Crisis
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Previous deliberate self-harm (DSH) is the strongest predictor of suicide. Although several studies exist in other countries, characteristics of DSH have not been well-studied in Pakistan. ⋯ Despite the difference in socio-cultural background of our patients, many of our results were found to be consistent with Western data. Our findings suggest that problem-solving therapy, stress management and improved mental health care may be effective interventions in preventing DSH. Prescription of medications should be regulated. Further studies are suggested at the community level.
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A retrospective review of 98 patients through medical and billing records, over a period of 12 months (January to December 2004), was conducted to evaluate the cost of treatment of patients presenting with deliberate self-harm (DSH) to a private tertiary care teaching hospital in Karachi, Pakistan. After initial treatment in the Emergency Department (ED), 34 patients were admitted to the medical wards for further treatment and 64 patients were either discharged or left against medical advice from ED. ⋯ The cost of treatment of DSH is extremely high in a country like Pakistan, where the patients have to bear the hospital cost out of their own pocket. The most important determinant of cost was length of hospital stay, averaging 2.91 days.
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Very high rates of suicide have been reported from India and the developing world. However, much of the debate on suicide prevention focuses on individuals, methods, site-specific solutions, or particular suicide prevention strategies. This article argues for population based approaches that focus on improving the general health of populations (e.g., macroeconomic policies that aim for social justice, schemes to meet basic human needs, organizing local support groups within vulnerable sections of society, developing and implementing an essential pesticide list, addressing gender issues, and increasing public awareness through the mass media) rather than medical, psychiatric, and other strategies that target individuals (e.g., treatment of mental illness, counseling, etc.) in order to reduce high suicide rates in India and developing countries. Individual approaches will help people in distress and prevent individuals from committing suicide, but will not reduce population suicide rates.
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A modified grounded-theory (qualitative) study was undertaken in an attempt to discover the psychosocial processes involved when psychiatric/mental health nurses provide care to suicidal people, and in so doing, to induce the first comprehensive theory of psychiatric nursing care of the suicidal person. The findings highlight that the key psychosocial process (or core variable of the theory) is "reconnecting the person with humanity" and that this has three stages: reflecting an image of humanity, guiding the individual back to humanity, and learning to live.
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This study addressed the issue of a possible link between single-car accident drivers and suicidal intent. In the international literature this topic has generated both positive and negative results. Some authors have stressed unconscious suicidal motivations in various single accidents. ⋯ These patients had experienced more life events than controls. We conclude that, although suicide risk was low in our patients, they were engaged in looking for a solution to their problems in which the accident played a role in such a process. This behavior has some characteristics of the logic of suicidal individuals.