Crisis
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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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This article describes trends in suicide attempt visits to emergency departments in the United States (US). Data were obtained from the National Hospital Ambulatory Medical Care Survey using mental-health-related ICD-9-CM, E and V codes, and mental-health reasons for visit. From 1992 to 2001, mental-health-related visits increased 27.5% from 17.1 to 23.6 per 1000 (p < .001). ⋯ Ten-year regional increases in suicide attempt-related visits were significant for the West and Northeast only. US emergency departments have witnessed increasing rates of ED visits for suicide attempts during a decade of significant reciprocal decreases in postattempt hospitalization. Emergency departments are increasingly important sites for identifying, assessing and treating individuals with suicidal behavior.
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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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Switzerland has one of the highest rates of firearm suicides in the world. International studies show a positive correlation between the rate of households with guns and femicides with guns. Because its defense system requires a militia to keep personal firearms at home, Switzerland has a high rate of households with a gun. ⋯ The use of firearms for suicide, rather than homicide, and particularly of army weapons by young, well-educated men, requires more attention in debates and informed policy regarding access to firearms and suicide prevention in Switzerland.