Clinicians should assess the effect of stigma as part of the standard work-up for patients with mental illness, and help patients and family members reduce the effect of stigma on their lives.

Ideas about what constitutes recovery need to take account of patients' views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of medical staff.

No abstract

This article reports on a sample of 147 women under age 35 living in rural areas in China who had attempted suicide and were treated in the emergency room of hospitals in four different locations. The interview instrument took 2 to 3 hours to complete and included audiotaped in-depth interviews with the patient and family members (separately); detailed evaluation of the circumstances surrounding the attempt, life events, and the family environment; and a formal psychiatric evaluation by an attending-level psychiatrist. Overwhelmingly, the method used by the attempters was poisoning with highly lethal pesticides and organic fertilizers. The women's suicidal behavior was characterized by high levels of impulsivity; little effort to seclude themselves before and after ingesting poison; and low rates of mental illness, including depression. Detailed suggestions are made about ways to implement suicide prevention strategies within the particular social and economic context of China.

Further research directions are suggested as well as ways to change attitudes to the inclusion of medication in recovery.