There were no significant differences in age, gender, and clinical condition between the two groups at the baseline. The intervention group showed significant improvements in hopelessness and depressive symptoms. However, the number of cases of suicide ideation and of repetition of self-harm episodes was similar for both groups at the postintervention period. Conclusion: Postdischarge care provided by volunteers showed significant improvement in hopelessness and depression. Volunteers have been commonly involved in suicide prevention services. Further research using rigorous methods is recommended for improving service quality in the long term.

Abstract. Background: The use of the helium suicide method has been increasing in popularity in Hong Kong since 2012. We have learned a valuable lesson in curbing the spread of charcoal burning (CB) suicide in the past 15 years and hope to prevent the helium suicide method from taking off in the community. Aims: To document what actions have been taken to contain the spread of the helium suicide method and review the preliminary impact of these actions. Method: We adopted a public health approach by engaging stakeholders from multiple sectors, including the police force, the fire services department, coroners, pathologists, mass media, and online media outlets. Results: A monitoring system was established by compiling data extracted from news reports, coroners' reports, and police investigations. Risk and protective factors were identified. Intervention strategies were developed to strengthen protective factors and minimize risk factors. This novel suicide method has not spread as rapidly as the CB suicide method. The preliminary outcomes suggest our actions to be effective. Limitations: The count of helium suicides in 2015 might be low. The impacts of the interventions are only estimated and require additional empirical verifications. Conclusion: The public health approach of engaging multiple partners in the early phase of a potential epidemic can be a good guide to meeting the challenges posed by any new suicide methods that emerge in the future.