Bireysel Yaklaşımdan Toplumsal Yaklaşıma İntihar Önleme Araştırmaları

Year 2025, Volume: 17 Issue: 3, 623 - 632

Zeynep Uludağ , Esra Daşcı , Ali Eşref Keleş

https://doi.org/10.18863/pgy.1506867

Abstract

İntihar ve intihar teşebbüsü sonucu bireylerin gördükleri zararlar, dünya çapında binlerce kişiyi etkilemektedir. Bu sebeple, intihar eylemi gerçekleşmeden önce intiharı anlamak ve profesyonellerin müdahalesine yardımcı olmak önemlidir ve bunu sağlamak için birçok etken vardır. İntiharın önlenmesinde daha iyi bir sağlık politikası oluşturulabilmesi için çevresel faktörlerin yanı sıra bireysel faktörlere de odaklanan çalışmaların iyi anlaşılması gerekmektedir. Bu derlemede, intihar kavramı, intiharın yaygınlığı ve önlenmesi ile ilişkili bireysel ve sosyal faktörler araştırılmıştır. Böylece, bireyin yanı sıra bireyin yaşadığı ortamın da profesyonellerin intiharı anlaması açısından önemli olabileceği anlaşılmıştır. Ayrıca, insanların intihar ya da intihara bağlı kendine zarar verme vakalarını bildirmediği birçok durum söz konusu olduğundan intiharın yaygınlığı konusundaki bilgiler yetersiz olabilir. Bu nedenle tarama sürecinin genişletilmesi gerekmektedir. Sadece sağlık hizmetine başvuran kişileri değil, bölgedeki tüm insanları kapsayan tarama süreçleri gerçekleştirilmelidir. Ayrıca intiharı önleme yöntemleri de farklılık göstermektedir ve hem bireysel yaklaşımları hem de toplumsal yaklaşımları içermektedir. Bu yaklaşımların intiharı önleme çalışmalarına dahil edilmesi hayati önem taşımaktadır. Özellikle genç yetişkinlere ruh sağlığı sorunları ve intihar konusunda eğitim verilmesi intiharın önlenmesinde etkili görünmektedir. Ayrıca, intiharla daha etkili bir müdahale için kesişimsel yaklaşım ve önleyici sosyal tedavi, profesyoneller tarafından dikkate alınmalıdır. Son olarak intihar önleyici etkenlerden birinin de insanların kendilerini güvende hissettikleri yerel bölgelerde sağlık hizmetlerine erişim olduğu görülmektedir. Mevcut araştırma, bu bilgiler ışığında intihar, sağlık sistemleri, toplumsal yapılar ve potansiyel risk ve koruyucu faktörleri inceleyen kesişimsel intihar araştırmaları ile hassas grupları etkileyebilecek toplumsal ve kesişimsel faktörlere odaklanmayı amaçlamaktadır.

Keywords

intiharı önleme, kesişimsel yaklaşım, sosyal tedavi

Ethical Statement

etik beyan gerekmemektedir

Supporting Institution

destekleyen bir kurum yoktur

Suicide Prevention Research from Individual to Social Approach

Abstract

Suicide and self-harm are worldwide problems affecting thousands. There are many reasons and factors to be understood regarding suicide in order to help professionals to intervene before it happens. The studies focusing on individual factors as well as environmental factors need to be well understood in order to be able to make a well-established health policy that is better at preventing suicide. In this review, the concept of suicide, prevalence and prevention of suicide, and the factors related to it have been reviewed. Individualistic and social factors have been taken into account in order to understand the prevention of suicide. Consequently, both an individual and the environment people live in is often important for professionals to understand suicide. Also, the prevalence of suicide might be missing in many cases where people do not report suicide or self-harm related to suicide. Therefore, the screening process must be widened to cover all the people in the area rather than only people who report to the healthcare services. The prevention methods of suicide vary and include both individual approaches and social approaches; therefore, the implication of these various approaches into a prevention intervention seems to be vital. In that regard, education about both mental health problems and suicide, especially for young adults, seems to be effective in preventing suicide. Also, the intersectional approach and social cure for prevention should be considered by professionals for more effective suicide prevention intervention. Lastly, one of the factors seems to be the access to health services in local areas where people feel safe.

Keywords

suicide prevention, intersectional approach, social cure

References

• Abelson J, Miller FA, Giacomini M (2009) What does it mean to trust a health system: A qualitative study of Canadian health care values. Health Policy, 91:63-70.
• Ahmedani BK, Vannoy S (2014) National pathways for suicide prevention and health services research. Am J Prev Med, 47:222-228.
• Beautrais AL (2006) Women and suicidal behavior. Crisis, 27:153-156.
• Beck AT, Kovacs M, Weissman A (1979) Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol, 47:343-352.
• Bernal M, Haro JM, Bernert S, Brugha T, de Graaf R, Bruffaerts R et al. (2007) Risk factors for suicidality in Europe: results from the ESEMED study. J Affect Disord, 101:27-34.
• Bowe M, Gray D, Stevenson C, McNamara N, Wakefield JRH, Kellezi B e tal. (2020). A social cure in the community: A mixed‐method exploration of the role of social identity in the experiences and well‐being of community volunteers. Eur J Soc Psychol, 50:1523-1539.
• Bridge JA, Horowitz LM, Fontanella CA, Sheftall AH, Greenhouse J, Kelleher KJ et al. (2018) Age-related racial disparity in suicide rates among US youths from 2001 through 2015. JAMA Pediatr, 172:697-699.
• Carpiniello B, Pinna F (2017) The reciprocal relationship between suicidality and stigma. Front Psychiatry, 8:35.
• Cholbi M (2021) Suicide. In The Stanford Encyclopedia of Philosophy (Ed EN Zalta). Stanford, CA, Stanford University.
• Cramer RJ, Kapusta ND (2017) A social-ecological framework of theory, assessment, and prevention of suicide. Front Psychol, 8:300767.
• Crenshaw K (1989) Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. Univ Chic Leg Forum, 8:139-167
• Crenshaw KW (2013) Mapping the margins: Intersectionality, identity politics, and violence against women of color. In The Public Nature of Private Violence (Eds MA Fineman, R Mykitiuk):93-118. London, Routledge.
• Crenshaw KW (2017) On Intersectionality: Essential Writings. New York, The New Press.
• Demirkol ME, Namlı Z, Tamam L (2019) Psikolojik acı. Psikiyatride Güncel Yaklaşımlar, 11: 205-213.
• Durkheim E (2005) Suicide: A Study in Sociology. London, Routledge.
• Ferlatte O, Salway T, Oliffe JL, Kia H, Rice S, MorganJ et al. (2020) Sexual and gender minorities' readiness and interest in supporting peers experiencing suicide-related behaviors. Crisis, 41:273-279.
• Gilson L (2006) Trust in health care: theoretical perspectives and research needs. J Health Organ Manag, 20 359-375.
• Hawton K, Saunders KE, O'Connor RC (2012) Self-harm and suicide in adolescents. Lancet, 379:2373-2382.
• Holt-Lunstad J, Smith TB, Layton JB (2010) Social relationships and mortality risk: a meta-analytic review. PLoS Med, 7:e1000316.
• Iemmi V, Bantjes J, Coast E, Channer K, Leone T, McDaid D et al. (2016) Suicide and poverty in low-income and middle-income countries: a systematic review. Lancet Psychiatry, 3:774-783.
• Jetten J, Haslam C, Haslam SA (2012). The Social Cure: Identity, Health and Well-Being. New York, NY:Psychology Press.
• Jetten J, Haslam C, Haslam SA, Branscombe NR (2009) The social cure. Sci Am Mind, 20(5):26-33.
• Joe S, Bryant H (2007) Evidence-based suicide prevention screening in schools. Child Sch, 29:219-227.
• Kim JL, Kim JM, Choi Y, Lee TH, Park EC (2016) Effect of socioeconomic status on the linkage between suicidal ideation and suicide attempts. Suicide Life Threat Behav, 46:588-597.
• King CA, Grupp-Phelan J, Brent D, Dean JM, Webb M, Bridge JA et al. (2019) Predicting 3-month risk for adolescent suicide attempts among pediatric emergency department patients. J Child Psychol Psychiatry, 60:1055-1064.
• Klonsky ED, Qiu T, Saffer BY (2017) Recent advances in differentiating suicide attempters from suicide ideators. Curr Opin Psychiatry, 30:15-20.
• Marshall BD, Wood E, Shoveller JA, Patterson TL, Montaner JS, Kerr T (2011) Pathways to HIV risk and vulnerability among lesbian, gay, bisexual, and transgendered methamphetamine users: a multi-cohort gender-based analysis. BMC Public Health, 11:20.
• McCall L (2005) The complexity of intersectionality. Signs (Chic), 30:1771-1800.
• McCoy K, Kohlbeck S (2022) Intersectionality in pandemic youth suicide attempt trends. Suicide Life Threat Behav, 52:983-993.
• Mehtälä MA, Sääkslahti AK, Inkinen ME, Poskiparta ME (2014) A socio-ecological approach to physical activity interventions in childcare: a systematic review. Int J Behav Nutr Phys Act, 11:22.
• Niederkrotenthaler T, Gunnell D, Arensman E, Pirkis J, Appleby L, Hawton K et al. (2020) Suicide research, prevention, and COVID-19. Crisis, 41:321-330.
• Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM et al. (2013) Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents results from the national comorbidity survey replication adolescent supplement. JAMA Psychiatry, 70:300-310.
• O’Connor RC, Kirtley OJ (2018) The integrated motivational–volitional model of suicidal behaviour. Philos Trans R Soc Lond B Biol Sci, 373:0170268.
• O'Connor RC, Wetherall K, Cleare S, Eschle S, Drummond J, Ferguson E et al. (2018) Suicide attempts and non-suicidal self-harm: national prevalence study of young adults. BJPsych Open, 4:142-148.
• O'Keefe VM, Wingate LR, Cole AB, Hollingsworth DW, Tucker RP (2015) Seemingly harmless racial communications are not so harmless: Racial microaggressions lead to suicidal ideation by way of depression symptoms. Suicide Life Threat Behav, 45:567-576.
• Olson R (2022) Suicide and Language. Calgary, AB, Centre for Suicide Prevention.
• Opara I, Assan MA, Pierre K, Gunn III JF, Metzger I, Hamilton J et al. (2020) Suicide among Black children: An integrated model of the interpersonal-psychological theory of suicide and intersectionality theory for researchers and clinicians. J Black Stud, 51:611-631.
• Ozawa S, Sripad P (2013) How do you measure trust in the health system? A systematic review of the literature. Soc Sci Med, 91:10-14.
• Park S, Yim Y, Lee M, Lee H, Park J, Lee JH et al. (2024) Longitudinal trends in depression, suicidal ideation, and suicide attempts by family structure in South Korean adolescents, 2009–2022: a nationally representative serial study. Asian J Psychiatr, 104122.
• Patil PA, Porche MV, Shippen NA, Dallenbach NT, Fortuna LR (2018) Which girls, which boys? The intersectional risk for depression by race and ethnicity, and gender in the US. Clin Psychol Rev, 66:51-68.
• Pirkis J, Dandona R, Silverman M, Khan M, Hawton K (2024) Preventing suicide: a public health approach to a global problem. Lancet Public Health, 9:e787-e795.
• Rowe R, Calnan M (2006) Trust relations in health care—the new agenda. Eur J Public Health, 16:4-6.
• Shain B (2016) Suicide and suicide attempts in adolescents. Pediatrics, 138:e20161420.
• Sharaf AY, Thompson EA, Walsh E (2009) Protective effects of self-esteem and family support on suicide risk behaviors among at-risk adolescents. J Child Adolesc Psychiatr Nurs, 22:160-168.
• Snoberger D III (2020). The role of intersectionality on suicidal ideation in younger adulthood (Master’s thesis). Bowling Green, OH, Bowling Green State University.
• Song X, Liu X, Zhou Y, Zhang X (2023) Prevalence and correlates of suicide attempts in young patients with first-episode and drug-naive major depressive disorder: A large cross-sectional study. J Affect Disord, 340:340-346.
• Standley CJ (2022) Expanding our paradigms: Intersectional and socioecological approaches to suicide prevention. Death Stud, 46:224-232.
• Standley CJ, Foster‐Fishman P (2021) Intersectionality, social support, and youth suicidality: A socioecological approach to prevention. Suicide Life Threat Behav, 51:203-211.
• Standley CJ, Foster‐Fishman P (2021) Intersectionality, social support, and youth suicidality: A socioecological approach to prevention. Suicide Life Threat Behav, 51:203-211.
• Stanley B, Brown GK (2012) Safety planning intervention: a brief intervention to mitigate suicide risk. Cogn Behav Pract, 19:256-264.
• Stone DM, Jones CM, Mack KA (2021) Changes in suicide rates - United States, 2018-2019. MMWR Morb Mortal Wkly Rep, 70:261-268.
• Sutter M, Perrin PB (2016) Discrimination, mental health, and suicidal ideation among LGBTQ people of color. J Couns Psychol, 63:98-105.
• Van Orden KA, Cukrowicz KC, Witte TK, Joiner Jr TE (2012) Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire. Psychol Assess, 24:197-215.
• Walton QL, Boone C (2019) Voices unheard: An intersectional approach to understanding depression among middle-class black women. Women Ther, 42:301–319.
• WHO (2008) Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health: Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
• WHO (2021) Suicide rates. https://www.who.int/data/gho/data/themes/mental-health/suicide-rates. (Accessed 1.3.2024)
• Wiglesworth A, Clement DN, Wingate LR, Klimes‐Dougan B (2022) Understanding suicide risk for youth who are both Black and Native American: The role of intersectionality and multiple marginalization. Suicide Life Threat Behav, 52:668-682.
• Zou Y, Li H, Shi C, Lin Y, Zhou H, ve Zhang J (2017) Efficacy of psychological pain theory–based cognitive therapy in suicidal patients with major depressive disorder: A pilot study. Psychiatry Res, 249:23-29.