Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa : a qualitative study
Date
2016
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background:
Substance use is a well-established, and potentially modifiable, risk factor for suicide. Suicide preven-
tion interventions are typically framed within the biomedical paradigm and focus on addressing individual risk factors,
improving access to psychiatric care, and improving the skills of medical personnel to recognise at-risk individuals.
Few studies have focused on contextual factors that hinder suicide prevention in people with substance use disor
-
ders, particularly in low-resource settings. The aim of this qualitative study was to explore mental health care providers’
perceptions of barriers to suicide prevention in people with substance use disorders in South Africa.
Methods:
Semi-structured interviews were conducted with 18 mental health care providers who worked with sui-
cidal people with substance use disorders in Cape Town, South Africa. Data were analysed using thematic analysis and
Atlas.ti software was used to code the data inductively.
Results:
Two superordinate themes were identified: structural issues in service provision and broad contextual issues
that pose barriers to suicide prevention. Participants thought that inadequate resources and insufficient training
hindered them from preventing suicide. Fragmented service provision was perceived to lead to patients not receiving
the psychiatric, psychological, and social care that they needed. Contextual problems such as poverty and inequality,
the breakdown of family, and stigma made participants think that preventing suicide in people with substance use
disorders was almost impossible.
Conclusions:
These findings suggest that structural, social, and economic issues serve as barriers to suicide preven-
tion. This challenges individual risk-factor models of suicide prevention and highlights the need to consider a broad
range of contextual and socio-cultural factors when planning suicide prevention interventions. Findings suggest that
the responsibility for suicide prevention may need to be distributed between multiple stakeholders, necessitating
intersectoral collaboration, more integrated health services, cautious use of task shifting, and addressing contextual
factors in order to effectively prevent suicide in people with substance use disorders.
Description
CITATION: Goldstone, D. & Bantjes, J. 2016. Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa : a qualitative study. International Journal of Mental Health Systems, 11:46, doi:10.1186/s13033-017-0153-3.
The original publication is available at https://ijmhs.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at https://ijmhs.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund.
Keywords
Suicide prevention, Mental health services, Substance abuse
Citation
Goldstone, D. & Bantjes, J. 2016. Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa : a qualitative study. International Journal of Mental Health Systems, 11:46, doi:10.1186/s13033-017-0153-3