General practitioners' needs for support after the suicide of patient: A qualitative study.

BACKGROUND: Most patients that commit suicide consult their GPs before their death. This topic is often surrounded by secrecy and associated with guilt and shame. There is a lack of knowledge about support for GPs after patient suicide. OBJECTIVES: To identify the widest range of Slovenian GPs' problems and needs in connection with patient suicide, and, based on the findings of the study, to prepare ways to assist GPs after patient suicide. METHODS: Semi-structured interviews were held with GPs that had experienced a patient's suicide during their professional career until saturation was reached. The interview guide was piloted. Twenty-two in-depth interviews were carried out between April 2012 and February 2013. Transcripts were coded and thematically analysed using qualitative content analysis. RESULTS: Participating GPs suggested possible forms of support, most frequently individual consultation with a psychologist or a psychiatrist, in person, by phone, or via e-mail. Balint groups, group consultations and various workshops on suicide or depression would be a preferable form of support. Some GPs perceived critical incident review as an attempt to blame them, whereas others saw it as an opportunity for support. A group of peers that could discuss professional dilemmas in which more experienced GPs would help younger GPs would be helpful. CONCLUSION: Slovenian GPs did not have any formal support system at the time of the research, but they would appreciate such a possibility.

Origins of suicidality: compatibility of lay and expert beliefs - qualitative study.

BACKGROUND: Today there exist different views on origins of suicidal behaviour, which can influence the help-seeking behaviour and the adherence to the treatment of suicidal people. SUBJECTS AND METHODS: The beliefs lay people and patients have about the origins of suicidal behaviour as well as the compatibility of their beliefs with the views of the mental health personnel (general practitioners and psychiatrists) were assessed. 45 semi-structured interviews with the general population, suicide attempters, general practitioners and psychiatrists were conducted, audio typed, transcribed and a thematic analysis of the data was carried out. RESULTS: The results indicated the incompatibility of the views. The general population and the suicide attempters favoured psychological explanations of suicidal behaviour, whereas the general practitioners and psychiatrists promoted medical explanations. The only common theme was perception of the suicidal crisis as a crucial factor in suicidality. CONCLUSIONS: Lay people and experts believe that suicidal crisis is the main origin of suicidal behaviour. The awareness of this common denominator and also of the differences in opinions between lay people and experts should be kept in mind when planning and implementing prevention and treatment programmes if we wish to promote help-seeking behaviour and attain good adherence to treatment.

For which strategies of suicide prevention is there evidence of effectiveness?

This document describes the process of formulating and implementing national programmes for the reduction of suicide in five European countries and analyses the public health dimensions of suicide in Slovenia. Recommendations for the establishment of a national programme for the reduction of suicide in Slovenia are put forward

Attitudes toward suicide in the adolescent population.

BACKGROUND: Only few studies have so far confirmed the clear connection of attitudes toward suicide with prevalence of suicidal behavior, and there are several contradictory findings on the balance of this relationship. Slovenia has long had a very high suicide rate, including in the population of adolescents. AIMS: To examine attitudes of Slovene adolescents toward suicide and their connection to different suicide risk factors. METHODS: A questionnaire on attitudes toward suicide was given to 423 high school students from three regions based on the different regional suicide rates. RESULTS: The results proved our expectation of girls having more permissive attitudes toward suicide than boys. Also, a permissive attitude was positively associated with the majority of suicide risk factors. CONCLUSIONS: In the light of certain limitations of the study we discuss the implications of the main finding, namely, that permissive attitudes toward suicide are more likely a risk than a safety factor for suicidal behavior.

The association between life events and suicide intent in self-poisoners with and without a history of deliberate self-harm: a preliminary study.

The associations between life events in the 12 months preceding an episode of self-poisoning resulting in hospital attendance (the index episode), and the suicide intent of this episode were compared in individuals for whom the index episode was their first, episode and in individuals in whom it was a recurrence of DSH. Results indicated a significant interaction between independent life events, repetition status, and gender in the prediction of suicide intent, the association between life events and intent being moderated by repetition status in women only. The results provide preliminary evidence to suggest the presence of a suicidal process in women, in which the impact of negative life events on suicide intent diminishes across episodes.

Current understandings of suicide survivor issues: research, practice, and plans. Report of the 1st International Suicide Postvention Seminar, September 8, 2006, Portoroz, Slovenia.

The goals of the Postvention Taskforce of the International Association for Suicide Prevention (IASP) are to increase awareness of postvention and survivor issues. One of the strategies is to organize meetings. We report on the 1st International Suicide Postvention Seminar, held as a 1-day preevent at the 11th European Symposium on Suicide and Suicidal Behavior in Portoroz, Slovenia, September 2006. The seminar provided a state of the art review of the postvention field, with plenary presentations on research, psychotherapeutic care, development of national networks, and of postvention materials. We summarize the presentations below.

Expert and lay explanations of suicidal behaviour: comparison of the general population's, suicide attempters', general practitioners' and psychiatrists' views.

BACKGROUND: Different explanations of suicidal behaviour coexist today. The incompatibility of the beliefs among experts and (potential) users of medical services can influence the implementation of prevention programmes, help-seeking behaviour and adherence to treatment. AIMS: The aims of the study were to identify explanatory models of suicidal behaviour and to determine possible incompatibilities between lay (the general population and suicide attempters) and expert (the general practitioners and psychiatrists) views. METHODS: The Questionnaire on Attitudes towards Suicide was revised on the basis of semi-structured interviews with the general population, suicide attempters, general practitioners and psychiatrists. The revised version was then applied to each of these four groups. RESULTS: Five explanatory models were identified: namely, personality, sociological, medical, crisis and genetic models. Significant group differences on the explanatory models were found. The lay people favoured crisis, sociological and medical models whereas the experts shared the belief in the medical, genetic and crisis models. CONCLUSIONS: The crisis model gained considerable support and was generally accepted as correct. This could be the common ground between lay people and experts and the starting point of both treatment and prevention programmes.

What helps and what hinders the process of surviving the suicide of somebody close?

This paper presents similar findings about the lack of support and understanding for people bereaved through suicide from four different countries and reports on each country's unique response to this challenge. This paper reports on presentations made at the conference workshop of the International Association for Suicide Prevention meeting in Chennai in 2001, and on participants' suggestions of how best to help the bereaved.

Why people engage in parasuicide: a cross-cultural study of intentions.

Information obtained at interview from 1,646 parasuicide patients in 14 regions in 13 European countries participating in the WHO/EURO Multicentre Study on Suicidal Behaviour was used to study self-reported intentions involved in parasuicide. Comparisons were made across cultures, genders, and age groups. Although some statistically significant differences were found, the effect sizes were very small. The main finding from this study is thus that parasuicide patients in different countries tend to indicate that similar types of intentions are involved in their acts of parasuicide, and that the intentions do not vary greatly with gender or age. The hypothesis that rates of suicide and parasuicide vary between regions with the frequency with which suicidal intention is indicated by the patients was also tested, but was supported only for women and in relation to national suicide rates. The findings from this study are likely to be generalizable to other settings and have implications for clinical practice.

How to reduce suicide in Slovenia : proposal for a national programme for suicide prevention in Slovenia : national and international perspectives / edited by Onja T. Grad

This document describes the process of formulating and implementing national programmes for the reduction of suicide in five European countries and analyses the public health dimensions of suicide in Slovenia. Recommendations for the establishment of a national programme for the reduction of suicide in Slovenia are put forward