Journal
BRITISH JOURNAL OF PSYCHIATRY
Volume 199, Issue 1, Pages 64-70Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1192/bjp.bp.110.084129
Keywords
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Categories
Funding
- Bristol-Myers Squibb
- Eli Lilly
- GlaxoSmithKline
- Johnson & Johnson Pharmaceuticals
- Ortho-McNeil Pharmaceuticals
- Pfizer
- Sanofi-Aventis
- US National Institute of Mental Health (NIMH) [R01-MH070884, MH077883]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- US Public Health Service [R13-MH066849, R01-MH069864, R01-DA016558]
- Fogarty International Center [FIRCA R03-TW006481]
- Pan American Health Organization
- Eli Lilly Co.
- Ortho-McNeil Pharmaceutical
- Australian National Health and Medical Research Council
- State of Sao Paulo Research Foundation (FAPESP) [03/00204-3]
- Ministry of Health
- National Centre for Public Health Protection
- Shenzhen Bureau of Health
- Shenzhen Bureau of Science, Technology and Information
- Ministry of Social Protection
- European Commission [QLG5-1999-01042, 2004123]
- Piedmont Region (Italy)
- Fondo de Investigacion Sanitaria
- Instituto de Salud Carlos III, Spain [FIS 00/0028]
- Ministerio de Ciencia y Tecnologia, Spain [SAP 2000-158-CE]
- Departament de Salut
- Generalitat de Catalunya, Spain
- Instituto de Salud Carlos III [GIBER CB06/02/0046, RETICS RD06/0011 REM-TAP]
- WHO (India)
- United Nations Development Group Iraq Trust
- Israel National Institute for Health Policy and Health Services Research
- National Insurance Institute of Israel
- Japan Ministry of Health, Labour and Welfare [H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013]
- Lebanese Ministry of Public Health
- WHO (Lebanon)
- Fogarty International
- Janssen Cilag
- Roche
- Novartis
- National Institute of Psychiatry Ramon de la Fuente [INPRFMDIES 4280]
- National Council on Science and Technology [CONACyT-G30544-H]
- New Zealand Ministry of Health
- Alcohol Advisory Council
- Health Research Council
- WHO (Geneva)
- WHO (Nigeria)
- Federal Ministry of Health
- Abuja
- Nigeria
- Ministry of Public Health (formerly ministry of Health)
- US National Institute of Mental Health [R01-MH059575]
- National Institute of Drug Abuse
- South African Department of Health
- University of Michigan
- NIMH [R01-MH61905, U01-MH60220]
- Robert wood Johnson Foundation (RWJF) [044708]
- John W. Alden Trust
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [03/00204-3] Funding Source: FAPESP
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Background Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment. Aims To examine the receipt of mental health treatment and barriers to care among suicidal people around the world. Method Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization's World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care. Results Two-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment. Conclusions Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.
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