![](3D"slide0001_image002.gif")
TEACH-VIP
T rainin=
g,
E ducating,
A dvancing
C ollaboration in
H ealth on
V iolence and
I njury
P revention
=
Core curriculum
Lesson 16
![](3D"slide0025_image003.gif")
Injury prevent=
ion
and control strategies for suicide and self-inflicted harm
Self-inflicted
injuries
Section V. Applied
injury prevention and control, and safety promotion
Main
objectives of this lesson
<=
u>
1. To introduce
students to the study, prevention and control of fatal and non-fatal
self-inflicted
injuries.
=
2. To explore
measures taken to control and prevent self-inflicted injuries by means of
practical
examples drawn from communi=
ty and
national levels.
Core
competencies that students should attain by the end of the session
<=
u>
The ability
to:
1. define suic=
ide
and suicidal behavior
2. recognize t=
he
global burden of injuries due to suicidal behavior
3. describe the
risk factors and determinants associated with suicidal behavior
4. describe
interventions or strategies aimed at controlling or preventing suicides.&#=
13;
![](3D"slide0022_image004.gif")
Self-inflicted injuries
TEACH-VIP
Suicide Definitions
Death from injury, poisoning, or suffocation w=
here
there is evidence
(either explicit or implicit) that the injury was self-inflicted and that the decedent i=
ntended
to kill him/her-self.
=
Source: Rosenberg et al., 1988.
A deliberate, wilful, self-inflicted and
life-threatening act resulting in death.
=
Source:
National Council for Suicide Prevention, 1996.
Self-inflicted injuries
![](3D"slide0002_image005.gif")
Typology
Self-directed&=
#13;
Self-abuse
Suicidal
behaviour
Physical
Sexual
Psychological
Deprivation or neglect
Nature of violence
Source: adapted from Krug=
et
al., eds., 2002.
Global burden
<=
span
style=3D'font-family:Arial'>• Considerable national
variation
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Demographic character=
istics
(gender and age)
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Ethnic group
differences
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Coding and identifying
suicide
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Non-fatal suicidal
behaviour
![](3D"slide0018_image007.jpg")
Global burden
Source: WHO, 2002.=
Global burden
![](3D"slide0007_image009.jpg")
Source: WHO, 2000.=
Global burden
![](3D"slide0004_image011.jpg")
![](3D"slide0019_image013.jpg")
Global burden
Source: Krug et al., eds.,
2002.
Risk factors
<=
span
style=3D'font-family:Arial;font-size:133%'>• Psychiatric problems
<=
span
style=3D'font-family:Arial;font-size:133%;visibility:hidden'>•<=
/span>
<=
span
style=3D'font-family:Arial;font-size:133%'>• Biological and medical markers
=
;
<=
span
style=3D'font-family:Arial;font-size:133%;visibility:hidden'>•<=
/span>
<=
span
style=3D'font-family:Arial;font-size:133%'>• Life events
Risk factors
• Social and environmental factors&#=
13;
–<=
/span> access to means
=
–<=
/span> social isolation
–<=
/span> immigration
------=_NextPart_01C8328D.04E8EAD0
Content-Location: file:///C:/AD279A56/CoreLesson16_files/slide0013.htm
Content-Transfer-Encoding: quoted-printable
Content-Type: text/html; charset="us-ascii"
–<=
/span> religion
–<=
/span> economic conditions<=
/div>
Prevention
•<=
/span> Treatment of mental disorders
=
– =
early
identification and access to treatment
•<=
/span> Behavioural approaches
=
– improving problem-solving skills&#=
13;
– improving access to services
<=
/span>
– =
social
relationships
Prevention
•<=
/span> Community-based efforts
– =
suicide
prevention centres/hot lines
– programmes for youth and elders=
3;
– =
support
groups
– =
media
campaigns
•<=
/span> Social or environmental strategies=
– reduction of access to means
<=
/span>
– =
media
reporting
– post-event care
Policy recommendations
<=
span
style=3D'font-family:Arial'>• Improvement of data
collection systems
=
(fatal and non-fatal events)
<=
span
style=3D'font-family:Arial'>• Increased research on
psychosocial, biological factors
=
and behaviour
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Improved psychiatric
treatments and access to mental
=
health services
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Reduction of exposure=
to
means for committing suicide
<=
span
style=3D'font-family:Arial;visibility:hidden'>•
<=
span
style=3D'font-family:Arial'>• Strengthening of
community-based prevention efforts
‹header›
‹date/time›=
=
Click to edit Master text styles
Second level
Third level
Fourth level
Fifth level
‹footer›
‹#›
=
Self-inflicted injuries include suicide and suicide attempts as wel=
l as
acts that involve
self-harm without the intention of inflicting death.
There is no general agreed definition on what suicide means, howeve=
r,
the following two
are presented to illustrate what this behaviour means. A close agreement on the definitions about this
problem is important because it allows comparability between different sources within a specified p=
lace
or between mult=
iple
places.
According to a generally accepted typology of intentional injuries,
self-directed
violence as well as other forms of violence are complex problems that affect individuals in many ways. T=
his
concept also includes many forms of behaviour. As shown, self-directed violence includes suici=
de
(or suicidal
behaviour) and self-abuse. Both suicidal behaviour and self-abuse <=
span
lang=3DEN-GB style=3D'font-family:Arial;mso-ascii-font-family:Arial;mso-bi=
di-font-family:
Arial;mso-hansi-font-family:Arial'>have consequences at physical and
psychological levels but can also be expressed in the form of deprivation or neglect. Self-directed viol=
ence
has consequences=
for
individuals at multiple levels. It also has consequences at levels that are greater than the
individual for it also affects families, communities and societies as a whole.
Currently, self-directed violence constitutes the largest proportio=
n of
all intentional
injuries as reported by the World Health Organization. For the year 2000, the WHO reported an estimated
815,000 deaths due to suicide or one death every 40 seconds. There is considerable variation on
suicides among nation=
s.
There are also differences by gender and age group. For example, suicide is the fourth leading
cause of death among those aged 15-44 years. In some countries evidence suggests that suicide rates te=
nd
to be similar with=
in
the same ethnic group. For example in Eastern Europe suicide rates are similar between Finland and
Hungary which despite their geographic distance share common ethnic heritage.
In other regions such as Fiji and Canada, there are large differenc=
es between in rates of suicide between eth=
nic
groups that share similar geographic areas.
Some of the differences between nations might be artifactual becaus=
e of
different ways of
defining, coding or identifying suicides. Finally, non-fatal suicidal behaviour is also difficult to
identify and report.
Data on suicide mortality is usually underestimated not only becaus=
e of
reporting problems=
but
also because of stigmatization of families, political reasons or for social convenience
(insurance benefits, masking as unintentional injuries).
This map shows the wide variation of suicide rates by region accord=
ing
to data reporte=
d to
the WHO for the year 2000. The regions with highest suicide rates in the world are Eastern
Europe, the Russian Federation and China. The regions that report the lowest rates of suicide are in L=
atin
America and a few
Asian countries.
Data from countries such as Sweden and Finland that dates from the =
18th
century show a trend of increase in suicide rates. Other countries which s=
how
increasing trends in suicide rates are Bulgaria, Costa Rica, Ireland,
Mauritius, Norway, Singapore, Scotland and Spain. The highest rates report=
ed
are by Belarus, Estonia and Lithuania. Globally, since 1950, a trend towar=
ds
increasing suicide rates has been reported to the WHO by its member countr=
ies.
However, this global trend masks some countries that during the 20th
century have seen decreasing trends in suicide rates. The countries report=
ing
decreases in suicide rates and for which there is available information
include England and Wales, Italy, New Zealand, Switzerland and Australia.&=
#13;
Overall, trends of suicide among males have increased since the
mid-twentieth century.
Suicide rates increase with age in general. Rates of suicide among
people older than 60
years are about 3 times higher than those aged 15-29. However in absolute terms the number of
deaths due to suicide is greater among populations younger than 45 years.
With the exception of some regions in A=
sia,
rates of suicide are about three times more frequent in males than in females.
Suicidal attempts however, are much more
common among younger populations and the ratio among attempted to completed suicide can
range from 100 to
200:1. Overall, about 10% of people who attempt suicide eventually complete it.
Also a general trend is that non-fatal
suicidal behaviours tend to be 2-3 times more frequent in females compared to males.
This graph shows again, marked differences between gender and age a=
t a global level.
However, there are some countries that
report higher rates of suicide among populations younger than 45 years of age. Those include Australia,
Bahrain, Canada,
Colombia, Ecuador, Guyana, Kuwait, Mauritius, New Zealand, Sri Lanka and the United Kingdom. In some
pacific islands such as Fiji and Samoa, youth suicides are particularly high.
Many of the
differences that have been shown reflect the interaction between factors such as sex, culture and
ethnicity but also because of reporting differences.
Apart
from the different characteristics previously discussed, there are many underlying factors associ=
ated
to the occurrence of suicides or suicidal behaviour. Understanding the
interactions between these factors provides useful information for prevention.
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t.SetInactive=3D _TBSetI
t.SetPressed =3D _TBSetP
t.SetDisabled=3D _TBSetD
t.SetEnabled =3D _TBSetE
t.GetState =3D chkState
t.UserAction =3D action
t.ChgState =3D _TBUI
t.mObjId =3D oId
t.m_elementsId=3D oeId
t.mIsOn =3D 1
}
function _TBSetA()
{
var t=3Dthis
if( t.mIsOn && !t.GetState() )
t.ChgState( gHiliteClr,gShadowClr,0,0 )
}
function _TBSetI()
{
var t=3Dthis
if( t.mIsOn && !t.GetState() )
t.ChgState( gFaceClr,gFaceClr,0,0 )
}
function _TBSetP()
{
if( this.mIsOn )
this.ChgState( gShadowClr,gHiliteClr,1,1 )
}
function _TBSetD()
{ =20
this.ChgState( gFaceClr,gFaceClr,0,0 )
this.mIsOn =3D 0
}
function _TBSetE()
{
var t=3Dthis
if( !t.GetState() )
t.ChgState( gFaceClr,gFaceClr,0,0 )
else
t.ChgState( gShadowClr,gHiliteClr,1,1 )
t.mIsOn =3D 1
}
function _TBP()
{
var t=3Dthis
if( t.mIsOn ) {=20
if( t.UserAction !=3D null )
t.UserAction()
if( !t.GetState )
return
if( t.GetState() )
t.SetPressed()
else
t.SetActive()
} =20
}
function _TBUI( clr1,clr2,lOffset,tOffset )
{
SetBorder( GetObj( this.mObjId ),clr1,clr2 )
Offset( GetObj( this.m_elementsId ),lOffset,tOffset )
}
function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle=
ft }
function SetBorder( obj, upperLeft, lowerRight )
{
s=3Dobj.style;
s.borderStyle =3D "solid"
s.borderWidth =3D 1=20
s.borderLeftColor =3D s.borderTopColor =3D upperLeft
s.borderBottomColor=3D s.borderRightColor =3D lowerRight
}
function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] }
function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() }
function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() }
function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() }
function BtnOnUp()
{
b=3DGetBtnObj()
if( b !=3D null )
b.Perform()
else
Upd()
}
function GetNtsState(){ return parent.gNtsOpen }
function GetOtlState(){ return parent.gOtlOpen }
function GetOtlTxtState(){ return parent.gOtlTxtExp }
function NtsBtnSetFlag( fVal )
{
s=3Ddocument.all.item( this.m_flagId ).style
s.display=3D"none"
if( fVal )
s.display=3D""
else
s.display=3D"none"
}
function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S=
etActive() }
function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S=
etInactive() }
function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S=
etPressed() }
function _BSetA_BorderImg()
{=20
b =3D gBtnArr[this.mBorderId]=20
if( b !=3D null && this.mIsOn && !b.GetState() ) {
obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 )
obj.style.posTop=3D0
}
}
function _BSetI_BorderImg()
{=20
b =3D gBtnArr[this.mBorderId]
if( b !=3D null && this.mIsOn && !b.GetState() ) {
obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 )
obj.style.posTop=3D0
}
}
var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"=
THREEDFACE"
var gBtnArr =3D new Array()
gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan=
e,GetOtlState )
gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt=
lPane,GetOtlState )
gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN=
tsPane )
gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg;
gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg;
gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.=
ToggleNtsPane,GetNtsState )
gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To=
ggleNtsPane,GetNtsState )
gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n=
b_prevBorder",30,parent.GoToPrevSld )
gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n=
b_nextBorder",30,parent.GoToNextSld )
gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent=
.FullScreen )
gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa=
rent.FullScreen,null )
gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border;
gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border;
gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent=
.FullScreen,null )
gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border;
gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border;
gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice=
","nb_voiceBorder",18,parent.ToggleVNarration )
gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT=
xt","nb_otlTxtBorder",23,parent.ToggleOtlText )
gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts"
gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag
gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState
/*********************************************
Context menu implementation
_CM() is the function that's hooked up to
the oncontextmenu event. Once we're asked to
show the menu, we first build it by creating
DIVs on-the-fly. Then we position it=20
within the screen area so it doesn't get
clipped.
Creating the DIVs using createElement() means
we don't have to write out any extra HTML
into the slide HTML files.
**********************************************/
var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr=
row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval"
function ShowMenu()
{
BuildMenu();
var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y=
=3DPPTSld.event.clientY+doc.scrollTop
m =3D PPTSld.document.all.item("ctxtmenu")
m.style.pixelLeft=3Dx
if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) )
m.style.pixelLeft=3Dx-m.scrollWidth
m.style.pixelTop=3Dy
if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) )
m.style.pixelTop=3Dy-m.scrollHeight
m.style.display=3D""
}
function _CM()
{
if( !parent.IsFullScrMode() ) return;
if(!PPTSld.event.ctrlKey) {
ShowMenu()
return false
} else
HideMenu()
}
function BuildMenu()
{
if( PPTSld.document.all.item("ctxtmenu") ) return
var mObj=3DCreateItem( PPTSld.document.body )
mObj.id=3D"ctxtmenu"
mObj.style.visibility=3D"hidden"
var s=3DmObj.style
s.position=3D"absolute"
s.cursor=3D"default"
s.width=3D"120px"
SetCMBorder(mObj,"menu","black")
var iObj=3DCreateItem( mObj )
SetCMBorder( iObj, "threedhighlight","threedshadow" )
iObj.style.padding=3D2
CreateMenuItem( iObj,sNext,M_GoNextSld,M_True )
CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld )
=09
CreateSeparator( iObj )
CreateMenuItem( iObj,sEnd,M_End,M_True )
mObj.style.visibility=3D"visible"
}
function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa=
lue=3Dfalse }
function Highlight() { ChangeClr("activecaption","threedhighlight") }
function Deselect() { ChangeClr("threedface","menutext") }
function Perform()
{
e=3DPPTSld.event.srcElement
if( e.type=3D=3D"menuitem" && e.IsActive() )
e.Action()
else
PPTSld.event.cancelBubble=3Dtrue
}
function ChangeClr( bg,clr )
{
e=3DPPTSld.event.srcElement
if( e.type=3D=3D"menuitem" && e.IsActive() ) {
e.style.backgroundColor=3Dbg
e.style.color=3Dclr
}
}
function M_HasPrevSld() { return( parent.HasPrevSld() ) }
function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() }
function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();=
PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() }
function M_True() { return true }
function M_End() { window.close( self ) }
function CreateMenuItem( node,text,action,eval )
{
var e=3DCreateItem( node )
e.type=3D"menuitem"
e.Action=3Daction
e.IsActive=3Deval
e.innerHTML=3Dtext
if( !e.IsActive() )
e.style.color=3D"threedshadow"
e.onclick=3DPerform
e.onmouseover=3DHighlight
e.onmouseout=3DDeselect
s=3De.style;
s.fontFamily=3DsFont
s.fontSize=3D"9pt"
s.paddingLeft=3D2
}
function CreateSeparator( node )
{
var sObj=3DCreateItem( node )
SetCMBorder(sObj,"menu","menu")
var s=3DsObj.style
s.borderTopColor=3D"threedshadow"
s.borderBottomColor=3D"threedhighlight"
s.height=3D1
s.fontSize=3D"0px"
}
function CreateItem( node )
{
var elem=3DPPTSld.document.createElement("DIV")
node.insertBefore( elem )
return elem
}
function SetCMBorder( o,ltClr,rbClr )
{
var s=3Do.style
s.backgroundColor=3D"menu"
s.borderStyle=3D"solid"
s.borderWidth=3D1
s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr
}
------=_NextPart_01C8328D.04E8EAD0
Content-Location: file:///C:/AD279A56/CoreLesson16_files/fullscreen.htm
Content-Transfer-Encoding: quoted-printable
Content-Type: text/html; charset="us-ascii"
PowerPoint Presentation
------=_NextPart_01C8328D.04E8EAD0--
Psychiatric factors associated with suicide disorders include major=
depression, mood (affective) disorders,
schizophrenia, anxiety, impulsive behaviour and sense of hopelessness in life.
Biological and med=
ical
markers include a family history of suicide and genetic conditions associated to
psychiatric illnesses. Severe and painful diseases are also associated with suici=
dal
ideation.
Life events such as
the loss of a loved one, an important day, legal or work-related problems, interpersonal conflict
and broken relationships have also been associated to suicide. A history of physical or sexual abuse,
being bullied or b=
eing
a perpetrator of bullying, and having been victim of intimate partner violence have also been associa=
ted
with suicidal behaviours. This highlights important interrelationships that exist between
interpersonal violence and
self-inflicted violence.
Conditions such as being in a stable relationship, bringing up chil=
dren
have been shown to
reduce the likelihood of suicide in some cultures. In some countries this relationship is reversed
such as in Pakistan and China.
Some important social and environmental factors associated with an =
increased likelihood of occurrence of
suicide include access to means, place of residence, immigration status, affiliation to a religion a=
nd
economic conditions.&=
#13;Access to means is frequently a strong
determinant of the method chosen for attempting or committing suicide. Countries where availability =
of
guns is widespread t=
end
to report suicides by firearms as a common method. Other methods include hanging, jumping =
from
heights drowning and using pesticides. Generally women use “softer” methods such as
medication overdose with
the exception of India where self-immolation is common among women.
There are also urban and rural differen=
ces.
Suicide rates tend to be higher in rural than in urban areas possibly because of higher social
isolation and greater
difficulty in detecting warning signs. In some rural areas of Europe and south-east Asia, the easy availabil=
ity
of pesticides provides easy access to means.
Differences between immigrants in some countries suggest strong
cultural factors
intervening in suicidal behaviour.
Countries that discourage or persecute
religious practices have been shown to report higher rates of suicide.
Unemployment has a=
lso
been associated with increased suicides.
Preventive activities are therefore directly related to some of the
factors previously
mentioned.
For example,
early identification and treatment of psychiatric disorders associated with suicide will reduce the=
m.
This also implies efforts to educate primary health care practitioners to diagnose and treat these
conditions.
Behavioural
approaches including discussion of previous or current suicidal behaviour (problem-oriented interventio=
ns),
shows promising results though not conclusive in terms of efficacy. A technique using cards with
immediate access to
services (on-call or hospitalization) has shown to have effect in <=
span
lang=3DEN-GB style=3D'font-family:Arial;mso-ascii-font-family:Arial;mso-bi=
di-font-family:
Arial;mso-hansi-font-family:Arial'>reducing first-time suicidal
behaviours.
Interventions
focusing on improving social relationships or maintaining existing ones have also been attempted =
but
not proved to reduce suicidal behaviours.
Suicide prevention centres are useful to identify high-risk populat=
ions
but have not
demonstrated positive or negative effects in changing suicidal behaviours.
Other community programmes include school-based interventions that =
can be useful when existence of adequate
referral protocols to health professionals are in place. Schools complement the prevention
activities of overburdened
health sectors.
Societal means that restrict access to means have shown an effect i=
n reducing suicides such as restricting
access to barbiturates or pesticides. The latter has been studied extensively=
in
Samoa where the introduction and the control of access to this chemical lead to an increase and
decrease respectively=
in
suicides using this method of poisoning. CO2 gas detoxification in the home in the UK le=
ad
to decreases in suicide using this method.
Restrictions of access to firearms by means of safe storage practic=
es
or restrictions=
to
ownership have proved effective in some countries.
In some cases media reporting of suicide can lead to emulation. Thi=
s highlights the importance of responsible
reporting techniques.
Community support groups for families affected by suicide are also =
important in addressing feelings associ=
ated
to the event.
Consequently, and based on the effectiveness of the previously
presented preventive
measures, several issues are important for improving our knowledge about suicide:
------=_NextPart_01C8328D.04E8EAD0
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for(ii=3D0;iiThe need for better data is imperative. Many countries greatly
underreport or do not re=
port
at all self-inflicted injuries. This is especially important when <=
span
lang=3DEN-GB style=3D'font-family:Arial;mso-ascii-font-family:Arial;mso-bi=
di-font-family:
Arial;mso-hansi-font-family:Arial'>addressing the issues of some minority
groups within nations.
Strengthening of surveillance activities on this topic is especially
important both for fat=
al
and non-fatal events. Additionally, information on social indicators and its subsequent linkage to
suicidal events can greatly improve the knowledge about the problem.
Research on the potential genetic aspects related to suicide should=
be encouraged as well as research focused =
on
the interaction between alcohol and depression, the role of hostility, aggression and impulsivity.&=
#13;
Better psychiatric treatment should be promoted through the develop=
ment
of improved
treatment protocols.
Environmental changes aimed at restricting access to means such as =
fencing of bridges, product modificatio=
ns,
monitoring of medications and restriction to firearms should be promoted.
Improved quality of services and evaluation of community efforts sh=
ould
also be promoted.=
' + ENDSHOW_MESG + '
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