Impact of postvention focused strategies on psychological markers among suicide attempters admitted in Government head quarters hospital at Erode

Sampoornam. W

Professor, Department of Mental Health Nursing, Annai JKK Sampoorani Ammal College of Nursing, Komarapalayam, India.

*Corresponding Author E-mail:

ABSTRACT:

Context: Postvention includes procedures to alleviate the distress of suicidally bereaved individuals. Methods: Total 70 subjects were interviewed before intervention by assessing background variables and clinical variables. The levels of psychological markers were assessed by using defeat scale, entrapment scale and adult suicidal ideation questionnaire. Experimental arm received postvention focused strategies sessions conducted for the period of 5 weeks. Face to face sessions were conducted in the first week for 3 times. Subsequent follow up sessions were conducted once in a week for the period of 4 weeks through phone communication. Control arm received standard methods of care. Posttest was conducted at the end of 5^th week by using the same assessment techniques in experimental arm and control arm. Results: Paired‘t’ test showed statistical significance in scaling down the psychological markers in experimental arm comparatively to the control arm among suicide attempters. Unpaired ‘t’ test showed statistical significance between experimental and control arm. Significant positive correlation was observed between the psychological markers in experimental arm. Non significant correlation was observed between the psychological markers in control arm. Conclusion: Postvention focused strategies was quite effective for curtailing psychological markers among suicide attempters.

KEYWORDS: Postvention, Defeat, entrapment, Suicidal ideation, Suicide attempters.

INTRODUCTION:

According to The World Health Organization, in India, suicide is an emerging and serious public health issue. Suicide rates in India have been rising over the past five decades (Swain, Prafulla Kumar, etal., 2021). Suicides during 2019 increased by 3.4% in comparison to 2018. Shockingly, every 3 seconds someone attempts suicide in India. It posits that experiences of defeat, triggered by stressful life events or other environmental precipitants, lead to entrapment and ultimately suicidal ideation (O Connor and Kirtley, 2018).

Postvention refers to a range of activities following a suicide. Suicide postvention is part of the overall spectrum of suicide prevention activities. Although postvention occurs after a death by suicide, it is preventive in that it reduces suicide risk by identifying and supporting the emotional and mental health needs of the survivors. Postvention includes procedures to alleviate the distress of suicidally bereaved individuals, reduce the risk of imitative suicidal behavior, and promote the healthy recovery of the affected community.

METHODS:

After obtaining written informed consent, suicide attempters who fulfilled the inclusion criteria was recruited and enrolled in the study. The total sample size was 70 suicide attempters. Study subjects were assigned randomly to either experimental arm (n=35) or control arm (n=35).

Total 70 subjects were interviewed before intervention by assessing background variables like age, gender, education, occupation, pattern of work, religion, marital status, annual income of family, support system, diet preference, leisure time activities. Clinical variables such as cause of current suicide attempt, number of previous suicide attempts, previous history of suicide attempt in family, sleep pattern, use of psychoactive substances and blood group was also appraised. The levels of psychological markers were assessed by using defeat scale, entrapment scale and adult suicidal ideation questionnaire.

Experimental arm received postvention focused strategies ie individualized crisis intervention sessions in which the subjects and caregivers were included. The sessions of postvention focused strategies were introduction, intervening the psychological trauma, prevention of suicide and follow up sessions. The sessions were conducted for the period of 5 weeks. Face to face sessions were conducted in the first week for 3 times. Subsequent follow up sessions were conducted once in a week for the period of 4 weeks through phone communication.

Control arm received standard methods of care. Posttest was conducted at the end of 5^th week by using the same assessment techniques in experimental arm and control arm.

RESULTS:

Paired‘t’ test showed statistical significance in scaling down the psychological markers in experimental arm (t=10.13) comparatively to the control arm (t=2.15) among suicide attempters. Unpaired ‘t’ test showed statistical significance between experimental and control arm (t=11.40).

Karl Pearson correlation coefficient was used to correlate psychological markers in experimental arm and control arm. Significant positive correlation (r= 0.87) was observed between the psychological markers in experimental arm. Non significant correlation (r= 0.05) was observed between the psychological markers in control arm.

DISCUSSION:

Harrington LaMorie J, et.al., (2018) conducted a study on surviving families of military suicide loss by exploring postvention peer support. The United States military began to experience a steady increase in suicide rates across all service branches at the inception of the wars in Afghanistan and Iraq. As the number of suicide deaths increased, so did the number of affected survivors who seek postvention support.

Unique issues that accompany suicide death may expose survivors to a more distressing and complicated grief process. Peer support has clinically been observed to be widely utilized by suicide loss survivors. This article explores unique issues accompanying military suicide loss, potential benefits of postvention peer-based support, clinical considerations and future directions.

Jordan JR, (2017) conducted a systematic review on postvention as the suicide prevention strategy. There is now convincing empirical evidence that exposure to suicide increases the risk of subsequent suicide, as well as other negative mental health sequelae, in those who have been exposed. This article provides a review of this empirical evidence.

It also concludes that this substantial evidence base makes the compelling case that all suicide prevention programs need to include postvention services as a direct form of suicide prevention with a population of people known to be at heightened risk for suicide themselves, suicide loss survivors.

Andriessen K, et.al., (2017) conducted an online survey to take stock of ongoing studies and to inquire about future research priorities regarding suicide bereavement and postvention. The questionnaire was accessed 77 times, and 22 records were included in the analysis. The respondents provided valuable information regarding current research projects and recommendations for the future. Bearing in mind the modest number of replies, all from respondents in Westernized countries, it is not known how representative the findings are. The survey generated three strategies for future postvention research, increase intercultural collaboration, increase theory driven research and build bonds between research and practice. Future surveys should include experiences with obtaining research grants and ethical approval for postvention studies.

CONCLUSION:

Postvention focused strategies was quite effective for curtailing psychological markers among suicide attempters.

REFERENCES:

1. Suicide - India. who.int. Retrieved 7 September 2021.

2. Swain, Prafulla Kumar; Tripathy, Manas Ranjan; Priyadarshini, Subhadra; Acharya, Subhendu Kumar (29 July 2021). "Forecasting suicide rates in India: An empirical exposition". PLOS ONE. 16 (7): e0255342.

3. Accidental Deaths and Suicides in India – 2019. National Crime Records Bureau. ncrb.gov.in. Retrieved 7 September 2021.

4. O’Connor, R. C., and Portzky, G. (2018). The relationship between entrapment and suicidal behavior through the lens of the integrated motivational-volitional model of suicidal behavior. Curr. Opin. Psychol. 22, 12–17. doi: 10.1016/j.copsyc.2017.07.021

5. Harrington-LaMorie, J., Jordan, J. R., Ruocco, K., and Cerel, J. (2018). Surviving families of military suicide loss: Exploring postvention peer support. Death Studies, 42(3), 143–154

6. Jordan JR. Jordan JR. Postvention is prevention-The case for suicide postvention. Death Stud. 2017 Nov-Dec;41(10):614-621.

7. Andriessen K, Castelli Dransart DA, Cerel J, Maple M. Andriessen K, et al. Current Postvention Research and Priorities for the Future. Crisis. 2017 May;38(3):202-206.

Received on 25.10.2022 Modified on 16.11.2022

A and V Pub Int. J. of Nursing and Medical Res. 2022; 1(1):5-7.

DOI: 10.52711/ijnmr.2022.02