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1. Deliberate Self Harm Among South Asians in London Professor Dinesh BhugraProfessor of Mental Health and Cultural DiversityInstitute of Psychiatry, Kings College, London
3. Deliberate Self Harm
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..is an act with non-fatal outcome in which an individual deliberately initiates a non habitual behaviour that without intervention from others will cause self harm. It includes substance ingestion in excess of the prescribed or generally recognized therapeutic dosage and is aimed at realising change which is desired via actual or expected physical consequences
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4. Location
5. Population of Ealing
In 2001 the total population of Ealing was 300,950
Of which, 176,750 (59%) were White and 124,200 (41%) Black and Asian
6. Sample: White & Asian, Community Instruments: socio-demographic details
DACS
GHQ-28
CIS-R
Life events inventory (Cochrane & Robertson, 1973)
Racial Life Events
Cultural Identity
7. Rates of Attempted Suicide
8. Age Specific Rates in Ethnic Groups
9. Ethnicity and Method:numbers (%)
10. Details
Asian females 29, 16 married (55%)
White females 47, 16 married (35%)
P=0.08
11. Other Differences Asians more likely to be living in owner occupied accommodation
(20 of 29, 68%) Whites (18 of 47) p=0.008
Whites more likely to have used alcohol (33 of 46, 72%) Asians 4 of 29 (p=0.0000)
12. Other Features Regret 36% (17 of 47)Whites did
62% (18 of 29) Asians did (p=0.03)
Wanted to die
62% (29 of 47 Whites)
86% (25 of 29 Asians) (p=0.01)
Suicide note
23% (10 of 47 Whites)
31% (9 0f 29 Asians)
13. Other Features Depressed 52% (24 of 47 whites)
27% (8 of 29 Asians)
No psych disorder
11% (6 0f 47 Whites)
48% (14 of 29 Asians)
Whites more likely p=0.001
14. Life Events Relationships (28%) p=0.002
Marriage (26%) p=0.005
Children (21%) p=0.004
Personal/family illness(58%) p=0.004
Finances (26%) p=0.003
Physical violence (27%)
Racial life events (26%)
15. Asian Patients and Controls n =26 n=26 controls
GP surgery
Age and sex matched
Same questionnaires to both groups
Interviewed after consent
16. Social Class in the 2 Groups
17. Religious Affiliation
18. Employment Status
19. Past Suicidal Attempt
20. Racial Life Events
21. Adolescents Case note study
Three years
All contacts with child and adolescent services
Socio-demographic factors
Attempts
Circumstances
22. The Sample Total 99
Ethnicity Self Ascribed
Whites 76
M:F 13:63 (1:4.8)
Asians 23
M:F 2:21 (1:10.5)
23. Age Distribution
24. Sex Ratio
25. Causes
26. Predisposing Factors
27. DSH Characteristics
28. DSH Characteristics
29. Social Problems
30. School Problems
31. DSH Characteristics
32. White Female: 38
White Male: 8
Asian Female: 12
Others Male: 2
Others Female: 13
33. Inception Rates in Adolescents
34. Self Ascribed Symptoms
38. Deliberate Self Harm Characteristics
54. Distal Causes
55. Religion
56. Educational Pamphlet
57. Contents
58. To Test the Affects Towards:
59. Educational Pamphlet PRE PAMPHLET AND POST PAMPHLET QUESTIONNAIRES
300 DISTRIBUTED 182 RETURNED
FINAL ANALYSIS ON 180 160 COMPLETED
FOLLOW-UP 4-6 WEEKS LATER
GP SURGERIES
60. Results of Pamphlet Increase in people agreeing that they could recognise depression
Increase in knowing where to seek help
64. Causes
66.
67. Baseline vs. Immediately after pamphlet Baseline vs. at 4-6 weeks follow-up Community Organisation group Total n=97 Follow-up n=90