Youth Suicide Strategy of Aboriginal Community - Case Study Example

?Youth Suicide Strategy of Aboriginal Community Youth Suicide Strategy of Aboriginal Community Case Study Susan Smith, having moved to Aboriginal community to participate in the development of the community’s youth suicide development strategy encounters the following problems, most of her clients are Aboriginal who seem to be there by choice, most but do not look her in the eye and are reluctant to talk. Women are introverted, say very little to her but later talk together outside the clinic. Men treat her as a child and are determined to talk about their physical health and their families not about themselves personally. She also senses segregation within the community between the Aboriginal and non-Aboriginal people. Many of her contributions are ignored and senses gender hierarchy segregation. Due to this, she starts questioning her own professional competence and how to apply her knowledge and skills when treating new clients. This angers Susan and makes her feel isolated. She decides to discuss her concerns with Daisy, who seems very close to the locals and agrees to mentor Susan. Introduction The society has been found to be highly in denial of the worrying trends. People believe in various myths, a reason why they could have opted not to talk to Susan. There are believes that people who talk about suicide are trying to get attention. People who contemplate on committing suicide after making the decision cannot be stopped from taking away their lives. The assumption that people who commit suicide are crazy and weak is wrong. Other people believe that those people who talks about suicide have the intention of manipulating others is not true. Most of the communities believe that the young people do not think about suicide because they have the whole life to live. Research has revealed a worrying trend on the levels of suicide among the adolescents and young adults. Globally, youth have been found to be faced with a high risk of committing suicide than the old people and the children. The age of vigorous changes in the physiology of the youth and fear of maturity are a reason for this trend. Moreover, the various issues affecting them have been found to have adverse effects, yet more dangerous effects on them. Increased pressure from the society that includes expectations, dreams and ambitions also contribute to the high cases of risk among the youth. Recently, there has been a sharp rise in the number of suicides among the youth around the world. Startling statistics have been reported in various countries due to the sharp increase in cases of suicide. While a number of people have been unsuccessful in suicide attempts, others have successfully committed suicide. A lot of studies have been conducted to determine the risk factors that cause suicide among the adolescent people. One death can have a significant impact on the population health data due to low numbers of this population within the general Australian population context. However, in areas where Aboriginal communities reside, suicide figures are very high. Their lifestyles, the community and society beliefs have a major contribution to the high cases of suicide. This paper will look at the various causes of the increased cases of suicide among the youth in Aboriginal community and the various interventions of dealing with the cases of suicide. Literature Review Research based on population of young people has identified recognized risks for suicide attempts. They include gender, race or ethnicity, historical cases of depression, hopelessness, alcohol use and drug abuse, sexualisation and violence. Factors that are likely to trigger these risks are underlying psychological stress such as marginalization, isolation, and rejection. Among other factors, homosexuality has been suggested as a major contributor for suicide. Gay, lesbianism and bisexuality have not been proven to have successful influence on suicide. However, suicides related to gay youth have proved to be difficult due to the social stigma associated with the topic (Brausch & Gutierrez 2010). Suicide is a complex process that is defined as a conscious act of self-induced annihilation which is understood as a multi-dimensional malaise in a needful individual who defines an issue for which the suicide is perceived as the best known solution. In 2009 alone, about 2,132 deaths were reported in Australia which is ranked as the 14th leading cause of all deaths. Over three quarters of the said deaths were males while the rest of the deaths reports were females. In order to understand suicide and non-suicidal self-injury For Smith to understand the issues affecting the people of Aboriginal, she had to understand crucial elements useful in preventing suicide. She had to gain proper understanding and knowledge of suicide issue. The definition of the term suicide and how it relates to the people is crucial for a Smith. Considering individual or community prevalent attitudes relating to suicide and their impact on intervention should be considered. Identification of the suicidal risks among the people is the next step. This is perhaps the most important part of the process as it deals with diagnosis of the individual risks affecting the society. Developing a risk assessment and intervention framework and deciding on the most suitable intervention skills is the most appropriate method of approaching the problem of suicide. Smith should thus be knowledgeable about community resources and promote interagency networking. The last step is providing a response to the self-harming behaviour among the people (Granello, 2010). According to Joiner (2010), stress vulnerability model divides risk factors into biological factors, psychological distress and social or vocational factors which are embedded within the biological, psychological and social and vocational protective factors as the methods of prevention. The model aims at ensuring that all aspects of a mental illness have been diagnosed. The model offers the client with the best opportunity to recover from the illness. It is implemented by either an individual nurse or through combined efforts of a team. Biological risk factors for suicide include low cerebrospinal fluid 5-hydroxyindolacetic levels of acid, hypothalamic-pituitary-adrenal axis deregulation, low levels of blood cholesterol, medical or neurological illnesses that include multiple sclerosis, stroke, Huntington disease and epilepsy and cigarette smoking. Biological preventive measures of suicide include antidepressants and antipsychotics prescription. The methods enable the understanding of biology of illness. The last result of biological treatment is hospitalization of the patient (Murdoch, 2010). Physiological risk factors affecting suicide include the acceptability of suicide, childhood history of physical abuse or sexual abuse, discouraged behaviour of geared at seeking help, traits of aggressiveness, pessimism concerning the future, hopelessness, low self-esteem, and poor access to psychiatrist attention. Psychological measures include individual psychotherapy and family therapy. The family plays a big role in correcting a suicidal case. Family members offer emotional support to the patients. Proximal stressing factors that are indicative of increased levels of risk among the adolescent youth include problems relating to relationships, financial problems, and a personal or family history of suicide, major depression and substance abuse. A clinical evaluation of the both medical and psychiatrist history of a client in relation to the current state that they are in is the crucial yet essential element of suicide assessment process. For a successful study, Smith was able to successfully identify and evaluate both risk and protective factors so as to determine the immediate safety and design the best method of diagnosis and treatment. Social measures of reducing suicide cases include rehabilitation, community re-integration and vocational and educational training and support from the members of the community. Major common health problems that affect Aborigines include circulatory and respiratory disorders, ear and eye diseases, communicable diseases, intestinal infections and infestations, skin infections and infestations, STDs, mental health, alcohol abuse, petrol inhalation and dental caries. Such a diagnosis is important in preventing secondary suicide prevention. Researchers have found a number of preventive strategies that could be used for secondary preventive measures of suicide. These include pharmacological interventions, psychological interventions, follow-up care, reduced assess to lethal means and responsible media reporting on the issue of suicide. Although antidepressant medications have been used widely in pharmacological interventions for secondary suicide prevention, they have showed mixed results in the success of reducing suicide. Suicidal patients have been found to benefit from therapies that address repetition of suicidal thoughts and behaviours, adherence to treatment and other factors associated with suicide. Follow up care in a great way enables the patients to adherence to the therapy after any suicidal attempts. Social factors addressed in follow up treatment include family support within the hospital and at home or the assigned person who is supposed to monitor the patient. Methods of suicide vary from place to place in relation to the availability. Most common methods used by suicide victims include hanging, poisoning and the use of firearms. A myriad of factors influence the likelihood of suicide among people in the society which include of religion, honour, and meaning of life. Biblically, suicide is seen as an offence towards God due to the sanctity associated with life. Although studies based on population have been found to have an association between sexual orientation, risk of suicide, and other risk associated factors, the complexity of these relationships have not been well described. Suicide is caused by a number of factors which are either economically or socially related. Most cases of suicide are associated with mental disorders. Almost half of all people who die of suicide may have an association with major disorders with depression. A person who exhibits such forms of disorders or any other form of mood disorder including bipolar has a higher likelihood of committing suicide. Drug and substance abuse is the second most causal factor that causes suicide. Both chronic misuse of substances and acute substance intoxication are factors associated with suicide. If personal grief is incorporated into the equation, the risk of an individual increases substantially. Moreover, substance abuse is considered to be a major contributing factor to committing suicide. The major affected types of drugs include excessive use of alcohol, marijuana, cocaine, crack, steroids, inhalants, and injectable. Other illegal drugs include LSD, PCP, ecstasy, mushrooms, speed, ice or heroine. The past usage and the trend of the people who use these drugs are likely to determine their likelihood of committing suicide. Most people who commit suicide have been found to have had been under the influence of either alcohol or benzodiazepines. Alcohol abuse has been to be the highest contributing factor of suicide cases. Societies and regions which have high rates of alcohol consumption have been found to have high rates of suicide than those that have low rates of alcohol consumption. Alcoholic people who have the highest possibility of committing suicide have to be male people. Misuse of cocaine and methamphetamines also had a high contribution suicide cases. However, people at the withdrawal stages of cocaine use are at a high risk of committing suicide. What researchers have found to be a peculiar reality is the increase in suicide cases among cigarette smokers. The correlation between the two has remained a mystery as evidence data cannot be linked with the trend. Only hypothesis suggestions have been linked with the trend relates to the health dangers which are associated with cigarette smoking. Psychological conditions have also been found to possess relative influence on the youth. Hopelessness, increased pleasure in life, depression and anxiousness are all causes of suicide among the youth especially the adolescents. Inability to solve problems and the lack of experience in solving problems and lack of proper understanding of issues that affect people highly contribute to cases of suicide. Sometimes, the youth may find themselves as being a bother to the adults, which largely contributes to high cases of suicide. Stress which may be as a result of loss a family member or relative, a friend or social isolation increases the risk of suicide among the adolescents. The single but people who are at the age of marriage are too faced with a high risk of suicide. Lack of emotional support is perhaps a major contributing factor to this worrying trend. Highly religious people are less likely to commit suicide than the unreligious people. While this is not attributed to the absence of stress among the religious people, the negative association of suicide among the religious people is a major reason for this trend. Muslims have been found to be less prone to suicide when compared to other forms of religion due to their astute faith and religious beliefs (Boyd, 2007). Silenzio et al. (2007) identifies five sexual behaviours that determine the likelihood of an adolescent committing suicide include how sexually active a person is, or the number of sexual partners a person has had intercourse with. The use of drugs or alcohol before sexual intercourse is a big consideration. The likelihood of a person having had ever been pregnant or not determines their level of committing suicide. Same gender related sexual experiences affect the level of the adolescent suicide. A number of remedies have been proposed to reduce the number of suicide cases among the adolescent youth. Although screening is argued to have a big impact on reducing cases of suicide, it does not offer full solution to the problem. Cases of people testing positive to the screening tool and yet do not commit suicide have been found to exist. This method has however been found to have significant mental health care resource utilization. Experts however recommend that assessing the people who are at a higher risk of suicide is very important in saving lives of the people (Verona & Javdani, 2011). Psychiatrists largely recommend that people with high risks of suicide to be admitted in wards either voluntary or involuntary. Such people should be kept away from objects that are likely to be used to cause harm to them. However, the practice has not been found to have a lot of effect as the people, once set free will still attempt to commit suicide. The most effective remedy for mental health cases is treatment of the mental problem which is likely to solve the problem completely. According to Boyd (2007), gender is a major contributing factor to cases of suicide among the people in any region. Gender influence cuts across all age groups but is more prevalent among the adolescent youth. Male are four times likely to commit suicide than women. However, women attempt suicide around three to four times more than men. The fear of death and grief that they are likely to leave behind after death is the biggest consideration which makes women opt not to commit suicide. The means of committing suicide is too a major cause of this trend. While men choose lethal means of taking away their lives, women opt for more soft means that end up being abortive. Ramey, et al., (2010) tested three methods that are important in reducing the number of suicide behavioural cases and real cases of suicide. They include early intervention of the various cases seeks to link clients with other people which enable them receive social support. Moreover, early intervention of suicidal risk cases warrants immediate support from workers that leads to referral counselling which leads to effective intervention. There are a number of reasons that make early intervention important to the individuals. It leads to less suicidal behaviour, hence reduced cases of suicide. Zivin et al. (2007) notes that the main objectives and rationale of workshops created to prevent suicide is to develop an understanding which reduces the possibility for contagion in schools or in the community setting. Post prevention provides a broad support base that is highly alert to the aspects of risk. Individuals receive counselling as a means of achieving social support. Primary prevention is aimed at reducing the stressors and improving the coping strategies as well as resilient behaviours among the individuals. Secondary suicide prevention that aims to reduce the likelihood of suicide attempts by high risk patients is very important yet it has not been given the desired attention that it deserves. Partially, this is because research into secondary prevention is on its initial stages of its application (Power & McKeon, 2012). Various nursing interventions have been put forward for the various groups in a suicidal case. In an attempted suicide, the nurse should assess and treat any physiological injuries through wound care and administer antidote in cases of drug overdose. In recuperation process, all weapons, blades, cords, strings, plastic bags, pills or liquids should be kept away. The nurse should refer the patient to the psychiatrist. Emotional support from the family is yet another intervention that is likely to help the patient in the recovering process. Family and friends are a major source of this form of support. The community forms part of the support team. The nurse can easily ensure that a patient is receiving emotional support by carrying out after clinical follow up. Conclusion Suicide is currently referred to as one of the major causes of death among the adolescents in Aboriginal community. The weird behaviours exhibited by the residents of the community towards Susan can be said to have been as a result of the myths associated with suicide. Most people do not feel free ailing to strangers about the various issues that affect them. They tend to shy away from them, opting to remain mum on the issue. Perhaps the biggest challenges that Susan faced were as a result of victimization of the people of one community by others. The various risks associated with adolescent youth are classified as biological, social or physiological. Early intervention and preventive measures are essential in reducing the number of suicide cases among the youth in Aboriginal community. To be successful in her assignment, Susan ought to have taken into account the various suicide risk factors that are associated with the people of the community. Demystifying the myth associated with suicide in the community will be helpful in acquiring the best support from the society members. References Top of Form Boyd, M. (2007). Psychiatric nursing. Philadelphia, Pa: Lippincott Williams & Wilkins. Brausch, A. M., & Gutierrez, P. M. (2010). Differences in non-suicidal self-injury and suicide attempts in adolescents. Journal of Youth and Adolescence, 39(3), 233-42. Retrieved from http://search.proquest.com/docview/204523123?accountid=45049 Granello, D. H. (2010). The process of suicide risk assessment: Twelve core principles. Journal of Counseling and Development : JCD, 88(3), 363-371. Retrieved from http://search.proquest.com/docview/518797704?accountid=45049 Joiner, T. E. (2010). Myths about suicide. Cambridge, Mass: Harvard University Press. Murdoch, L. (2010). Suicide risk of anti-depressants compared in adolescents and children. Pharmacy Practice, 26(3), 22-22. Retrieved from http://search.proquest.com/docview/864907301?accountid=45049 Power, A. K., & McKeon, R. (2012). Preventing suicide is a national imperative. American Journal of Public Health, 102, 1-S7. Retrieved from http://search.proquest.com/docview/964002392?accountid=45049 Ramey, H. L., Busseri, M. A., Khanna, N., & Rose-Krasnor, L. (2010). Youth engagement and suicide risk: Testing a mediated model in a canadian community sample. Journal of Youth and Adolescence, 39(3), 243-58. Retrieved from http://search.proquest.com/docview/204523031?accountid=45049 Silenzio, Vincent M B,M.D., M.P.H., Pena, J. B., PhD., Duberstein, P. R., PhD., Cerel, J., & Knox, K. L., PhD. (2007). Sexual orientation and risk factors for suicidal ideation and suicide attempts among adolescents and young adults. American Journal of Public Health, 97(11), 2017-9. Retrieved from http://search.proquest.com/docview/215094639?accountid=45049 Verona, E., & Javdani, S. (2011). Dimensions of adolescent psychopathology and relationships to suicide risk indicators.Journal of Youth and Adolescence, 40(8), 958-71. doi:http://dx.doi.org/10.1007/s10964-011-9630-1 Zivin, K., Kim, H. M., McCarthy, J. F., PhD., Austin, K. L., M.P.H., Hoggatt, K. J., PhD., Walters, H., & Valenstein, M. (2007). Suicide mortality among individuals receiving treatment for depression in the veterans affairs health system: Associations with patient and treatment setting characteristics. American Journal of Public Health, 97(12), 2193-8. Retrieved from http://search.proquest.com/docview/215088884?accountid=45049 Read More