By Ashley Mooney
Although suicide is one of the leading causes of death in youth world wide, prevention research is often undervalued, said Monica Swahn, associate vice president for research at Georgia State University, who visited Duke this week.
In her talk to global health advocates and medical students on Monday, Sept. 9, she presented her data on social factors that contribute to youth suicide attempts in Kamapala, Uganda. Swahn noted that suicide research is often focused on deaths, which most countries generally are good at tracking. Her interest, however, was in suicide ideation—the ideas, thoughts and feelings that precede suicide planning and attempts, since twenty times as many people think about suicide as actually succeed at it.
“We talk about why are people at risk for suicidal behaviors and suicidal thoughts, and typically we come from a psychological perspective, but there are also biological factors and social-environmental factors,” Swahn said.
Approximately one million people commit suicide every year, and about 20 million attempt suicide. In the United States, suicide is the third leading cause of death for youth ages 10 to 24. Swahn’s study population, however, focused on “slum youth” living in Uganda.
“I still struggle with the term slum youth,” she said. “When we talk about slum youth, it’s one of those difficult conventions of how many street youth are there in the world, well there’s no way to know exactly. Estimates range from 100-300 million worldwide.”
Swahn’s data show that 31 percent of “slum youth” living in Kampala report suicide ideation. Of those who think often of suicide, many also reported either that both of their parents had died or neglected them due to alcohol abuse. Girls were also more likely to report suicide ideation than boys.
For the 23 percent of Ugandan youth who reported actually planning a suicide attempt, the majority expressed that they suffered from parental neglect due to alcohol, sadness and the feeling of expecting to die early.
“Suicide is a very complex problem not unlike other global health problems that we study, in that there are also differences across countries and cultures, but those haven’t been studied consistently,” Swahn said.
Studies of suicide prevention in Uganda will become increasingly important, Swahn said, with the population continuing to expand past the country’s capacity to meet its people’s healthcare needs. Right now, Uganda has a population of approximately 37 million, and Swahn noted that the country is expected to experience a five-fold increase in its population by 2050.
Beyond the challenges of a rapidly increasing population, Uganda suffers from the highest level of alcohol consumption per capita in the world, contributing to the neglect due to alcohol that many youth thinking of suicide cited in the surveys.
Even though Swahn has identified some of the correlates to suicide in the slum youth, knowing what the problem is remains only a small part of the battle.
“By the time we do a cross-sectional survey like this, it’s almost too late,” she said. “The question is, how do we broaden the access to care?”