Volume 32, Issue 122 (February 2020)
IJN 2020, 32(122): 91-106 |
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Inanlou M, Basiri S, Zamani N, Haghani H. Help-seeking for Suicidal Thoughts in the Poisoned Patients at Loghman Hakim Teaching Hospital in Tehran, Iran. IJN 2020; 32 (122) :91-106
URL: http://ijn.iums.ac.ir/article-1-3142-en.html
URL: http://ijn.iums.ac.ir/article-1-3142-en.html
1- Instructor, Department of Pediatric and Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
2- MS in Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: +989368743343 Email: basiri.sh@tak.iums.ac.ir
3- Assistant Professor, Department of Clinical Toxicology, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- Instructor, Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran
2- MS in Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: +989368743343 Email: basiri.sh@tak.iums.ac.ir
3- Assistant Professor, Department of Clinical Toxicology, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- Instructor, Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran
Abstract: (3018 Views)
Background & Aims: A history of suicide attempt is the most important risk factor for repeated and successful suicide. Seeking help is essential to access to proper mental healthcare services, and appropriate help-seeking could protect individuals against the risks of suicidal thoughts and behavioral progress in this regard. In addition, seeking help from a professional or personal source that could facilitate access to professional psychological help mitigates or eliminates the immediate risk of successful suicide in those with suicidal thoughts or manifesting suicidal behaviors. The level of help-seeking is higher in the areas where the suicide rate is lower. Considering the role of cultural background in help-seeking, studies must be conducted in Iran to gain insight into the intention of help-seeking for suicidal thoughts. The present study aimed to determine the intention of help-seeking from formal sources for suicidal thoughts and assess its correlation demographic factors in the poisoned patients with a history of suicide attempt prior to the current condition in Loghman Hakim teaching hospital in Tehran, Iran.
Materials &Methods: This cross-sectional, descriptive study was conducted on all the poisoned patients with a history of suicide attempt prior to the current condition, who were being discharged from the men's and women's poison wards of Loghman Hakim teaching hospital affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. In total, 130 patients were selected via continuous sampling from late April to late June, 2019. In addition to the demographic form (age, gender, education level, marital status, occupation status, economic status, number of suicide attempts, family history of suicide, history of receiving consultative and psychological services, history of psychiatric medication use under the supervision of a physician, and history of admission to the psychological ward), data were collected using the general help-seeking questionnaire (GHSQ) developed by Wilson et al. (2005) in Australia for the measurement of help-seeking intentions. To confirm the validity of the GHSQ, the process of translation and re-translation was utilized. Moreover, the reliability of the scale was confirmed by 15 eligible poisoned patients (not the main research units) who completed the questionnaire, and the Cronbach’s alpha coefficient was calculated to be 0.70. After obtaining informed consent and explaining the responding process of the questionnaires, the demographic form and GHSQ were completed for each research unit by the researcher based on the responses of the patients within 15-20 minutes at their bedside. Data were obtained from 130 completed questionnaires. Data analysis was performed in SPSS version 20, and descriptive statistics were used in the form of tables and numerical measures in order to describe the research units. To determine the correlations between the demographic variables and help-seeking intentions, the data were analyzed using Pearson's correlation-coefficient, independent t-test, and the analysis of variance (ANOVA) at the significance level of P<0.05.
Results: In total, 76.9% of the participants were female, and the age of the patients was within the range of 18-57 years (mean: 26.76±9.1 years). Among the patients, 40.0% had a high school diploma, 56.9% were single, 61.5% were unemployed, and 41.5% had an average economic status. The number of suicide attempts was 2-14 times (mean: 2.91±2.3), and 11.5% of the subjects had a family history of suicide attempt. In addition, 41.5% had no history of receiving consultative and psychological services, 52.3% had no history of psychiatric medication use under the supervision of a physician, and 20.8% had a history of admission to the psychiatric ward. The help-seeking intentions for suicidal thoughts from formal sources were low, with the mean of 2.51±1.18 (achievable range: 1-7), and the most significant formal sources of help-seeking intentions were psychologists (3.78±2.65), psychiatrists (3.64±2.58), and social services hotlines (2.34±2.08), respectively. Among the demographic variables, no significant correlations were observed between help-seeking intentions from formal sources and age, gender, education level, marital status, occupation status, economic status, number of suicide attempts, history of receiving consultative and psychological services, history of psychiatric medication use under the supervision of a physician, and history of admission to the psychiatric ward. History of suicide attempt in the first-degree family members was the only demographic variable that had a significant correlation with help-seeking intentions from formal sources (P=0.021), and the mean score of help-seeking intentions from formal sources was higher in the patients with a family history of suicide attempt.
Conclusion: According to the results, the help-seeking intentions from formal sources for suicidal thoughts were low in the poisoned patients with a history of suicide attempt. Help-seeking is an effective coping strategy when experiencing suicidal thoughts, which facilitates access to professional psychological help and plays a key role in reducing the rate of suicide; therefore, efforts should be made to promote help-seeking. The individuals who are at the risk of suicide need interventions developed to improve mental health care, especially primary care to encourage quicker help-seeking from proper sources. In this regard, measures such as the normalizing of help-seeking from formal sources, expanding insurance coverage to cover mental healthcare services, and improving communication skills in the families of those with a history of suicide could act as the facilitators of help-seeking from formal sources, as well as the training, identification, and referral of these individuals to available professionals, such as teachers and clerics. The familiarity of these individuals with various help-seeking sources (e.g., social aid hotlines and media campaigns) to increase the level of help-seeking may also facilitate the access of individuals to proper help-seeking sources. Moreover, the barriers against help-seeking in the individuals attempting suicide must be identified and mitigated. In this study, only about half of the individuals with a history of suicide attempt had a history of visiting a professional psychologist or using psychiatric medications under the supervision of a physician, while their intention of help-seeking from formal sources was relatively low. Therefore, the prevention of suicide required investment for creating a positive image of mental health care, which must be made accessible to the highest extent possible to the individuals who need to seek help from formal sources.
Materials &Methods: This cross-sectional, descriptive study was conducted on all the poisoned patients with a history of suicide attempt prior to the current condition, who were being discharged from the men's and women's poison wards of Loghman Hakim teaching hospital affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. In total, 130 patients were selected via continuous sampling from late April to late June, 2019. In addition to the demographic form (age, gender, education level, marital status, occupation status, economic status, number of suicide attempts, family history of suicide, history of receiving consultative and psychological services, history of psychiatric medication use under the supervision of a physician, and history of admission to the psychological ward), data were collected using the general help-seeking questionnaire (GHSQ) developed by Wilson et al. (2005) in Australia for the measurement of help-seeking intentions. To confirm the validity of the GHSQ, the process of translation and re-translation was utilized. Moreover, the reliability of the scale was confirmed by 15 eligible poisoned patients (not the main research units) who completed the questionnaire, and the Cronbach’s alpha coefficient was calculated to be 0.70. After obtaining informed consent and explaining the responding process of the questionnaires, the demographic form and GHSQ were completed for each research unit by the researcher based on the responses of the patients within 15-20 minutes at their bedside. Data were obtained from 130 completed questionnaires. Data analysis was performed in SPSS version 20, and descriptive statistics were used in the form of tables and numerical measures in order to describe the research units. To determine the correlations between the demographic variables and help-seeking intentions, the data were analyzed using Pearson's correlation-coefficient, independent t-test, and the analysis of variance (ANOVA) at the significance level of P<0.05.
Results: In total, 76.9% of the participants were female, and the age of the patients was within the range of 18-57 years (mean: 26.76±9.1 years). Among the patients, 40.0% had a high school diploma, 56.9% were single, 61.5% were unemployed, and 41.5% had an average economic status. The number of suicide attempts was 2-14 times (mean: 2.91±2.3), and 11.5% of the subjects had a family history of suicide attempt. In addition, 41.5% had no history of receiving consultative and psychological services, 52.3% had no history of psychiatric medication use under the supervision of a physician, and 20.8% had a history of admission to the psychiatric ward. The help-seeking intentions for suicidal thoughts from formal sources were low, with the mean of 2.51±1.18 (achievable range: 1-7), and the most significant formal sources of help-seeking intentions were psychologists (3.78±2.65), psychiatrists (3.64±2.58), and social services hotlines (2.34±2.08), respectively. Among the demographic variables, no significant correlations were observed between help-seeking intentions from formal sources and age, gender, education level, marital status, occupation status, economic status, number of suicide attempts, history of receiving consultative and psychological services, history of psychiatric medication use under the supervision of a physician, and history of admission to the psychiatric ward. History of suicide attempt in the first-degree family members was the only demographic variable that had a significant correlation with help-seeking intentions from formal sources (P=0.021), and the mean score of help-seeking intentions from formal sources was higher in the patients with a family history of suicide attempt.
Conclusion: According to the results, the help-seeking intentions from formal sources for suicidal thoughts were low in the poisoned patients with a history of suicide attempt. Help-seeking is an effective coping strategy when experiencing suicidal thoughts, which facilitates access to professional psychological help and plays a key role in reducing the rate of suicide; therefore, efforts should be made to promote help-seeking. The individuals who are at the risk of suicide need interventions developed to improve mental health care, especially primary care to encourage quicker help-seeking from proper sources. In this regard, measures such as the normalizing of help-seeking from formal sources, expanding insurance coverage to cover mental healthcare services, and improving communication skills in the families of those with a history of suicide could act as the facilitators of help-seeking from formal sources, as well as the training, identification, and referral of these individuals to available professionals, such as teachers and clerics. The familiarity of these individuals with various help-seeking sources (e.g., social aid hotlines and media campaigns) to increase the level of help-seeking may also facilitate the access of individuals to proper help-seeking sources. Moreover, the barriers against help-seeking in the individuals attempting suicide must be identified and mitigated. In this study, only about half of the individuals with a history of suicide attempt had a history of visiting a professional psychologist or using psychiatric medications under the supervision of a physician, while their intention of help-seeking from formal sources was relatively low. Therefore, the prevention of suicide required investment for creating a positive image of mental health care, which must be made accessible to the highest extent possible to the individuals who need to seek help from formal sources.
Type of Study: Research |
Subject:
nursing
Received: 2019/11/21 | Accepted: 2020/02/17 | Published: 2020/02/17
Received: 2019/11/21 | Accepted: 2020/02/17 | Published: 2020/02/17
References
1. Boyd MA. psychiatric nursing(contemporary practice). 6th ed. Illinois: Wolters kluwer; 2018.
2. WHO. Suicide prevention. Geneva: The Organization;2019. Available from: https://www.who.int/health-topics/suicide#tab=overview. Accessed sep 25، 2019.
3. Naghavi M. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. bmj. 2019;364(l94):1-11. [DOI:10.1136/bmj.l94] [PMID] [PMCID]
4. Compare GB. Viz Hub. Institute for Health Metrics and Evaluation [website]. Seattle, WA: Institute for Health Metrics and Evaluation, University of Washington. 2019. Available from: https://gbd2016.healthdata.org/gbd-compare/. 2019.
5. IRNA. Access to mental health services reduces suicide. Tehran: News Agency; 2019. Available from: https://www.irna.ir/news/83466055/. Accessed sep 5، 2019.
6. Cleary A. Help-seeking patterns and attitudes to treatment amongst men who attempted suicide. J Ment Health. 2017;26(3):220-4. [DOI:10.3109/09638237.2016.1149800] [PMID]
7. Shaker SH, Kasnaviyyeh SM, Ghafouri HB, Tavakkoli N, Yasinzadeh M, Masoumi G, Chahardovali M, Amiri H, Attaran H, Koohestani L, Noughan ZE. XML Epidemiological survey of the attempted suicide patients admitted at Hazrat Rasoul Hospital in Tehran 2007-2011. Iranian Journal of Forensic Medicine. 2017;23(1):7-15.
8. Frey LM, Hans JD, Cerel J. Suicide disclosure in suicide attempt survivors: Does family reaction moderate or mediate disclosure's effect on depression?. Suicide and Life‐Threatening Behavior. 2016;46(1):96-105. [DOI:10.1111/sltb.12175] [PMID]
9. Oexle N, Herrmann K, Staiger T, Sheehan L, Rüsch N, Krumm S. Stigma and suicidality among suicide attempt survivors: a qualitative study. Death studies. 2018;43(6):381-8. [DOI:10.1080/07481187.2018.1474286] [PMID]
10. Scocco P, Castriotta C, Toffol E, Preti A. Stigma of Suicide Attempt (STOSA) scale and Stigma of Suicide and Suicide Survivor (STOSASS) scale: two new assessment tools. Psychiatry Research. 2012;200(2-3):872-8. [DOI:10.1016/j.psychres.2012.06.033] [PMID]
11. Kearns M, Muldoon OT, Msetfi RM, Surgenor PW. Understanding help-seeking amongst university students: the role of group identity, stigma, and exposure to suicide and help-seeking. Frontiers in psychology. 2015;6(1462):1-8. [DOI:10.3389/fpsyg.2015.01462] [PMID] [PMCID]
12. Rickwood D, Deane FP, Wilson CJ, Ciarrochi J. Young people's help-seeking for mental health problems. Australian e-journal for the Advancement of Mental health. 2005;4(3):218-51. [DOI:10.5172/jamh.4.3.218]
13. Reynders A, Kerkhof AJ, Molenberghs G, Van Audenhove C. Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions. Soc Psych Psychiat Epidemiol. 2014;49(2):231-9. [DOI:10.1007/s00127-013-0745-4] [PMID]
14. Chan WI, Batterham P, Christensen H, Galletly C. Suicide literacy, suicide stigma and help-seeking intentions in Australian medical students. Australasian Psychiatry. 2014;22(2):132-9. [DOI:10.1177/1039856214522528] [PMID]
15. Yap MB, Reavley NJ, Jorm AF. Associations between stigma and help-seeking intentions and beliefs: Findings from an Australian national survey of young people. Psychiatry Research. 2013;210(3):1154-60. [DOI:10.1016/j.psychres.2013.08.029] [PMID]
16. Cryer RE, Calear AL, Batterham PJ, Patel SR. Suicide, mental, and physical health condition stigma in medical students. Death studies. 2020 2;44(4):230-6. [DOI:10.1080/07481187.2018.1539049] [PMID]
17. Dervic K, Akkaya-Kalayci T, Friedrich MH, Csorba J, Tringer L, Rozsa S, Lenz G. Attitudes toward suicide and help-seeking in Hungarian adolescents [5]. J Am Acad Child Adolescent Psychiatry. 2005;44(7):628-9. [DOI:10.1097/01.chi.0000162573.32826.db] [PMID]
18. Rimkeviciene J, Hawgood J, O'Gorman J, De Leo D. Personal stigma in suicide attempters. Death studies. 2015;39(10):592-9 [DOI:10.1080/07481187.2015.1037972] [PMID]
19. Bidel Z, Nazarzadeh M, Ayubi E, Sayehmiri K. Prevalence of important poisoning methods used in Iranian suicides: a systematic review and meta-analysis. Koomesh. 2013;14(3):257-64.
20. Daliri S, Bazyar J, Sayehmiri K, Delpisheh A, Sayehmiri F. Investigation of the Incidence rate of suicide in Iran During Years 2001-2014 A Systematic Review and Meta-analysis study. JOURNAL OF SHAHID SADOUGHI UNIVERSITY OF MEDICAL SCIENCES AND HEALTH SERVICES . 2016;24(9):748-56.
21. Kashfi SM, Yazdankhah M, Khani Jeihooni A, Motamedi MJ, Babaei Heydarabadi A, Vejdani M. Study of Important Risk Factors of Suicide Attempts in Patients Admitted to Hospitals Covered by Shiraz University of Medical Sciences. Journal of Sabzevar University of Medical Sciences. 2016;23(4):634-43.
22. Monsef Kasmaie V, Asadi P, Maleki Ziabari SM. A Demographic study of suicide methods in the patients aided by emergency Paramedics Guilan. Journal of Guilan University of Medical Sciences. 2013;22(87):31-7.
23. Shokrzadeh M, Hoseinpoor R, Hajimohammadi A, Delaram A, Shayeste Y. Epidemiological survey of suicide attempt by drug poisoning in Gorgan, Iran, 2008 to 2015. Journal of Mazandaran University of Medical Sciences. 2016;26(143):201-10.
24. Pattyn E, Verhaeghe M, Sercu C, Bracke P. Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study. Soc Psych Psychiat Epidemiol. 2013;48(10):1637-45. [DOI:10.1007/s00127-013-0671-5] [PMID]
25. Pattyn E, Verhaeghe M, Sercu C, Bracke P. Public stigma and self-stigma: Differential association with attitudes toward formal and informal help seeking. Psychiatric Services. 2014;65(2):232-8. [DOI:10.1176/appi.ps.201200561] [PMID]
26. Rüsch N, Heekeren K, Theodoridou A, Dvorsky D, Müller M, Paust T, Corrigan PW, Walitza S, Rössler W. Attitudes towards help-seeking and stigma among young people at risk for psychosis. Psychiatry Research. 2013;210(3):1313-5. [DOI:10.1016/j.psychres.2013.08.028] [PMID]
27. Calear AL, Batterham PJ, Christensen H. Predictors of help-seeking for suicidal ideation in the community: risks and opportunities for public suicide prevention campaigns. Psychiatry Research. 2014;219(3):525-30. [DOI:10.1016/j.psychres.2014.06.027] [PMID]
28. Hollinger JM. Adolescent Attitudes Toward and Perceptions of Suicide, Stigma, and Help-Seeking Behavior. Unpublished PhD.Thesis, Philadelphia College of Osteopathic Medicine. 2016.
29. Ko J. Help-seeking pathway among working-age adults with suicidal ideation: testing the integrated model of suicide help-seeking. Social work in public health. 2018;33(7-8):467-82. [DOI:10.1080/19371918.2018.1546251] [PMID]
30. Michelmore L, Hindley P. Help‐seeking for suicidal thoughts and self‐harm in young people: A systematic review. Suicide and Life‐Threatening Behavior. 2012;42(5):507-24. [DOI:10.1111/j.1943-278X.2012.00108.x] [PMID]
31. Han J, Batterham PJ, Calear AL, Ma J. Seeking professional help for suicidal ideation: A comparison between Chinese and Australian university students. Psychiatry research. 2018;270:807-14. [DOI:10.1016/j.psychres.2018.10.080] [PMID]
32. Wilson CJ, Deane FP, Ciarrochi JV, Rickwood D. Measuring help seeking intentions: properties of the general help seeking questionnaire. Revue canadienne de counseling. 2005;39(1):15-28. [DOI:10.1037/t42876-000]
33. Olivari C, Guzman-Gonzalez M. Validation of the general help-seeking questionnaire for mental health problems in adolescents. Revista Chilena de Pediatria. 2017;88(3):324-31. [DOI:10.4067/S0370-41062017000300003] [PMID]
34. Zeinali E. Assessment of relationship between medication adherence with coping strategies and help-seeking among clients with chronic Heart failure. Unpublished master of psychiatric nursing. dissertation, Iran University of Medical Sciences. 2017.
35. Wilks CR, Coyle TN, Krek M, Lungu A, Andriani K. Suicide ideation and acceptability toward online help‐seeking. Suicide and Life‐Threatening Behavior. 2018;48(4):379-85. [DOI:10.1111/sltb.12356] [PMID]
36. Frey LM, Hans JD, Cerel J. Perceptions of suicide stigma: How do social networks and treatment providers compare?. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 2016;37(2):95. [DOI:10.1027/0227-5910/a000358] [PMID]
37. Han J, Batterham PJ, Calear AL, Wu Y, Xue J, van Spijker BA. Development and pilot evaluation of an online psychoeducational program for suicide prevention among university students: A randomised controlled trial. Internet interventions. 2018;12:111-20. [DOI:10.1016/j.invent.2017.11.002] [PMID] [PMCID]
38. Lueck JA. What's the risk in seeking help for depression? Assessing the nature and pleasantness of outcome perceptions among individuals with depressive symptomatology. Health Educ Behav. 2019;46(3):463-70. [DOI:10.1177/1090198118811898] [PMID]
39. Azizpour M, Taghizadeh Z, Mohammadi N, Vedadhir A. Fear of stigma: The lived experiences of Iranian women after suicide attempt. Perspectives in psychiatric care. 2018;54(2):293-9. [DOI:10.1111/ppc.12237] [PMID]
40. Barney LJ, Griffiths KM, Jorm AF, Christensen H. Stigma about depression and its impact on help-seeking intentions. Aust New Zealand J Psychiatry. 2006;40(1):51-4. [DOI:10.1080/j.1440-1614.2006.01741.x] [PMID]
41. Taylor-Rodgers E, Batterham PJ. Evaluation of an online psychoeducation intervention to promote mental health help seeking attitudes and intentions among young adults: randomised controlled trial. J Affect Disord. 2014;168:65-71. [DOI:10.1016/j.jad.2014.06.047] [PMID]
42. Blais RK, Renshaw KD. Stigma and demographic correlates of help‐seeking intentions in returning service members. J Traumatic Stress. 2013;26(1):77-85. [DOI:10.1002/jts.21772] [PMID]
43. Mahdizadeh M, khosravi Z, editors. A Review of the Stigmatization in the Iranian Community and Muslim World: 2017: Proceedings of The First International Conference on Culture, Psychopathology and Education; 2017 May 3-4 ,Iran; Tehran: Alzahra University; 2017.
44. Rickwood D, Thomas K. Conceptual measurement framework for help-seeking for mental health problems. Psychol Res Behavr Manag. 2012;5:173. [DOI:10.2147/PRBM.S38707] [PMID] [PMCID]
45. Czyz EK, Horwitz AG, Eisenberg D, Kramer A, King CA. Self-reported barriers to professional help seeking among college students at elevated risk for suicide. J Am College Health. 2013;61(7):398-406. [DOI:10.1080/07448481.2013.820731] [PMID] [PMCID]
46. Tucker JR, Hammer JH, Vogel DL, Bitman RL, Wade NG, Maier EJ. Disentangling self-stigma: Are mental illness and help-seeking self-stigmas different?. J Couns Psychol. 2013;60(4):520. [DOI:10.1037/a0033555] [PMID]
47. Reynders A, Kerkhof AJ, Molenberghs G, Van Audenhove C. Stigma, attitudes, and help‐seeking intentions for psychological problems in relation to regional suicide rates. Suic Life‐Threat Behav. 2016;46(1):67-78. [DOI:10.1111/sltb.12179] [PMID]
48. Weiss MG, Parkar SR. Facets of clinical stigma after attempted suicide in Mumbai, India. Anthropol Med. 2020;27(2):212-33. [DOI:10.1080/13648470.2019.1640025] [PMID]
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