Pezzia Carla, Hernandez Luisa M
University of Dallas.
Transcult Psychiatry. 2022 Feb;59(1):93-105. doi: 10.1177/1363461520976930. Epub 2021 Jan 14.
Reported suicide rates in Latin America remain low, but there is evidence to suggest they may be increasing, particularly among indigenous populations. To better understand who may be at risk for suicide, we examined the prevalence of suicidal ideation and explored factors contributing to suicidal thoughts in an ethnically mixed, highland Guatemalan community. The data presented in this article are from a mixed methods ethnographic field project conducted over 15 months from 2010 to 2011 in Panajachel, Guatemala. We surveyed a random sample of 350 community members. Survey questions included standardized modules from the Mini-International Neuropsychiatric Interview, as well as questions on experiences of violence and mental health care. We also conducted semi-structured interviews with 13 self-selected survey participants with current suicidal ideation. These interviews included questions regarding survey responses, experiences of mental illness, and access to mental health care. A total of 55 survey participants (N = 350; 15.7%) scored positive for suicidality. Ethnic identity, gender, psychiatric illness, and experiences of violence were all correlated to suicidal ideation. Qualitative interview data highlight distinctions between genders within prominent themes of religion, family, experiences of violence, and seeking resources. Three key findings emerged from our research that are relevant to the literature: 1) ethnic identity may be both a critical risk and a protective factor for suicide in some indigenous people; 2) intersections between violence and gender highlight different patterns in suicidal ideation; and 3) high rates of suicidal ideation and other psychiatric comorbidities underscore the need for greater access to mental health services.
拉丁美洲报告的自杀率仍然较低,但有证据表明自杀率可能正在上升,尤其是在原住民群体中。为了更好地了解哪些人可能有自杀风险,我们调查了危地马拉高地一个种族混合社区中自杀意念的患病率,并探讨了导致自杀想法的因素。本文所呈现的数据来自于2010年至2011年在危地马拉的帕纳哈切尔进行的一项为期15个月的混合方法民族志实地项目。我们对350名社区成员进行了随机抽样调查。调查问题包括来自《迷你国际神经精神病学访谈》的标准化模块,以及关于暴力经历和心理健康护理的问题。我们还对13名自我选择的有当前自杀意念的调查参与者进行了半结构化访谈。这些访谈包括关于调查回答、精神疾病经历和获得心理健康护理的问题。共有55名调查参与者(N = 350;15.7%)自杀倾向得分呈阳性。种族身份、性别、精神疾病和暴力经历都与自杀意念相关。定性访谈数据突出了在宗教、家庭、暴力经历和寻求资源等突出主题中不同性别之间的差异。我们的研究得出了三个与文献相关的关键发现:1)在一些原住民中,种族身份可能既是自杀的关键风险因素,也是保护因素;2)暴力与性别的交叉突出了自杀意念的不同模式;3)自杀意念和其他精神疾病共病的高发生率强调了需要更多地获得心理健康服务。