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postgraduate thesis: Silent suicides: studies on the non-contact group of suicide

TitleSilent suicides: studies on the non-contact group of suicide
Authors
Issue Date2012
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Law, Y. [羅亦華]. (2012). Silent suicides : studies on the non-contact group of suicide. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b4807966
AbstractBackground: Substantial attention has been given to studying suicides among those who had been in contact with healthcare providers. However, effective suicide prevention must target both users (contact) and non-users of healthcare services (non-contact). The non-contact group has been under-researched and prevention programs are often designed based on studies that over-rely on samples of the contact group. Using both quantitative and qualitative methods, this thesis aims to retrospectively explore and explain the profiles and service-use patterns of the non-contact group alongside service utilization models. The quantitative studies, which aimed to identify factors associated with the non-contact groups, were conducted based on the samples drawn from the psychological autopsy study of suicides (aged 15-59) in Hong Kong (2003-2005). Study 1: Portfolio analysis of the non-contact group with psychiatric illnesses Considering psychiatric illness as the basic “evaluated need” for psychiatric service-use, it was controlled for in the comparison between the contact (n=52; 43.7%) and non-contact group (n=67; 56.3%). The non-contact group was associated with having relatively stable employment, a higher level of problem solving ability, unmanageable debts, and non-psychotic disorders. They were evidently different from the contact group, while accounting for a larger proportion of the suicide population. Study 2: Study of suicides without psychiatric illnesses Twenty-nine suicide cases without any psychiatric diagnoses were compared to live controls without diagnoses (n=135), and live controls (n=15) and deceased (n=86) with non-psychotic diagnoses. They were not significantly different to the groups with psychiatric illness on the level of impact from various life events, either acute or chronic, including relationship, family, legal, physical, and job insecurity. However, with fewer signs of detectable abnormalities such as previous suicide attempts, they were not given timely attention from healthcare or psychosocial services. Alternative preventive measures are suggested to address the service needs arising from their negative life events. Study 3: Study of suicides with distress from job insecurity Suicides who were employed at time of death tended to make no contact with healthcare services. They were single, lived alone, earned less income, and suffered from depression. Chronic job insecurity, which was partially mediated by psychiatric illness, was found to influence their non-contact pattern. This could be due to fear of job loss or being stigmatized at work if they decided to receive treatment. Strengthening mental health programs and financial management in workplaces is suggested. Study 4: Study of perceptions towards pathway to care among patients survived from near-lethal suicide attempts The personal accounts of patients that survived from near-lethal suicide attempts revealed that the higher their suicide intent, the lower their perceived needs and the greater their resistance to receiving healthcare services. Themes associated with their non-contact pattern were irrelevancy, non-usefulness and self-reliance. Their views were detouring or against the pathway to care. Conclusion: The non-contact pattern of suicides cannot be explained by conventional service-use models. They showed a distinctive profile from the contact group, and it is suggested that they be helped through proactive prevention programs and / or population-based preventive measures, e.g. restriction of suicide means.
DegreeDoctor of Philosophy
SubjectSuicidal behavior - China - Hong Kong.
Dept/ProgramSocial Work and Social Administration
Persistent Identifierhttp://hdl.handle.net/10722/185516

 

DC FieldValueLanguage
dc.contributor.authorLaw, Yik-wa.-
dc.contributor.author羅亦華.-
dc.date.accessioned2013-08-08T04:12:39Z-
dc.date.available2013-08-08T04:12:39Z-
dc.date.issued2012-
dc.identifier.citationLaw, Y. [羅亦華]. (2012). Silent suicides : studies on the non-contact group of suicide. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b4807966-
dc.identifier.urihttp://hdl.handle.net/10722/185516-
dc.description.abstractBackground: Substantial attention has been given to studying suicides among those who had been in contact with healthcare providers. However, effective suicide prevention must target both users (contact) and non-users of healthcare services (non-contact). The non-contact group has been under-researched and prevention programs are often designed based on studies that over-rely on samples of the contact group. Using both quantitative and qualitative methods, this thesis aims to retrospectively explore and explain the profiles and service-use patterns of the non-contact group alongside service utilization models. The quantitative studies, which aimed to identify factors associated with the non-contact groups, were conducted based on the samples drawn from the psychological autopsy study of suicides (aged 15-59) in Hong Kong (2003-2005). Study 1: Portfolio analysis of the non-contact group with psychiatric illnesses Considering psychiatric illness as the basic “evaluated need” for psychiatric service-use, it was controlled for in the comparison between the contact (n=52; 43.7%) and non-contact group (n=67; 56.3%). The non-contact group was associated with having relatively stable employment, a higher level of problem solving ability, unmanageable debts, and non-psychotic disorders. They were evidently different from the contact group, while accounting for a larger proportion of the suicide population. Study 2: Study of suicides without psychiatric illnesses Twenty-nine suicide cases without any psychiatric diagnoses were compared to live controls without diagnoses (n=135), and live controls (n=15) and deceased (n=86) with non-psychotic diagnoses. They were not significantly different to the groups with psychiatric illness on the level of impact from various life events, either acute or chronic, including relationship, family, legal, physical, and job insecurity. However, with fewer signs of detectable abnormalities such as previous suicide attempts, they were not given timely attention from healthcare or psychosocial services. Alternative preventive measures are suggested to address the service needs arising from their negative life events. Study 3: Study of suicides with distress from job insecurity Suicides who were employed at time of death tended to make no contact with healthcare services. They were single, lived alone, earned less income, and suffered from depression. Chronic job insecurity, which was partially mediated by psychiatric illness, was found to influence their non-contact pattern. This could be due to fear of job loss or being stigmatized at work if they decided to receive treatment. Strengthening mental health programs and financial management in workplaces is suggested. Study 4: Study of perceptions towards pathway to care among patients survived from near-lethal suicide attempts The personal accounts of patients that survived from near-lethal suicide attempts revealed that the higher their suicide intent, the lower their perceived needs and the greater their resistance to receiving healthcare services. Themes associated with their non-contact pattern were irrelevancy, non-usefulness and self-reliance. Their views were detouring or against the pathway to care. Conclusion: The non-contact pattern of suicides cannot be explained by conventional service-use models. They showed a distinctive profile from the contact group, and it is suggested that they be helped through proactive prevention programs and / or population-based preventive measures, e.g. restriction of suicide means.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.source.urihttp://hub.hku.hk/bib/B48079662-
dc.subject.lcshSuicidal behavior - China - Hong Kong.-
dc.titleSilent suicides: studies on the non-contact group of suicide-
dc.typePG_Thesis-
dc.identifier.hkulb4807966-
dc.description.thesisnameDoctor of Philosophy-
dc.description.thesislevelDoctoral-
dc.description.thesisdisciplineSocial Work and Social Administration-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5353/th_b4807966-
dc.date.hkucongregation2012-

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