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Introduction The feelings experienced after a suicide attempt by the individual and the reaction of close relatives or friends to attempt is important in designing preventive mechanisms. Objective To describe the experience of the patient after the previous suicide attempt and the reaction of close relatives or friends to the previous suicide attempt. Method From 668 presented with attempted suicides presented to National Hospital of Sri Lanka (April to December 2002), 300 were randomly selected and interviewed using a pretested questionnaire. Results Previous suicidal attempts were present in 29 (9.7%) out of total 300 attempted suicides. The feelings following the previous suicide attempt were as follows: 19 felt pity (65.5%), 16 felt embarrassed (55.2%), 13 felt ashamed (44.8%), 11 felt afraid (37.9%), 10 felt angry (34.5%), 4 felt released (13.8%) and 2 felt proud (6.9%). Regarding reaction of close relatives or friends to last attempt, 25 (86.2%) of patients felt that others showed pity for patient, 11 (45.8%) patients felt that some people showed understanding, 16 (57.1%) felt that no one showed anger or irritation, 21 (75%) felt that others did not show embarrassment or avoided them, 24 (85.7%) felt no body laughed at them, 23 (82.1%) felt others did not ignore them. Conclusion The feeling following the suicidal attempts was of shame and embarrassment. The close relatives or friends of attempted suicides do not show negative emotions.

ObjectivesTo describe the repetition of suicidal attempts and the awareness of suicidal behaviour among close people.MethodsFrom 668 attempted suicides presented to National Hospital of Sri Lanka (April to December 2002), 300 were randomly selected and interviewed.ResultsPrevious suicidal attempts were present in 29 (9.7%) among which six have attempted more than twice. Majority (25, 86.2%) were deliberate self-poisoning (DSP) while few were intentional self harm (4, 13.8%). Knowledge of family or close friend who committed suicide was reported by 96 (32%). There were 13 (4.4%) reported suicides in biological family while 46 (15.4%) were close friends and 42 (14%) were neighbours. Among the known persons of DSP, drugs were consumed by 30 (43.5%) and pesticides by 26 (37.7%). Among intentional self harm the commonest method used was fire (11, 45.8%) and hanging/strangulation (07, 29.2%). The time lapse between the index suicidal attempt in the subjects was within 1 year of the suicidal attempt of the family member or friend in 45 (41.3%) of those who reported knowledge of a family member or close friend who committed suicide.ConclusionThe number with past suicidal attempts in our study is 10% which is a contrast to 54% reporting a previous suicide attempt in the WHO/EU multi-centre study on parasuicide. A total of 33% reporting knowledge of a close friend relative or neighbour who attempted suicide may indicate a strong influence of models in suicidal behaviour.

Objectives To describe characteristics of patients admitted to National Hospital Sri Lanka (NHSL) following attempted suicide. Methods Trained researchers identified all patients admitted following attempted suicide to NHSL from April 2002 to April 2003. A pretested questionnaire was used to collect relevant information. Results Of 1067 cases, 593 (55.6%) were females, 183 (61%) were less than 24 years of age, 609 (57.8%) single, 845 (83.9%) had received up to secondary education, and 448 (44.9%) were in full time employment. Mean duration of admission was 82.38 h. Case death rate was 4.6% (49 deaths). There were 965 (91.8%) deliberate self-poisoning among which 316 (30.1%) ingested pesticides; 222 (21.1%) non-opioid analgesics, antipyretics and antirheumatics, 130 (12.4%) other drugs, 135 (12.8%) other noxious substances. Substances used in self-poisoning were 197 (20.4%) Paracetamol, 126 (13%) Run-rat, 41 (4.2%) Kerosene oil and 39 (4%) Diazepam. Two hundred and three (30%) were referred for psychiatric care and none to police. Conclusion Substances used for attempted suicide have changed, with an increased use of medicines, in contrast to organophosphates reported as commonest substance in 1976. Paracetamol has emerged commonest substance and necessitates policies for minimising access to substance, along with developing guide-lines for management. A change in referral pattern was seen. An audit of records in 1994 indicated 90% of persons were referred to police, while in this study police referral was not observed and follows decriminalisation of attempted suicides.

Objective To determine effectiveness of an intervention and follow-up of patients admitted following attempted suicide. Methods 300 patients admitted following attempted suicide allocated to an intervention (a session of psycho-education) and follow up or treatment as usual group using random numbers. The inclusion criteria included age above 12 years, having telephone access, and agreeing to participate in the research. Those residing in the Colombo Municipal area who did not have telephone access were given an additional option of home visits by area family health worker (FHW). Follow up was by telephone interviews or FHW visits while non-intervention subjects were traced at 18 months. Results 668 persons were initially interviewed and 300 recruited. The intervention arm had 151 allocated of whom 96 (64%) received telephone follow up and 55 (36%) received FHW visits, while in the non-intervention group this was 115 (77.1%) and 34 (22.9%), respectively. At 18 months there were 32 (10.6%) drop outs, with 135 in the intervention group while 132 in the non-intervention group. In the non-intervention group 39 (29.5%) requested support, 35 (26.5%) sought support and there were three (2.3%) suicides, five (3.8%) re-attempted suicides while in the intervention group these were 81 (59.3%), 76 (56.3%), one (0.7%) and three (2.2%), respectively. Conclusion Intervention group requested more support and had a lower trend towards repeat suicides. Telephone and FHW follow-up is a feasible method to provide information and support.