EXPERIENCES AND SUPPORT STRUCTURES OF HOUSEHOLD MEMBERS OF SUICIDE ATTEMPT SURVIVORS PRESENTING AT AFRICA INLAND CHURCH LITEIN HOSPITAL

Abstract

Suicide is a serious public health problem, with a previous suicide attempt being the greatest risk factor for repeat and completed suicide. Household members of a person who attempts suicide, who are greatly affected by a suicide attempt, are key gatekeepers in prevention of suicide, hence their experiences and support needs cannot be ignored. However, there is a paucity of data on the effects of a suicide attempt on household members in Kenya and their support needs have not been explored or exhaustively included in existing local mental health policies. This study‘s objectives were to describe the experiences of household members following a suicide attempt presenting at Africa Inland Church (AIC) Litein Hospital and to explore the existing and desired support structures following the event. A qualitative phenomenological study design was used, with the study participants being household members living of suicide attempt survivors presenting at AIC Litein Hospital recruited using a purposive sampling technique. Following an informed consent, in-depth interviews were conducted using a semi-structured interview guide. Interviews were audio recorded, transcribed verbatim, and thematically analysed. 16 in-depth interviews were conducted. Participants experienced a range of negative emotional and psychological responses and relationships within households were either strengthened or weakened while others experienced social isolation and stigma from community. Physical harm during rescue attempts was sustained and participants reported additional responsibilities including financial burden and reduced work productivity. Support structures available included good healthcare provision, practical support from family and community including rescuing the survivor and financial support. Spiritual and moral support from religious leaders and community was reported. Household members desired mental health and professional support and expressed the need for education and information on suicide which could be relayed both at the hospital and community level. Community support financially, materially and through formation of support groups was desired and participants expressed the role of community leaders in addressing suicide triggers and advocating for the needs of affected households. Considering the crucial role of household members and the adverse effects of a suicide attempt, addressing their needs is not only the mandate of healthcare workers but also the clergy, the government, community leaders and the larger community working collaboratively. Healthcare institutions must institute well structured counselling services for these individuals, and support groups need to be initiated at community level. The role of community and religious leaders in supporting these households needs to be well defined in the Kenya Mental Health policy and access to mental health services at community level improved in line with the World Health Organization‘s call for de-institutionalization of mental health services to cater for the mental health needs of these households.