It is vital that both cultural and gender differences are taken into account when drawing up programmes aimed at preventing suicide among young people in low- to middle-income countries. This is the conclusion of a doctoral thesis from Sweden's Umeå University.
"Suicide among young people is a global health problem. There is a lack of knowledge and understanding about the factors that affect the risk of suicide and about the importance of different suicidal expressions in many low and middle-income countries. In order to implement effective preventative measures it is necessary to study the differences in suicidal expressions between different countries," says Bhoomikumar Jegannathan, PhD student at the Department of Clinical Sciences, Umeå University, who will be defending his thesis on the subject.
He says that many young people in Cambodia have challenges in negotiating between old traditions and modern life. Besides, there is an ambiguity within Buddhism when it comes to the understanding of suicide; cultural influences from other countries may be contributing to an increase in suicidal tendencies among young people. Conflicts with parents can put young people in a difficult situation and some view suicide as a means to escape from these difficulties.
In his thesis, Bhoomikumar Jegannathan, who is also child psychiatrist in the Kandal province of Cambodia, has conducted questionnaire surveys where school students can anonymously state their mental health status, life experiences and whether they had ever had a death wish, suicidal thoughts, or if they have ever planned or attempted suicide. In one study, he also compared different expressions of suicide in Cambodian and Nicaraguan youths. Nicaraguan teenagers reported more suicidal expressions than Cambodian teenagers, on the contrary the Cambodian teenagers reported more mental health problems than Nicaraguans. Suicidal problems were associated with mental health problems in Nicaragua, unlike in Cambodia which shows that the associated factors differ from culture to culture.
His thesis contains a study in which he investigates ways in which the educational programme Life Skills Education can be used to influence the mental health of young people and their ability to handle life's situations. The programme is made up of six modules and is taught by specially trained teachers.
"These results show the importance of taking cultural and gender-specific differences into account when preparing suicide prevention programmes. It is also vital that we analyse what triggers these suicidal expressions among teenagers. It has been established, however, that school-based programmes create possibilities for improving mental health and preventing suicide among young people in Cambodia," says Bhoomikumar Jegannathan.