Culture and Self-Harm: Attempted Suicide in

Culture and Self-Harm considers the factors that attribute to the increased rate of self-harm and suicide among south Asians in London. It offers a new preventative strategy that will be of great interest and use to all mental health professionals.

Dinesh Bhugra is Professor of Mental Health and Cultural Diversity, Institute of Psychiatry, King's College London.

List of figures

x

List of tables

xi

Acknowledgements

xiii

Suicidal behaviour

1

(6)

Introduction

1

(1)

Factors in suicide attempts

2

(5)

South Asia and concepts of self

7

(24)

Introduction

7

(1)

Basic tenets of Hinduism and self

8

(2)

Basic tenets of Buddhism and self

10

(5)

Islam

15

(3)

Sikhism

18

(2)

Jainism

20

(1)

Concepts of self

20

(2)

Elements of self

22

(2)

Self and social context

24

(1)

Hinduism and suicide

24

(6)

Suicide among Buddhists

30

(1)

Conclusions

30

(1)

Definitions of suicidal behaviour

31

(8)

Introduction

31

(1)

Concept of body

31

(2)

Attempted suicide, parasuicide, or deliberate self-harm

33

(1)

Suicidal intent

34

(1)

Suicidal ideation

34

(1)

Mass suicide

35

(2)

Conclusions

37

(2)

The Sociology of self-harm: Contributions of Durkheim

39

(10)

Introduction

39

(1)

Classification of suicide

40

(3)

Egotistic suicide

43

(1)

Altruistic suicide

44

(1)

Anomic suicide

45

(3)

Conclusions

48

(1)

Social and personal factors and suicidal behaviour in adolescents

49

(24)

Introduction

49

(1)

Self-harm by adolescents

49

(2)

General risk factors

51

(2)

Psychiatric disorder and suicide

53

(1)

Repetition of attempts

54

(1)

Depression and suicide

55

(2)

Substance misuse

57

(1)

Personal factors

58

(1)

The role of gender

58

(2)

Ethnicity and attempted suicide

60

(2)

Cultural factors

62

(1)

Racism

63

(1)

Other factors

64

(8)

Conclusions

72

(1)

Women and suicidal behaviour

73

(8)

Introduction

73

(1)

Social factors and gender

74

(1)

Gender roles and gender socialisation

74

(5)

Conclusions

79

(2)

Sati and jauhar

81

(14)

Sati

81

(10)

Jauhar

91

(1)

Protest suicide

92

(1)

Conclusions

93

(2)

Attempted suicide in the Indian subcontinent

95

(16)

Introduction

95

(1)

India

96

(4)

Pakistan

100

(1)

Sri Lanka

101

(2)

Follow-up and repetition

103

(2)

Methods

105

(1)

Self-immolation

106

(2)

Organophosphorous compounds

108

(1)

Conclusions

109

(2)

Attempted suicide and the Indian diaspora

111

(14)

Introduction

111

(1)

Trinidad and Tobago

112

(2)

Fiji

114

(4)

Malaysia

118

(2)

UK

120

(3)

Conclusions

123

(2)

Rates of attempted suicide and social cultural factors in West London

125

(18)

Introduction

125

(1)

Method

125

(6)

Results

131

(5)

Interpretation of findings

136

(5)

Conclusions

141

(2)

Rates of attempted suicide in adolescents in West London

143

(20)

Introduction

143

(1)

Case-note study

144

(5)

Study of rates of attempted suicide by adolescents

149

(6)

Inferential analysis

155

(3)

Interpretations

158

(3)

Conclusions

161

(2)

Cultural identity and deliberate self-harm

163

(10)

Introduction

163

(2)

Development of the Asian Cultural Identity Schedule (ACIS)

165

(7)

Conclusions

172

(1)

Prevention strategies and community involvement

173

(42)

Introduction

173

(1)

Aims of the study

173

(1)

Overview of study methodology

174

(1)

Phase 1: Focus group study

175

(13)

Phase 2: Development of educational pamphlet

188

(1)

Phase 3: Pilot test intervention with educational pamphlet

189

(23)

Conclusions

212

(2)

Recommendations

214

(1)

Conclusions and the way forward

215

(10)

Conceptual model of aetiological factors

215

(3)

A new hypothesis

218

(6)

Conclusions

224

(1)

Appendix I: The Asian Cultural Identity Schedule (ACIS)

225

(22)

Appendix II: Educational pamphlet

247

(4)

Appendix IIIA: DHS Assessment by Clinicians (DACS) Adolescent version

251

(6)

Appendix IIIB: DHA Assessment by Clinicians (DACS) Adult version

257

(6)

References

263

(18)

Author index

281

(5)

Subject index

286

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Culture and Self-Harm: Attempted Suicide in South Asians in London

Summary

Author Biography

Table of Contents

Supplemental Materials

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Culture and Self-Harm: Attempted Suicide in South Asians in London

Summary

Author Biography

Table of Contents

Supplemental Materials

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