From condemnation to understanding: Views on suicidal behavior in Ghana in transition.

The cultural context in which suicide occurs has been emphasized as critical in understanding the act and informing prevention. Yet the penchant of psychiatrizing suicidality in mainstream suicidology relegates cultural issues to the background. Through the lenses of critical cultural suicidology, the authors have re-emphasized the importance of culture by reviewing the two major meanings of suicide as observed in our 8-year study in Ghana: moral transgression and life crisis. They have also showed the usefulness of the life crisis perspective of suicidality in reducing stigma and sustaining advocacy in decriminalizing attempted suicide in the country.

Suicide and mental disorders: A discourse of politics, power, and vested interests.

One of the most well-established truths in suicidology is that mental disorders play a significant role in at least 90% of suicides, and a causal relationship between the two is often implied. In this article, the authors argue that the evidence base for this truth is weak and that there is much research questioning the 90% statistic. Based on numerous examples, they also argue that ideology, politics, power, and vested interests among influential professionals in the field obstruct argument-based discussion of this issue. The authors also discuss unfortunate consequences of the constant reiteration of the 90% statistic.

The law criminalizing attempted suicide in Ghana: the views of clinical psychologists, emergency ward nurses, and police officers.

BACKGROUND: Attempted suicide is still considered a crime in Ghana. AIMS: The purpose of this study was to investigate the attitudes toward this law held by health workers and police officers in Ghana so as to provide culture-sensitive arguments to aid in abolishing the law. METHOD: Qualitative interviews were conducted with eight clinical psychologists, eight emergency ward nurses, and eight police officers. RESULTS: The majority of informants did not agree with the law criminalizing attempted suicide in Ghana, although five of the emergency ward nurses and two police officers did. Arguments for agreeing with the law were that people have no right to take life and that the law has a deterrent effect and thus it will help reduce the suicide rate. The main argument for not agreeing with the law was that suicidal behavior is a mental health issue. Those who argued in favor of the law did not seem to reflect much on the reasons for suicidal behavior. CONCLUSION: Education on how to understand suicidal behavior and suicidal people may aid the work toward decriminalizing attempted suicide in Ghana.

Psychological autopsy studies as diagnostic tools: are they methodologically flawed?

One of the most established "truths" in suicidology is that almost all (90% or more) of those who kill themselves suffer from one or more mental disorders, and a causal link between the two is implied. Psychological autopsy (PA) studies constitute one main evidence base for this conclusion. However, there has been little reflection on the reliability and validity of this method. For example, psychiatric diagnoses are assigned to people who have died by suicide by interviewing a few of the relatives and/or friends, often many years after the suicide. In this article, we scrutinize PA studies with particular focus on the diagnostic process and demonstrate that they cannot constitute a valid evidence base for a strong relationship between mental disorders and suicide. We show that most questions asked to assign a diagnosis are impossible to answer reliably by proxies, and thus, one cannot validly make conclusions. Thus, as a diagnostic tool psychological autopsies should now be abandoned. Instead, we recommend qualitative approaches focusing on the understanding of suicide beyond mental disorders, where narratives from a relatively high number of informants around each suicide are systematically analyzed in terms of the informants' relationships with the deceased.

Self-reported suicidal behavior and attitudes toward suicide and suicide prevention among psychology students in Ghana, Uganda, and Norway.

Self-reported suicidal behavior and attitudes toward suicide in psychology students are reported and compared in Ghana, Uganda, and Norway. Small differences only were found in own suicidal behavior. However, experience of suicidal behavior in the surroundings was more common in Uganda than in Ghana and Norway. Although differences were found between the three countries in attitudes toward suicide, which emphasizes the need for culture-sensitive research and prevention, many of the differences were not as big as expected. The most pronounced difference was that the Norwegian students were more reluctant to take a stand on these questions compared to their African counterparts. Some differences were also found between the two African countries. The implications of the results for suicide prevention in Africa are discussed.