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Suicidal ideation and attempts among men who inject drugs in Delhi, India: psychological and social risk factors

Abstract

Objective

Suicide is major public health problem in India. The objective of the analyses presented in this paper is to examine depressive and anxiety symptoms and socio-demographic indicators as correlates of suicidal ideation and attempts among people who inject drugs (PWID), a high-risk group for suicide.

Method

We analysed data collected in April–May of 2012 from a community-based sample of 420 PWID in Delhi using time location sampling. Self-report symptom scales were used to measure the severity of symptoms of depression (PHQ-9) and anxiety (GAD-2) within the preceding 2 weeks. We assessed the presence of suicidal thoughts within the past 12 months.

Results

Depressive and anxiety symptoms were associated with suicidal ideation, as were a range of social stressors including poor physical health, length of injecting drug use, housing insecurity, and experiences of violence and sexual abuse. However, depressive and anxiety symptoms were not associated with suicide attempts. Factors associated with suicide attempts among ideators were housing insecurity and relational dynamics including a poor relationship with family and, interestingly, being married.

Conclusion

Suicide prevention interventions among this population should address not only individual mental health and addiction support needs but also the overwhelmingly poor psychosocial circumstances of this group.

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Acknowledgments

The authors are thankful to Nossal Institute for Global Health (University of Melbourne, Australia) for funding this study. The authors acknowledge the skilled contribution of all the research staff and data collectors involved in implementing this study. We thank Dr Sandy Clarke and Dr Michael Palmer for providing their time and expertise in discussing aspects of the statistical analyses. We thank the participants for their willingness to share very personal information about their lives and their mental health.

Conflict of interest

The authors declare that they have no competing interests.

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Correspondence to Gregory Armstrong.

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Armstrong, G., Jorm, A.F., Samson, L. et al. Suicidal ideation and attempts among men who inject drugs in Delhi, India: psychological and social risk factors. Soc Psychiatry Psychiatr Epidemiol 49, 1367–1377 (2014). https://doi.org/10.1007/s00127-014-0899-8

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  • DOI: https://doi.org/10.1007/s00127-014-0899-8

Keywords

  • India
  • Suicide
  • Substance abuse, intravenous
  • Mental health