Title: What do we know about people who kill themselves: A trajectory for prevention in Developing Countries. Amresh Shrivastava 1, Megan Johnston 2 Address: 1. Department of Psychiatry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada); Mental Health Foundation of India (PRERANA Charitable Trust) 209 Shivkripa Complex, Gokhale Road, Thane, Mumbai, Maharashtra, India 400 602 (Present Address: Regional Mental Health Care, 467 Sunset Drive, St. Thomas, Ontario, Canada N5H 3V9; 2. Department of Psychology, University of Toronto. About one million people die due to suicide every year. and five to Six million make an attempt .Needless to say that suicide is grossly under reported and under recognized. Sitigma of suicide and stigma of mental illness, continues to be a major barrier in the pathway of identification, intervention , treatment and prevention [1,2].Suicide prevention strategies are culturally and geographically driven. The common strategies are to address underlying mental disorders and psychosocial stressful situations. Developing countries have more that two-third share of suicide in the world. Understanding the problem of suicide in context of mental illness needs to change because it appears ill conceived. Recent data continues to support increasing role of non-disease or No Axis –I factors. It lays emphasis on changing concept of psychiatric diagnosis from categorical approach to dimensional approach. It explains that individuals who remain at risk may not have a mental illness and they still have high rates and risk of suicide. [3,4,5]Current biological research also shows that traditional and well known risk factors have their roots of origin in several socio-ecological factors e.g. abuse, trauma, inadequate parenting, religious and spiritual beliefs. [7,8,9]We propose that vision for prevention needs a paradigm shift to focus on psychosocial factors, risk situations, quality of life. It should address the issues like marginalization and social equity rather than to continue to project a tunnel vision of mental illness. This only adds to further stigma. Education can make a difference. More research is required in biopsychosocial model of trajectory of suicide and for pathways of prevention.
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