Charcoal burning is also popular for suicide pacts made on the internet [4]

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Media influence on suicide. Media's role is double edged

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Early intervention for psychosis in Hong Kong - the EASY programme

Aim: This article aims to describe the Hong Kong experience in developing and implementing an early psychosis programme. Methods: In 2001, the Early Assessment Service for Young People with Psychosis programme was launched in Hong Kong, providing both educational and service components. Public education includes promotion of timely help-seeking, accessible channels to service and knowledge of psychosis. The 2-year phase-specific intervention includes intensive medical follow-up and individualized psychosocial intervention. The programme has adopted the case-management approach, in which case managers provide protocol-based psychosocial intervention. The programme collaborates with non-governmental organizations and community networks in the provision of rehabilitation service. Results: An average of over 600 young patients enter the programme for intensive treatment each year. Based on preliminary data from a 3-year outcome study, patients in the programme have remarkable reductions in hospital stay accompanied by improvements in vocational functioning. Conclusions: The results suggested that the programme improved patients' outcome. Additional costs such as extra medical staff and medications may be offset by the shortened hospital stay. Further directions in early intervention are also discussed. © 2010 Blackwell Publishing Asia Pty Ltd.postprin

Suicide in response to changing societies

Suicide is a major health problem for youths, and existing studies focus mainly on psychiatric aspects of suicide. This article brings a global perspective to youth suicide, with emphasis on the effects that local sociocultural factors and the transformation of societies have on this problem. This phenomenon is illustrated by the case of China and its comparisons with findings from the West.link_to_subscribed_fulltex

Charcoal-burning suicide in post-transition Hong Kong

Background: Charcoal-burning, a new suicide method, emerged in Hong Kong during the latest economic recession. Within 2 months charcoal-burning had become the third most common suicide method. Aims: To examine the characteristics of suicides by charcoal-burning, and to delineate the pathways linking macro-level economic and social changes with the subjective experiences of those surviving a charcoal-burning suicide attempt. Method: Both quantitative and qualitative methods were used. In the coroner's records study, the first 160 cases of suicide by charcoal-burning were compared with a control group. In the ethnographic enquiry, we interviewed 25 consecutive informants who had survived serious suicide attempt using charcoal-burning. Results: People who completed suicide by the charcoal-burning method were more likely to have been economically active and physically healthy, and were less likely to have had pre-existing mental illness. Charcoal-burning suicide was associated with overindebtedness. Media reports were pivotal in linking overindebtedness and financial troubles with charcoal-burning. Conclusions: The political economy of suicide by charcoal-burning illustrated how historical, socio-economic and cultural forces shaped the lived experience that preceded suicide.link_to_OA_fulltex

Burning charcoal: A novel and contagious method of suicide in Asia [6]

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Media influence on suicide [1] (multiple letters)

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Tackling stigma and promoting recovery through art: The graffiti project

Stigmatizing attitudes and misconceptions about people with severe mental illnesses such as psychosis, severely affect the lives of individuals with these conditions. Research suggests that members of the general public who have more knowledge about mental illness and more personal contact with those affected, are less likely to endorse stigmatising attitudes. Service users themselves also place great importance on social contact with peers as an essential part of their recovery. A school-based project aimed at tackling stigma and facilitating contact between service users and peers within the North East of England is described in detail. The graffi ti project brought together young service users and pupils from a local school to plan, design and paint a run-down subway. Throughout the project, pupils were engaged in regular workshops by professionals from an Early Intervention service in order to discuss their proposed art work but to also learn more about psychosis. The completed subway now includes messages about mental health for passing commuters as well as creating a visual display outlining some of the young people’s personal experiences. The project was evaluated using a pre- and post-questionnaire of the students understanding and knowledge of psychosis, whilst a focus group discussion took place after completion of the subway. Qualitative data are presented from both of these methods and clearly outlines just how successful this project has been in tackling stigma and promoting recovery in the local community

A double-blind randomized placebo-controlled study of relapse prevention in remitted first-episode psychosis patients following one year of maintenance therapy

Background: Currently, there is no consensus regarding how long antipsychotics medication should be continued following a first/single psychotic episode. Long-term maintenance therapy carries side-effects and may not be necessary for some patients. Clinically, patients often request discontinuation after a period of remission. This is one of the first double-blind randomized-controlled studies designed to address the issue. Methods: Patients with DSM-IV schizophrenia and related psychoses (excluding substance induced psychosis) who remitted well following a first/single-episode and had remained well on maintenance medication for 1 year were randomized to receive either maintenance therapy with quetiapine (400 mg/day), or placebo for 12 months. Relapse was defined by the presence of (i) an increase in at least one of the following Positive and Negative Syndrome Scale (PANSS) psychotic symptom items to a threshold score (delusion, hallucinatory behaviour, conceptual disorganization, unusual thought content, suspiciousness); (ii) Clinical Global Impression (CGI) Severity of Illness 3 or above and (iii) CGI Improvement 5 or above. Results: 178 patients were randomized. 144 patients completed the study (80.9%). The relapse rate was 35% (31/89) for the maintenance group and 66% (59/89) for the placebo group (log-rank test, χ2 = 15.858, p < 0.001). Relapse was not related to age or gender. Other significant predictors of relapse include medication status, pre-morbid schizotypal traits, verbal memory and soft neurological signs. Conclusions: This study provides new data for relapse risks in remitted first-episode psychosis patients following 1 year of maintenance therapy. There is a substantial risk of relapse if medication is discontinued. Maintenance medication halves relapse rate. On the other hand, 34% of patients discontinued medication and remained well. Explorations of potential predictors of relapse may help further to estimate risks so that an informed decision about medication discontinuation can be made. Acknowledgement: This study was supported by an investigator-initiated study award from AstraZeneca and the Research Grants Council, Hong Kong (Project number: 765505).link_to_subscribed_fulltex