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2REGARDING THE IMPROVEMENT OF THE QUALITY AND EFFECTIVENESS OF INFORMATION AND EXPLANATORY INITIATIVES FOR PREVENTING SUICIDE
AMONG THE YOUNG POPULATION
*A. Shakhanova, M. Brimzhanova, M. Baimuratova, M. Kopzhasarova
LLP Kazakhstan's Medical University "KSPH" Almaty, Kazakhstan
Summary
In this review article, the addressed issue is concerned the ongoing global trend of insufficient implementation of comprehensive measures for preventing suicides and suicide attempts among the youth. It is noteworthy in this context that suicide is currently perceived as an integrative phenomenon, with the suicidal act itself being essentially interpreted as the «tip of the iceberg».
This, in turn, highlighting the need to explore avenues for strengthening intersectoral integration aimed at suicide prevention among the young population of the country.
Key words: suicide, suicide attempts, suicide prevention.
Introduction. The responsibility of public health leaders and healthcare providers lies in implementing proven, evidence-based, and cost-effective strategies [1]. Presently, the existing solutions fall short in effectively preventing suicides and suicide attempts within this age group. It is noteworthy that suicide is perceived as a complex phenomenon, where the act itself is seen as just the "tip of the iceberg" [2]. This emphasizes the need to focus on bolstering cross-sectoral integration to address the issue comprehensively.
Youth suicide risk is influenced by various factors, including psychiatric disorders, previous suicide attempts, specific personality traits, genetic predisposition, and family dynamics. These factors, when combined with psychosocial stressors, exposure to role models, and the availability of means for suicide, contribute significantly to the problem. To combat this, comprehensive and multisectoral prevention initiatives are necessary to minimize risk factors and maximize protective measures [3]. In the United States and globally, the Question, Persuasion, and Recommendation (QPR) program is widely implemented in schools. This gatekeeping program involves training community members, who have substantial interactions with the population, to identify individuals at an elevated risk of suicide and guide them toward appropriate mental health services. The QPR program has shown considerable promise in reducing suicide risk [4].
The main part. While there are apprehensions regarding the potential adverse effects of questions related to suicide, studies conducted in the United States and Australia have revealed that young individuals who are queried about suicide do not exhibit elevated levels of distress, depressive feelings, or suicidal thoughts when compared to control groups [5]. In the context of suicide prevention, existing literature indicates that targeted activities are organized specifically for high-risk groups. Examples such as the C-CARE (Counselor-Care, Assess, Respond, Empower) and CAST (Coping and Support Training) programs in the USA and Canada highlight school interventions tailored for high-risk adolescents. Participants in these integrated programs demonstrated improvements in personal control, coping abilities, and perceived family support [6]. The evaluation utilized a computer-assisted suicide assessment interview, directing at-risk students to motivational counseling sessions and small group skills training for improvement in self-esteem, decision-making, personal control, and interpersonal communication [3,6]. In the
Reframe IT program, the school intervention involves weekly Internet -based cognitive behavioral classes [3]. Another short-term, app-supported intervention for preventing suicide among hospitalized adolescents is As Safe as Possible (ASAP), with a focus on utilizing a smartphone application to reinforce skills [7]. Dialectical behavior therapy (DBT), originally designed for borderline personality disorder, has been adapted for suicidal adolescents, emphasizing skill development in emotion regulation, interpersonal effectiveness, stress tolerance, and mindfulness. Evaluating road traffic accidents has shown promising results as a method for addressing self-harm, suicidal ideation, and depressive symptoms [5].
As per the Epidemiological Study of Mental Disorders, 15.6% of adults have experienced serious suicidal ideation at least once in their lifetime. Additionally, 3.3% and 3.2% of adults have planned and attempted suicide, respectively. Despite 27.6% of the population facing a mental disorder at least once, only 15.3% sought consultation or treatment from psychiatrists or other mental health professionals. The remaining 85% never sought medical help, emphasizing the need to identify suicide risk factors in non-clinical populations and provide suitable interventions [8]. Suicidal risk is associated with biological, psychological, social, and environmental factors. However, predicting suicidality is challenging due to the complex nature of suicidal behavior, the involvement of multiple factors, and the dynamic interactions among them. The relatively low incidence of suicide deaths further complicates the development of a valid scale to assess suicide risk, exacerbated by a lack of specificity [9]. Regarding minors with deviant behavior, both domestic and foreign literature outline a variety of functional, psychological, and social disorders, including mental disorders [10,11,12]. Timely diagnosis is hindered by the intricacies of children's social lives, including the specifics of parent-child relationships. Upon admission to the Temporary Detention Center for Juvenile Offenders (TCJO), children often present with several undiagnosed chronic diseases and conditions. During their limited stay, a comprehensive, multidisciplinary assessment of their medical and social status is essential at the Central Military Hospital [13].
The Columbia Suicide Severity Rating Scale (C-SSRS) is a concise questionnaire designed for quick completion by specialists in the field. Widely employed, it serves as a self-report tool assessing lifetime suicide attempts and the prevalence of suicidal ideation, negative mood, and substance use within the past three months. Translated into over 150 languages, this scale has been implemented in diverse settings, including schools. Its effectiveness is substantiated by more than 600 peer-reviewed studies, attesting to its validity across various populations [14]. The significance of investigating the risk of emerging suicidal tendencies in adolescents with eating disorders lies in the need to develop algorithms for optimizing therapeutic and preventive measures and making differentiated choices in psychotherapeutic tactics [15,16].
Conclusions. Therefore, addressing the ongoing high rate of suicide among young people, including adolescents, calls for urgent and concerted efforts to disseminate and implement highly effective prevention strategies. Drawing from international and domestic experiences available from various sources allows us to discern the rationale for an optimal approach, emphasizing practical implementation convenience and the systemic, long-term utilization of anti-suicidal programs [17,18].
Within the scope of universal (primary) prevention, the role of school programs, training programs for education system professionals, and primary care outpatient services is highlighted. The peculiarities of working with the media are considered. Screening for the risk of suicidal behavior in minors with medical and psychological support occupies a special place in selective prevention. The article outlines characteristic symptoms and emotional experiences of patients in the acute pre-suicidal period, along with scientifically proven effective psychotherapeutic approaches.
Primary prevention of suicidal behavior in minors should become a priority in healthcare and government policies. Awareness of suicide as a public health issue should be increased, considering the socio-economic, psychological, and cultural consequences of suicidal behavior [19].
Modern research suggests that the effectiveness of anti-suicidal therapy for minors depends on a doctor's ability to show empathy and perceive suicidality through the eyes of the young patient, treating them as an equal participant in the diagnostic and therapeutic process. In the U.S., promising results have been obtained regarding the therapeutic potential of the adolescent version of the Comprehensive Assessment and Management of Suicidality (CAMS) program, but there is still insufficient experimental data to consider it an evidence-based practice. Methods such as the Brief Intervention Program After Suicide Attempt (AS SIP) and Mentalization-Based Therapy (MBT) have proven effective in treating suicidal crises in adults and are currently being tested on adolescent samples [20].
ЖАСТАР АРАСЫНДА СУИЦИДТЩ АЛДЫН АЛУ ЖвШНДЕП А^ПАРАТТЫЩ-ТYСIНДIРУ Ж¥МЫСТАРЫНЬЩ САПАСЫ МЕН ТИШДШШН АРТТЫРУ
МЭСЕЛЕО ТУРАЛЫ
*А. Шаханова, М. Бримжанова, М. Баймуратова, М. Кепжасарова
«^КДСЖМ» ^азакстан медициналык университет ЖШС Алматы, ^азакстан
Тушндеме
Бул шолу макаласында GYrmri KYHre дешн элемде ез-езше кол жумсау мен жас кезшдеп езше кол жумсау эрекеттершщ алдын алу бойынша кешендi шаралардьщ жеткшказ жYзеге асырылу YPДiсi сакталып отырган проблема ашылады.
Осыган байланысты айта кететш жайт, казiргi уакытта суицид интегративт кубылыс ретiнде кабылданады, ал суицидтж эрекеттщ e3i негiзiнен «айсбергтщ ушы» ретiнде тYсiндiрiледi. Осыган орай, елiмiздщ жас тургындары арасында суицидтщ алдын алу Yшiн салааралык интеграцияны ныгайту жолдарын iздеу мэселесi eзектi болып отыр. Бул ез кезегiнде экономикада сектораралык интеграцияны ныгайту жолдарын iздеу мэселесiн eзектi етедi.
Tyrnndi свздер: суицид, суицид эрекеттер1, суицидтщ алдын алу.
К ВОПРОСУ УЛУЧШЕНИЯ КАЧЕСТВА И ЭФФЕКТИВНОСТИ ИНФОРМАЦИОННО-РАЗЪЯСНИТЕЛЬНЫХ РАБОТ ПО ПРОФИЛАКТИКЕ СУИЦИДА СРЕДИ МОЛОДОГО НАСЕЛЕНИЯ
*А. Шаханова, М. Бримжанова, М. Баймуратова, М. Копжасарова
ТОО Казахстанский медицинский университет «ВШОЗ» г. Алматы, Казахстан
Аннотация
В данной обзорной статье раскрыта проблема, заключающаяся в том, что по сей день в мире сохраняется тенденция в недостаточной реализации комплексных мер по профилактике суицидов и суицидальных попыток в молодом возрасте.
Необходимо отметить в этой связи, что суицид в настоящее время воспринимается как интегративный феномен, а непосредственно сам суицидальный акт интерпретируется
по сути как «вершина айсберга», что в свою очередь актуализирует проблему для поиска путей укрепления межсекторальной интеграции в целях профилактики суицида среди молодого населения страны.
Ключевые слова: суицид, суицидальные попытки, профилактика суицида.
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Conflict of interest. The author declares that there is no potential conflict of interest requiring disclosure in this article.
The contribution of the authors. The author contributed to the development of the concept, the execution and processing of the results, and the writing of the article. We declare that this material has not been previously published and is not under consideration by other publishers.
Financing. Absent.
Information about the authors
Corresponding author. Shakhanova Altyn Nurbulatovna — 2nd year master's student in the specialty «Public Health», LPP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan, E-mail: Nurbulatovna_a@,mail.ru, ORCID https://orcid.org/0000-0003-0788-3611
Brimzhanova Marzhan Dikhanovna - PhD, Advisor to the Rector LPP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan, E-mail: marzhan 1980@mail.ru, ORCID https://orcid.org/0000-0003-3517-4687
Baimuratova Mairash Aushatovna - candidate of Medical Sciences, docent of Departmet of Population Health and Social Sciences, Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan, E-mail: mairash@list.ru, ORCID https://orcid.org/0000-0003-0219-7874
Kopzhasarova Marzhan Leskalikyzy — 2nd year master's student in the specialty «Public Health», LPP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan, E-mail: marzhan kopzhasarova@mail.ru, ORCID https://orcid.org/0009-0006-9695-2074
Article submitted: 18.01.2024
Accepted for publication:24.01.2024
