Exploring early warning signs of suicide in Bangladesh

Abstract

Although sufficient work on general warning signs of suicide has been conducted worldwide, the numbers of studies that focus on behavior immediate to suicide are very limited. Additionally, as culture is known to shape human behavior in numerous ways, is necessary to understand the pre-suicidal behavior of Bangladeshi cases if any warning sign based intervention is to be developed for this country. The aim of the present study was to explore pre-suicidal behavior in order to identify early warning signs of suicide. A qualitative research design using phenomenological approach was adopted in this study. Purposive sampling technique was employed to select eight participants using predefined inclusion and exclusion criteria. Data were collected from para-suicide cases and family members of cases who have completed or attempted suicide. In-depth interview was used to collect data which were audio recorded for ensuring accuracy. Data analysis process involved verbatim transcription of the interviews, open and axial coding. The findings provided detailed insight and understanding of suicide warning signs along with overall suicide process. The findings clearly reflect the notion that suicide is preventable. Suicidal individuals provide pre suicide warning signs at different time frame and on different modalities such as behavioral, cognitive and emotional. Moreover, it was found that suicidal individuals often directly express their suicidal thoughts to the family members and friends. Their expression of suicidal warning signs ranged from proximal to distal in terms of time frame. Another important findings revealed in this study was that people around the suicidal individual were able to perceive their suicidal risk. However, instead of providing help these people ignored the risk based on subjective judgment. The probable reason behind this ignorance might be the lack of knowledge about warning signs and stigma around suicide. In either case present study can contribute into this through enhanced knowledge from detailed understanding gained in this study. Findings of the present study suggest a well defined set of warning signs in the context of Bangladesh. These warning signs can be utilized in designing national suicide prevention guidelines for Bangladeshi population.