Problem-Solving Counseling as a Therapeutic Tool on Youth Suicidal Behavior in the Suburban Population in Sri Lanka

Article excerpt

Byline: E. Perera Ramani, Samudra. Kathriarachchi

Background: Suicidal behaviour among youth is a major public health concern in Sri Lanka. Prevention of youth suicides using effective, feasible and culturally acceptable methods is invaluable in this regard, however research in this area is grossly lacking. Objective: This study aimed at determining the effectiveness of problem solving counselling as a therapeutic intervention in prevention of youth suicidal behaviour in Sri Lanka. Setting and design: This control trial study was based on hospital admissions with suicidal attempts in a sub-urban hospital in Sri Lanka. The study was carried out at Base Hospital Homagama. Materials and Methods: A sample of 124 was recruited using convenience sampling method and divided into two groups, experimental and control. Control group was offered routine care and experimental group received four sessions of problem solving counselling over one month. Outcome of both groups was measured, six months after the initial screening, using the visual analogue scale. Results: Individualized outcome measures on problem solving counselling showed that problem solving ability among the subjects in the experimental group had improved after four counselling sessions and suicidal behaviour has been reduced. The results are statistically significant. Conclusion: This Study confirms that problem solving counselling is an effective therapeutic tool in management of youth suicidal behaviour in hospital setting in a developing country.

Introduction

Deliberate self-harm and suicide have been a major concern in many societies and on an average, daily suicides are around 3000 globally. [sup][1] In the last five decades statistics on suicide has indicated a heavy upward trend. [sup][2] The World Health Organization has predicted that by the year 2020 approximately 1.5 million people will commit suicide annually. [sup][3] This amounts to an average of one death every 30 seconds and one attempt every one to two seconds. [sup][4] Sri Lanka has recorded one of the highest rates of suicide in the world. [sup][5]

The global suicide pattern among different age groups has distinctly changed in the recent past shifting toward youth from the elderly. At present, almost 60 percent of suicide deaths are among young adults in their productive years of life. [sup][6] On par with the global situation, the Sri Lankan youth population has also become more vulnerable. The latest available data in Sri Lanka, in 2001, indicates that intentional self-harm was the leading cause of death among the youth belonging to the age group of 15 to 24 years. [sup][7]

Attempted suicide is underreported in many countries including Sri Lanka. [sup][8] The magnitude of attempted suicide is not clearly indicated, as no single reporting agency records the incidence of attempted suicide data. [sup][6]

The literature on suicide suggested that suicide rates could be reduced if adequate preventive interventions were directed toward specific target groups, such as, individuals, families, schools or other sections of the society. [sup][9],[10] However, there was not much research carried out in the area of therapeutic interventions.

Counseling has been one therapeutic tool adopted in many countries to assist individuals with suicidal behavior due to stressful life events. The literature revealed that counseling has been a key element in many suicide prevention programs and in recent years, there have been attempts to apply a structured framework for counseling approaches. The problem-solving approach is one of the key counseling techniques largely used in the healthcare settings. The problem-solving approach is aimed at dealing with problems that emotionally disturb the client and require practical solutions. [sup][11],[12] In this scenario, the problem-solving approach is generally very helpful as the client would be able to deal with the stressful life events and also prevent future life events becoming overwhelming. …