Author(s): Bruffaerts R, Demyttenaere K, Hwang I, Chiu WT, Sampson N,
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Abstract BACKGROUND: Suicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment. AIMS: To examine the receipt of mental health treatment and barriers to care among suicidal people around the world. METHOD: Twenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization's World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care. RESULTS: Two-fifths of the suicidal respondents had received treatment (from 17\% in low-income countries to 56\% in high-income countries), mostly from a general medical practitioner (22\%), psychiatrist (15\%) or non-psychiatrist (15\%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58\%), followed by attitudinal barriers such as the wish to handle the problem alone (40\%) and structural barriers such as financial concerns (15\%). Only 7\% of respondents endorsed stigma as a reason for not seeking treatment. CONCLUSIONS: Most people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.
This article was published in Br J Psychiatry
and referenced in Journal of Depression and Anxiety