Background: Suicidal behaviour, primarily through self-poisoning, is a major public health problem among youth in Sri Lanka.
Methods: This article describes a qualitative study of student perspectives on suicidal behaviour and its prevention. Focus groups were held with students 17—20 years of age. A discussion of the perceived causes of suicidal behaviour provided the context for discussing prevention efforts.
Conclusion: Participants identified pathways to suicidal behaviour and emphasized experiential aspects and the variability of fatal intent. Suggestions for prevention tended to emphasize the strengthening of community-oriented actions in order to better realize lethal means restrictions.
Beautrais, A.L., Horwood, J.L. & Fergusson, D.M. ( 2004) Knowledge and attitudes about suicide in 25-year-olds . Australian and New Zealand Journal of Psychiatry , 4, 260-265.
2.
Bertolote, J.M., Fleischmann, A., Eddleston, M. & Gunnell, D. ( 2006) Deaths from pesticide poisoning: a global response . British Journal of Psychiatry, 189, 201-203.
3.
Byrne, M.M. ( 2001) Evaluating the findings of qualitative research . Association of Operating Room Nurses Journal, 73, 703-706.
4.
Centre for Policy Alternatives & Presswise Trust (UK) ( 2003) Suicide Sensitive Journalism Handbook. Retrieved June 3, 2005, from http://www.cpalanka.org/research_papers/suicide_report.pdf .
5.
Coggan, C., Patterson, P. & Fill, J. ( 1997) Suicide: qualitative data from focus group interviews with youth. Social Science & Medicine, 45, 1563-1570.
6.
Department of Census and Statistics (2001) Census of population and housing 2001: preliminary database. Retrieved December 19, 2005, from http://www.statistics.gov.lk/census2001 .
7.
Department of Census and Statistics (2002) Headcount index and population below poverty line by DS division - Sri Lanka: 2002. Retrieved December 22, 2005, from http://www.statistics.gov.lk/poverty/smallareareportNEW.pdf .
8.
de Silva, D. ( 2003) Suicide prevention strategies in Sri Lanka: the role of sociocultural factors and health services. Ceylon Medical Journal, 48, 68-70.
9.
de Silva, W.I., Somanathan, A. & Eriyagama, V. ( 2003) Adolescent and youth reproductive health in Sri Lanka: status, issues, policies, and programs. Retrieved April 2, 2007, from http://www.policyproject.com/pubs/countryreports/ARH_Sri_Lanka.pdf.
10.
Eddleston, M. ( 2000) Patterns and problems of deliberate self-poisoning in the developing world. Quarterly Journal of Medicine, 93, 715-731.
11.
Eddleston, M. & Phillips, M.R. ( 2004) Self-poisoning with pesticides. British Medical Journal, 328, 42-44.
12.
Eddleston, M., Sudarshan, K., Senthilkumaran, M., Reginald, K., Karalliedde, L., Senarathna, L., De Silva, D., Sheriff, M.H.R., Buckley, N.A. & Gunnell, D. ( 2006) Patterns of hospital transfer for self-poisoned patients in rural Sri Lanka: implications for estimating the incidence of self-poisoning in the developing world. Bulletin of the World Health Organization , 84, 276-282.
13.
Fernando, R. ( 2002) The National Poisons Information Center in Sri Lanka: the first ten years. Journal of Toxicology: Clinical Toxicology , 40, 551-555.
14.
Gould, M.S. ( 2001) Suicide and the media. Annals of the New York Academy of Science, 932, 200-221.
15.
Government of Sri Lanka. (1997) National Policy and Action Plan: Report of the Presidential Committee on Prevention of Suicide. Colombo: Government Press.
16.
Gunnell, D. & Eddleston, M. ( 2003) Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. International Journal of Epidemiology, 32, 902-909.
17.
Hawton, K. & James, A. ( 2005) Suicide and deliberate self harm in young people . British Medical Journal, 330, 891-894.
18.
Hettiarachchi, J. & Kodithuwakku, G.C.S. ( 1989) Self-poisoning in Sri Lanka: factors determining the choice of poisoning agents. Human Toxicology, 8, 507-510.
19.
Kearney, R.N. & Miller, B.D. ( 1985) The spiral of suicide and social change in Sri Lanka, Journal of Asian Studies, 45, 81-101.
20.
Kitzinger, J. ( 1995) Qualitative research: introducing focus groups . British Medical Journal, 311, 299-302.
21.
Knox, K.L., Conwell, Y. & Caine, E.D. ( 2004) If suicide is a public health problem, what are we doing to prevent it? American Journal of Public Health , 94, 37-45
22.
Konradsen, F., Van Der Hoek W. & Peiris, P. ( 2006) Reaching for the bottle of pesticide - a cry for help. Self-inflicted poisonings in Sri Lanka. Social Science & Medicine, 62, 1710-1719
23.
Marecek, J. ( 1998) Culture, gender, and suicidal behaviour in Sri Lanka. Suicide & Life-Threatening Behavior, 28, 69-81.
24.
Ministry of Health (2001) Annual Health Bulletin. Colombo: Ministry of Health.
25.
Perera, B., Torabi, M.R., Jayawardana, M.D. & Pallethanna, N. ( 2006) Depressive symptoms among adolescents in Sri Lanka: prevalence and behavioural correlates. Journal of Adolescent Health, 39, 144-146.
26.
Roberts, D.M., Karunarathna, A., Buckley, N.A., Manuweera, G., Rezvi Sheriff, M.H. & Eddleston, M. ( 2003) Influence of pesticide regulation on acute poisoning deaths in Sri Lanka. Bulletin of the World Health Organization , 81, 789-798.
27.
Sandelowski, M. ( 1994) The use of quotes in qualitative research. Research in Nursing and Health, 17, 479-482.
28.
Silva, K.T. ( 2000) Suicide as a form of violence and its implications for public health: the case of Sri Lanka. In Violence and Health, Proceedings of a WHO Global Symposium, 12-15 October 1999. pp. 62-78. Kobe : World Health Organization.
29.
Slaughter, P., Pinfold, P., Flintoft, V., Gort, E., Thiel, E., Blackstein-Hirsch, P., Axcell, T., Paterson, M., Cameron, C., Estabrooks, C., Mercer, S.L., Goel, V. & Williams, J.I. ( 1999) Focus Groups in Health Services Research at the Institute for Clinical Evaluative Sciences. Toronto: Institute for Clinical Evaluative Sciences.
30.
Sumathipala, A., Siribaddana, S. & Samaraweera, S.D. ( 2004) Do patients volunteer their life weariness and suicidal ideations? A Sri Lankan study. Crisis, 25, 103-107.
31.
Thalagala, N.I. ( 2000) Attempted suicides in Sri Lanka - antecedents and consequences . MD thesis. Post-Graduate Institute of Medicine, University of Colombo.
32.
UNESCO Institute for Statistics (2005) Gross and net enrolment ratios and gender parity index, secondary for school years 1998/1999 to 2004/2005. Retrieved December 19, 2005, from http://stats.uis.unesco.org.
33.
Van Der Hoek W. & Konradsen, F. ( 2005) Risk factors for acute pesticide poisoning in Sri Lanka . Tropical Medicine & International Health, 10, 589-596.
34.
Vijaykumar, L., Pirkis, J. & Whiteford, H. ( 2005) Suicide in developing countries (3): prevention efforts . Crisis, 26, 120-124.
35.
World Health Organization (2002) World Report on Violence and Health. Geneva: WHO.
36.
Who/Searo ( 2003) Country health profile: Sri Lanka. Retrieved January 13, 2005, from http://w3.whosea.org/cntryhealth/srilanka/srilanka.pdf .
