Abstract
Objectives
This research is aimed to examine the attitude of health-care workers toward suicidal patients in Malaysian hospitals, comparing responses from psychiatric and non-psychiatric workers, and to identify specific needs in suicide prevention and management training.
Method
This is a multi-site cross-sectional study. The authors conducted a survey based on a translated self-administered questionnaire to participants from seven core hospital departments.
Results
While most health-care workers regardless of department and specialty took their duty to prevent suicide seriously, a large majority of them expressed negative attitudes such as finding suicidal behavior irritating, and more than half believed suicidal attempts were a way of making others sorry. However, psychiatric workers were less likely to have judgmental attitudes that included believing suicide attempters as being selfish or trying to get sympathy from others.
Conclusions
As there were more similarities than differences in health-care workers’ attitudes toward suicide, recommendations on basic and continuous suicide prevention and management training among hospital workers were made. The interventions focused on improving knowledge, affective, and skill-based areas that were aimed to correct the wrongful understanding of and to minimize the negative attitudes toward suicidal individuals indicated by the study results.
This is a preview of subscription content, log in via an institution to check access.
Change history
09 August 2017
An erratum to this article has been published.
References
World Health Organization. Preventing suicide: a global imperative. http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/. Published 2007. Accessed 3 Nov 2015.
Ali NH, Zainun KA, Bahar N, et al. National Registry of Suicide Malaysia. Pattern of suicides in 2009: data from the National Suicide Registry Malaysia. Asia Pac Psychiatry. 2014;6(2):217–25.
Armitage CJ, Panagioti M, Abdul Rahim W, Rowe R, O’Connor RC. Completed suicides and self-harm in Malaysia: a systematic review. Gen Hosp Psychiatry. 2013;37:153–65.
Malaysian Psychiatric Association. Suicide—it’s SOS. http://www.psychiatry-malaysia.org/article.php?aid=504. Published 2007. Accessed 3 Nov 2015.
Sinniah A, Maniam T, Oei TP, Subramaniam P. Suicide attempts in Malaysia from the year 1969 to 2011. Sci World J. 2014;718367.
Maniam T, Chan LF. Half a century of suicide studies: a plea for new directions in research and prevention. Sains Malaysiana. 2013;42(3):399–402.
Burgess P, Pirkis J, Morton J, Croke E. Lessons from a comprehensive clinical audit of users of psychiatric services who committed suicide. Psychiatr Serv. 2000;51(12):1555–60.
Pirkis J, Burgess P, Jolley D. Suicide among psychiatric patients: a case control study. Aust N Z J Psychiatry. 2002;36(1):86–91.
Samuelsson M, Åsberg M, Gustavsson JP. Attitudes of psychiatric nursing personnel toward patients who have attempted suicide. Acta Psychiatr Scand. 1997;95(3):222–30.
Osteen PJ, Frey JJ, Ko J. Advancing training to identify, intervene and follow up with individuals at risk for suicide through research. Am J Prev Med. 2014;47(3 Suppl 2):S216–21.
Ministry of Health Malaysia. Guideline on suicide risk management in hospitals. Putrajaya: Author;2014.
Saunders KEA, Hawton K, Fortune S, Farrell S. Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review. J Affect Disord. 2012;139(3):205–16.
Taylor TL, Hawton K, Fortune S, Kapur N. Attitudes toward clinical services among people who self harm: a systematic review. Br J Psychiatry. 2009;194(2):104–10.
Hawton K, Taylor TL, Saunders KEA, Mahadevan S. Clinical care of deliberate self-harm patients: an evidence-based approach. In: O’Connor RC, Platt S, Gordon J, editors. International handbook of suicide prevention research. Chichester: John Wiley; 2011. p. 329–51.
Pompili M, Girardi P, Ruberto A, Katzalidis G, Tatarelli R. Emergency staff reactions to suicidal and self-harming patients. Eur J Emerg Med. 2005;12(4):169–78.
Kim SN, Lee KS, Lee SY, Yu JH, Hong AR. Awareness and attitude toward suicide in community mental health professionals and hospital workers. J Prev Med Public Health. 2009;42(3):183–9.
Srivastava M, Tiwari R. A comparative study of attitude of mental health vs. non-mental health professionals toward suicide. Indian J Psychol Med. 2012;34(1):66–9.
Norheim AB, Grimholt TK, Ekeberg Ø. Attitudes toward suicidal behavior in outpatient clinics among mental health professionals in Oslo. BMC Psychiatry. 2013;13:90.
Grimholt TK, Haavet OR, Jacobsen D, Sandvik L, Ekeberg O. Perceived competence and attitude toward patients with suicidal behavior: a survey of general practitioners, psychiatrists and internists. BMC Health Serv Res. 2014;14:208.
Sun FK, Long A, Boore J. The attitudes of casualty nurses in Taiwan to patients who have attempted suicide. J Clin Nurs. 2007;16(2):255–63.
Anderson M. Nurses’ attitudes toward suicidal behaviour—a comparative study of community mental health nurses and nurses working in an accidents and emergency department. J Adv Nurs. 1997;25(6):1283–91.
Domino G, Moore D, Westlake L, Gibson L. Attitudes toward suicide: a factor analytic approach. J Clin Psychol. 1982;38(2):257–62.
Bowling A, Rowe G, Lambert N, et al. The measurement of patients’ expectations for health care: a review and psychometric testing of a measure of patients’ expectations. 2012. In: NIHR Health Technology Assessment programme: executive summaries. Southampton (UK): NIHR Journals Library; 2003. Available from: http://www.ncbi.nlm.nih.gov/books/NBK99051/
Windfuhr K, Kapur N. International perspectives on the epidemiology and aetiology of suicide and self-harm. In: O’Connor RC, Platt S, Gordon J, editors. International handbook of suicide prevention. Wiley-Blackwell: Chichester; 2011. p. 27–57.
O’Connor RC, Nock MK. The psychology of suicidal behaviour. The Lancet Psychiatr. 2014;1(1):73–85.
Berlim MT, Perizzolo J, Lejderman F, Fleck MP, Joiner TE. Does a brief training on suicide prevention among general hospital personnel impact their baseline attitudes toward suicidal behavior? J Affect Disord. 2007;100(1):233–9.
Botega NJ, Silva SV, Reginato DG, et al. Maintained attitudinal changes in nursing personnel after a brief training on suicide prevention. Suicide Life Threat Behav. 2007;37(2):145–53.
Chan SW, Chien WT, Tso S. Evaluating nurses’ knowledge, attitude and competency after an education programme on suicide prevention. Nurse Educ Today. 2009;29(7):763–9.
Kodaka M, Inagaki M, Yamada M. Factors associated with attitudes toward suicide among Japanese pharmacists participating in the board certified psychiatric pharmacy specialist seminar. Crisis. 2013;34(6):420–7.
Ramberg I-L, Di Lucca MA, Hadlaczky G. The impact of knowledge of suicide prevention and work experience among clinical staff on attitudes toward working with suicidal patients and suicide prevention. Int J of Environ Res Public Health. 2016;13(2):195.
Ajzen I. Attitudes, personality, and behavior. UK: McGraw-Hill Education; 2005.
Pisani AR, Murrie DC, Silverman MM. Reformulating suicide risk formulation: from prediction to prevention. Acad Psychiatry. 2016;40:623.
Brown GK, Beck AT, Steer RA, et al. Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. J Consult Clin Psychol. 2000;68:371–7.
Goldblatt MJ, Waltsberger JT. Countertransference in the treatment of suicidal patients. Oxford textbook of suicidology and suicide prevention: a global perspective. 2009:389–93.
Cross WF, Seaburn D, Gibbs D, Schmeelk-Cone K, White AM, Caine ED. Does practice make perfect? A randomized control trial of behavioral rehearsal on suicide prevention gatekeeper skills. J Prim Prev. 2011;32(3–4):195–211.
Suokas J, Suominen K, Lönnqvist J. The attitudes of emergency staff toward attempted suicide patients: a comparative study before and after establishment of a psychiatric consultation service. Crisis. 2009;30(3):161–5.
Sudak H, Maxim K, Carpenter M. Suicide and stigma: a review of the literature and personal reflections. Acad Psychiatr. 2008;32:136.
Acknowledgements
The authors wish to convey our gratitude to the Director General of Health Malaysia for his permission to publish this article and to the directors and the heads of departments of the hospitals involved. We are also grateful to the blinded reviewers who made concrete and critical recommendations for the improvement of our article.
Authors’ Contributions
LHW and SY proposed the study to be carried out. KP, AM, ABR, CLE, SW, CSS, and SHY personally conducted the data collection in the selected hospitals. THA undertook the statistical analyses. CSS and LHW wrote the first draft of the manuscript. LHW, SY, SW, and SHY edited several drafts. All authors contributed to and approved the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosures
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Funding Sources
This study was funded by a grant from the Ministry of Health, Malaysia (Grant No.: 01068). The funding agency had no role in the study design, data collection, data analysis, manuscript writing, or publication.
Additional information
An erratum to this article is available at https://doi.org/10.1007/s40596-017-0789-y.
Rights and permissions
About this article
Cite this article
Siau, C.S., Wee, LH., Yacob, S. et al. The Attitude of Psychiatric and Non-psychiatric Health-care Workers Toward Suicide in Malaysian Hospitals and Its Implications for Training. Acad Psychiatry 41, 503–509 (2017). https://doi.org/10.1007/s40596-017-0661-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40596-017-0661-0