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International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2017

Open Access 01-12-2017 | Research

Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa: a qualitative study

Authors: Daniel Goldstone, Jason Bantjes

Published in: International Journal of Mental Health Systems | Issue 1/2017

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Abstract

Background

Substance use is a well-established, and potentially modifiable, risk factor for suicide. Suicide prevention 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 disorders, 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 suicidal 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 prevention. 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.
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Metadata
Title
Mental health care providers’ perceptions of the barriers to suicide prevention amongst people with substance use disorders in South Africa: a qualitative study
Authors
Daniel Goldstone
Jason Bantjes
Publication date
01-12-2017
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2017
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-017-0153-3

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