Heidi Burns, MD
Nominated From: University of Michigan
Research Site: Ghana
Research Area: Psychiatry, Mental health stigma, Suicide Prevention
Primary Mentor: Cheryl Moyer
Understanding healthcare provider attitudes, beliefs, and current practices when caring for patients with suicidal behavior in Ghana
Suicide is a significant public health issue that results in 800,000 deaths every year around the world. According to recently released CDC data, U.S. suicide rates have increased steadily since 1999. The impact of suicide is so profound that the World Health Organization declared suicide prevention a global imperative in 2014, which lead to the development of programs such as the Mental Health Gap Action Programme (mhGAP), to improve mental health care access. Despite the global significance of suicide, accurate data on suicide is limited. It is estimated that only 60 countries in the world have high-quality data on suicide and an estimated 78 percent of suicides occur in low- and middle-income countries, where there can be significant barriers to suicide data collection.
Ghana is a LMIC where there is anecdotal evidence suggesting a rise in suicidal behavior since 2012, but statistics on suicide are limited due to many factors such as stigma, religion, and criminalization of suicidal behavior. Further analysis is necessary to understand suicide behaviors, attitudes towards suicide, and current healthcare practices towards suicide in Ghana.
Suicide is also potentially preventable, and there are numerous studies in high income countries (HIC) that support the implementation of screening programs and risk assessment tools in emergency departments and primary care settings. It has also been documented that nearly half who complete suicide have sought out health care in the month prior to their death, which emphasizes the important role of healthcare provider contact in suicide prevention. Given the large volume of patients that present through emergency departments (ED), primary care settings, and inpatient hospital units, non-psychiatric providers are poised to make a major impact on suicide recognition and prevention. Some studies have shown that mental health screening and treatment directly in the ED can result in a reduction of repeated suicide attempts.
Ghanaian health providers’ knowledge, attitudes, and beliefs about suicide and suicide prevention are not currently well documented. There is also limited data on current treatment practices of non-psychiatric Ghanaian providers towards patients with suicidal behavior. Until we have a better sense of the true burden of suicide, current practices of providers who treat suicidal patients in Ghana, and Ghanaian health care provider attitudes towards suicide and prevention, it is unlikely that interventions to address suicide can be successfully implemented in this community. This research project hopes to build on emerging suicide data from Ghanaian research scientists in an effort to develop successful screening and prevention efforts in LMIC areas with elevated stigma towards mental health and suicide.
By exploring the attitudes and behaviors of healthcare providers in countries with stigmatization of mental health disorders, we can improve the general understanding of suicide stigma and possibly lead to more effective and culturally sensitive prevention programs.
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- Dr. Cheryl Moyer, Department of Learning Health Sciences and Obstetrics and Gynecology, Medical School, University of Michigan, USA
- Dr. Ruth Owusu-Antwi, Department of Psychiatry, KATH, Ghana
- Dr. Victor Hong, Department of Psychiatry, Medical School, University of Michigan, USA
- Dr. Ron Maio, Department of Emergency Medicine, University of Michigan, USA