Suicide Prevention in the Americas.

The Americas encompass the entirety of the continents of North America and South America, representing 49 countries. Together, they make up most of Earth's western hemisphere. The population is over 1 billion (2006 figure), with over 65 % living in one of the three most populated countries (the United States, Brazil, and Mexico). The Americas have low-, middle-, and high-income countries. Data from this region have not been readily and consistently available. There are several English-speaking Caribbean nations and countries in South America that have not had updated information. This chapter will focus on suicide prevention within North America (United States and Canada), some countries in the Caribbean region, and some countries in South America. Guyana, Suriname, and Trinidad and Tobago have severe issues with pesticide suicide, with average rates of 44.2 (global rank 1); 27.8 (global rank 5) and 13.0 (global rank 41) per 100,000 respectively. Jamaica, however, had one of the lowest rates: 1.2 per 100,000 (global rank 166). General, regional, and country-specific prevention proposals are suggested, highlighting intersectoral, private collaboration, attention to at-risk persons, substance abuse and mental health interventions, training, and reducing access to lethal means.

Mental Health Needs of Sexual Minorities in Jamaica.

This study examined the prevalence of Axis I disorders and associated risk factors in a sample of sexual minority men and women in Jamaica, a country that is widely known for its high societal rejection of homosexuality. Poor relationships with family, negative or abusive experiences related to one's sexual orientation, and greater openness about one's sexual orientation were independent risk factors for Axis I disorders. Prevention of mental disorders in sexual minorities in Jamaica should focus on rebuilding family support and promoting social acceptance of sexual minorities.

Suicide in Jamaica: some socio-demographic findings [abstract]

The objective of this study was to examine trends in suicide in Jamaica from 1974 to 2000; socio-demographic variables for suicide over the past 5 years and specific aspects of in the year 2000 were examined. Figures for suicide in Jamaica over the period 1974-2000, provided by the Police Computing Centre, were examined. The trends in respect of suicide methods used, and socio-demographic factors: age, gender, location (urban/rural), over the period 1996 to date were identified, and additionally, 57 cases (51 males, 6 females) of suicide in 2000, to date, were examined via month/ quarter of occurrence, and possible precipitating factors, including mental disorder, stressful life events, and larger social issues. The ages of the suicide cases ranged from 15 to 78 years with a mean age of 40 years. The data were analyzed at the Department of Administrative Computing. The SPSS package was used. There was a marked increase in suicide from 1992. Linear regression indicated a continued increase in suicide over the following three years unless there was appropriate intervention. Hanging emerged as the most commonly used method of suicide by both men (80.4 percent, (n= 41) and women (66.7 percent, (n= 4). Chi-square analysis showed no significant difference between the genders, both choosing hanging over all other methods. Regarding age and method, 100 percent of cases in age groups 20 to 29 years (n= 13) and 70 to 79 years (n= 6) used hanging, while 80 percent of cases in age group 50 to 59 years (n= 5) chose methods other than hanging, including shooting, setting self on fire, drowning, jumping from a height, throat and wrist slashing, and ingestion of poisonous liquids (levels of significance, p= 0.006). (AU)

A sociodemographic and clinical study of patients admitted to the University Hospital of the West Indies detoxification unit over a three-month period [abstract]

OBJECTIVE: To characterize the patients admitted to the Detoxification Unit for the 3-month period, May 28, 2001 to August 24, 2001, and to identify factors which may influence premature discharge. METHOD: The socio-demographic variables, drug use history, clinical assessment management and clinical of 17 persons admitted during the period under consideration were obtained. Particular attention was paid to group and one-to-one interaction. SPSS was used in data analysis. RESULTS: 94.1 percent (n= 16) were male and 5.9 percent, (n= 1), female. Most were in the 25 to 29-year age group (35.3 percent. n= 6). Most (76.6 percent, n= 13) had Kingston and St. Andrew addresses. Ten (58.8 percent) persons sucessfully completed the 4-week programme; one (5.9 percent) was transferred for medical reasons and 6 (35.3 percent) were discharged prematurely because of infringement of rules. The presence of dual Axis 1 or Axis 2 disorders was not in itself a significant contributory factor in premature discharge, though several of these individuals showed personality deficits; nor was poor schooling with poor literacy skills related. CONCLUSION: Further studies, including case control studies, are required. Patients who may not be suitable for in-patient therapy would be appropriately channelled to close outpatient follow up. (AU)

Suicide in Jamaica: some socio-demographic findings

OBJECTIVES: To examine trends in suicide between 1974 and 2000 and socio-demographic variables for suicide over the past 5 years, highlighting suicide cases for the year 2000. METHODS: Figures for suicide in Jamaica over the period 1974-2000, provided by the Police Computing Center, were examined. This include 57 cases (51 males, 6 females) of suicide for the year 2000. The trends in respect of methods used, age, gender, location (urban/rural), over the period 1996 to date were identified, and, were possible, the cases were examined for possible precipitating factors. The Department of Administrative Computing conducted the data analysis. RESULTS: There was a marked increased in suicide from 1994 to 2000. Linear regression indicated a continued increase in suicide beyond 2000. The primary method of suicide was hanging. In the 57 cases of suicide - age range 15 to 78 years (mean age 40 years)- hanging was the method used by 80.4 percent of males (n=41) and 66.7 percent of females(n=4). Chi-square analysis showed no significant male/female difference. Regarding age and method, all cases in age group 20-29 years (n=13) and 70-79 years (n=6) chose hanging, while 80 percent of cases in age group 50-59 years (n=5) used other methods, viz., shooting, self-immolation, drowning, jumping from a high, throat- and wrist slashing, and ingestion of poisonous liquids (p=0.006). CONCLUSION: More focused prevention/intervention strategies should be provided for persons in identified high-risk age groups (AU)

Smoking and health; tobacco use and anti-smoking campaigns in Jamaica

Lifestyle-related diseases of the cardiovascular, respiratory and digestive systems continue to be major causes of morbidity and mortality in Jamaica. The aims of the study were to obtain data on: a) Knowledge, attitudes, perceptions and use of tobacco products particularly cigarettes; b) The impact of the Medical Association of Jamaica/Pan American Health Organization media campaign against tobacco use. The Methodology: An islandwide sample of 628 persons, comprising 364 males and 264 females, and ranging in age from under 24, to over 70 years, was interviewed, using a modified World Health Organization (WHO) Comprehensive Tobacco Survey instrument with 12 additional questions relating to the media campaign. The sample was obtained via a two-stage systemic sampling system. Data processing was done at the UWI Computing Centre. Results: Lifetime prevalence of use was 54 percent (N=339). Current daily use was 27.7 percent (N=174). Concerning health effects, 80.5 percent (N=441) strongly agreed that smoking was harmful to health. 78 percent of persons had concerns about passive smoking. Regarding the Anti-smoking Campaign, 34.7 percent of the sample had seen the ads first-hand. The impact of the campaign on smokers was assessed by their level of use pre- and post-campaign. The paired t-test was used to test the level of significance. The mean use level before the campaign was 2.5217 and after, 2,1196, yielding a difference in means of 0.1112. The t value was 3.61 with degrees of freedom and a two-tailed probability of 0.001 - a highly significant and desirable result. Implications of the study, for behaviour change, are discussed.(AU)

Drugs and adolescence incorporating a survey of drug use in Jamaican high school students

This study outlined the history of drug use, tracing this from early civilizations to the 20th century, and highlighting available data from the West indies. Then followed the survey of 1,585 students in secondary schools in Kingston and St. Andrew. This was conducted by questionnaires and such factors as the students' personal experience and knowledge of drugs and their attitudes to drug use were elicited. The results indicated that students' knowledge of drugs was limited, particularly about drugs such as LSD, heroin and amphetamine, which are relatively well-known or publicized in the United States. Curiosity was the commonest reason for drug use in the student population. This was supported by the finding that after the initial experience, less than half of the sample continued to use the drug. A review of drug education programmes and some recommendations for the Jamaican population completed the study (AU)