Motives and Psychosocial Stressors in Parasuicides: Comparison of Self-Poisoners and Self-Cutters

Understanding the motives or intentions and what premeditated deliberate selfharm is an important aspect in dealing with parasuicides. The aim of this study was to compare motives and psychosocial stressors between deliberate self-poisoners and self-cutters. Methods: 77 parasuicides consecutively admitted to University Malaya Medical Center (UMMC) were included in the study. They were assessed on socio-demographic profiles and clinical history. They also completed a questionnaire related to the suicide attempt such as the method, the motives and the psychosocial stressors. The motives and psychosocial stressor were than compared between those who had deliberately cut themselves (n=25) and those who had taken overdoses or poisons. Results: More patients who cut themselves than those who took overdoses said that they had wanted to die (56.7% versus 43.2%, p <0.001) and had wanted to punish themselves (66.7% versus 33.3%, p<0.01). More self-poisoners reported that they wanted to find out if someone really loved them (92.3% versus 7.7%, p<0.05) and had wanted to get some attention (87.0% versus 13.0%, p<0.01) as compared to selfcutters. 70% of the psychosocial stressors were due to relationship problems. There were significant differences between the motives for selfpoisoning and self-cutting. The often impulsive nature of these acts means that prevention should focus on encouraging alternative methods of managing distress, problem-solving and help-seeking before thoughts of self-harm develop

The traditional belief system in relation to mental health and psychiatric services in Sudan

Traditional healers’ centres may constitute community resources for people with a mental illness. Traditional healers often have the respect of the population they serve. Many low-income countries are seeking to integrate mental health into their mainstream health services and primary healthcare, so as to decrease the duration of untreated mental illness. Traditional healers can help to meet these needs. A series of four studies has been conducted in central Sudan. In-patients with mental disorders undergoing treatment with traditional healers were recruited, as well as some of the healers themselves. The resulting observations should help practitioners trained in ‘Western’ psychiatry to better understand traditional healing as an alternative healthcare system. The results should contribute to current debates on whether or not traditional healers in Africa should be officially recognised as healthcare providers. They should also deepen social scientists’ understanding of the role of culture in mental health and help policy-makers to improve mental health services

Collaboration between traditional healers and psychiatrists in Sudan

The importance of traditional healing in low- and middle-income countries cannot be underestimated. It is generally perceived as part of the prevailing belief system and traditional healers are often seen as the primary agents for psychosocial problems in these countries; estimates of their service share range from 45% to 60% (World Health Organization, 1992).The World Health Organization (2000) estimated that 80% of people living in rural areas in low- and middleincome countries depend on traditional medicine for their health needs.In Sudan, a country with a mixed Arab/African culture,traditional healing is the most common method of treating people with mental illness, mostly because it is usually far cheaper than medical treatment (Elsafi & Baasher, 1981–94) but also because of the inaccessibility of medical services and lack of awareness among the population

The characteristics of people with mental illness who are under treatment in traditional healer centres in Sudan

Aims: To determine the general characteristics of people with mental disorders in traditional healers centres in Sudan in terms of sociodemographic profile, common clinical presentations and diagnostic features, and to look at the treatment methods and intervention procedures used in these centres for treating people with mental illness. Methods: This is a descriptive cross-sectional study using both quantitative and qualitative research methods. All inpatients with mental illness (405) from 10 selected traditional healers centres in Sudan who gave consent were interviewed, using a specially designed questionnaire and the Mini International Neuropsychiatric Interview (MINI). Results: Most of the visitors to the centres were from central Sudan with a mean age of 31 years, illiterate or with only a primary basic education, male and jobless. The average mean duration of stay in the traditional healer centre was five months and the mean duration of untreated illness before coming to the centre was 13 months. Only 17% reported a history of alcohol abuse and only 11% of drug abuse. The most common prevalent diagnosis was psychotic disorder. Conclusion: This study improves the understanding about what types of people with mental illness are treated at these traditional healer centres and gives recommendations that can help in improving the quality of services in these centres. It can probably be used in building bridges of collaboration between these centres and the available mental health and psychiatric services in Sudan, especially at primary healthcare level