Suicide among Ugandan university students: evidence from media reports for 2010-2020
Abstract
University students are in transition to adulthood and face multiple challenges that may lead to suicide. They are reported to have a higher risk of suicide by the World Health Organization. As there is no national suicide database in Uganda, we analysed student suicide using the press/media reports of suicides published between 2010 and 2020. A total of deaths by 23 suicide were identified: 19 were males, relationship problems were the main suicide reason (n = 6) and hanging was the most frequently used suicide method (n = 7). A strategic intervention to tackle suicide risk among university students is warranted.
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SPECIAL
PAPER Suicide among Ugandan university
students: evidence from media reports
for 2010–2020
Mark Mohan Kaggwa,
1
Moses Muwanguzi,
2
Elicana Nduhuura,
3
Jonathan Kajjimu,
4
Innocent Arinaitwe,
5
Moses Kule,
6
Sarah Maria Najjuka
7
and Godfrey Zari Rukundo
8
University students are in transition to
adulthood and face multiple challenges that
may lead to suicide. They are reported to have
a higher risk of suicide by the World Health
Organization. As there is no national suicide
database in Uganda, we analysed student
suicide using the press/media reports of
suicides published between 2010 and 2020.
A total of deaths by 23 suicide were identified:
19 were males, relationship problems were the
main suicide reason (n= 6) and hanging was
the most frequently used suicide method (n=7).
A strategic intervention to tackle suicide risk
among university students is warranted.
Suicide is a global health concern, with 79% of the
annual incidence occurring in low- and middle-
income countries.
1
However, suicide remains
illegal in many African countries, including
Uganda, and no suicide attempter would dare
not to complete it for fear of the repercussions
attached.
2
Although suicide rates in Uganda
decreased from 15.91 per 100 000 population in
2000 to 9.9 per 100 000 in 2017,
3
the rates
remained highest among the youth (approximately
700 000 are university students). University stu-
dents are transitioning from adolescence to adult-
hood, a stage associated with many stressors
(physical, psychological, social and spiritual) that
overpower many, leading to suicide. Previous
studies have demonstrated high numbers of sui-
cides among university students.
4–6
The year
2020 came with multiple unexpected challenges
due to the COVID-19 pandemic that may have
put many at risk of dying by suicide.
7
Looking
at past suicide cases may give us an insight into
what to expect for better preparation and inter-
ventions. With no central database for suicide in
Uganda, literature about suicide among univer-
sity students is limited. This paper describes a
study of press/media reports about suicide, its
risk factors and the commonly used methods
among university students in Uganda. We
adopted an approach used by countries without
suicide databases.
5
Method
Data collected were from various Ugandan media
reports of university students who completed
1
Postgraduate Student,
Department of Psychiatry,
Faculty of Medicine, Mbarara
University of Science and
Technology, Uganda; and African
Centre for Suicide Prevention and
Research, Uganda.
Email: kmarkmohan@gmail.com
2
Undergraduate Medical Student,
Faculty of Medicine, Mbarara
University of Science and
Technology, Uganda
3
Undergraduate Medical Student,
Faculty of Medicine, Mbarara
University of Science and
Technology, Uganda
4
Undergraduate Medical Student,
Faculty of Medicine, Mbarara
University of Science and
Technology, Uganda
5
Undergraduate Medical Student,
Faculty of Medicine, Mbarara
University of Science and
Technology, Uganda
6
Undergraduate Medical Student,
Faculty of Medicine, Mbarara
University of Science and
Technology, Uganda
7
Medical Student, College of
Health Sciences, Makerere
University, Kampala, Uganda
8
Senior Lecturer, Department of
Psychiatry, Faculty of Medicine,
Mbarara University of Science
BJPSYCH INTERNATIONAL VOLUME 18 NUMBER 3 AUGUST 2021 63
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suicide from 1 January 2010 to 31 December
2020. Our search used the keywords of suicide,
‘Yese’, suicide, university students, youth, stu-
dents and obutwa. Records with the same date of
death, name, age, gender and university were
considered duplicates and one entry retained
(Fig. 1). Only 23 reports were identified.
No ethical approval was required since the
study had no direct contact with participants.
Results
All 23 individuals were undergraduate students,
aged 19–25 years, and only 4 of them were female
(Table 1). The majority (n= 10/21) were do-
ing business-related programmes; the next most
common programmes were in computer science
(n= 3). The majority (n= 9/20) were in their
second year of study; 7 were in their final year
(the 3rd, 4th or and 5th year of study, depending
on the programme offered).
The majority of the students took their lives at
night (n= 11/14). The most common methods
were hanging (n= 7/18) and poisoning (n= 5).
These incidents most commonly occurred in hos-
tels (n= 13/20) and rentals near the universities
(n= 5). The most commonly reported reasons
for suicide were break-up of a romantic relation-
ship (n= 6/21), family problems (n= 5) and bet-
ting/gambling (n= 5); academic failure was
reported as a reason for only 1 student. Five stu-
dents were reported to have had a mental illness
at the time of the suicide, mainly depression
(n= 3). None of the students was reported to
have been using any substance of addiction.
Discussion
Risks associated with suicide
Gender
Completed suicide is consistently more common
in males, but females attempt more;
2,8
we attribu-
ted this to the culturally better coping skills of
women, who grow up with their mothers as role
models and learn from them how to handle
most stressful situations. Additionally, most
female students in Uganda are engaged with reli-
gious and spiritual groups/communities, which
highly condemn suicidality and guide them.
8,9
On the other hand, men are left alone because
their primary role models (fathers) are busy and
occupied with work and looking for money rather
than mentoring their sons. Culturally, men are
more determined not to fail; a failure makes
them ‘less of a man’. So, when it comes to suicide,
men use more lethal methods and make sure they
complete. Some reports also attribute the high
rates of suicide among men to their high-risk life-
style of being involved in gambling and addictive
substance use and being emotionally fragile.
Challenges/disappointments
Studies have found university students commonly
to take their lives towards the end of their pro-
grammes;
5,6
our investigation also found that
only four students took their lives during their
first year. This is possibly attributable to the com-
pounding pressure as one progresses in school
due to the various challenges that interplay.
When it comes to students, academic disappoint-
ment may top the list of risk factors for suicide,
Key: NW = New Vision, DM = Daily Monitor, O = Observer, RP = Red Paper, CBU = Campusbee Uganda, CCU =
Campus Cam Uganda, WDU = Watchdog Uganda, DPU = Daily Post Uganda, TTP = The Tower Post.
CCU (n = 4) CBU (n = 18) DPU (n = 5) DM (n = 6) NV (n = 11) NV (n = 3) O (n = 9)
RP
(n = 2)
TTP
(n = 2)
WDU
(n = 1)
Twitter
(n = 3)
Total complete suicide reports
n = 64
Merged
(n = 23)
Repeated entries
(n = 41)
Fig. 1
Flow diagram of case identification from the different media websites.
and Technology, Uganda; and
African Centre for Suicide
Prevention and Research,
Uganda.
Keywords. Suicide; media report-
ing suicide; university students;
youth; students.
First received 4 Jan 2021
Final revision 26 Feb 2021
Accepted 1 Mar 2021
doi:10.1192/bji.2021.13
© The Author(s), 2021. Published
by Cambridge University Press on
behalf of the Royal College of
Psychiatrists. This is an Open
Access article, distributed under
the terms of the Creative
Commons Attribution-
NonCommercial-NoDerivatives
licence (http://creativecommons.
org/licenses/by-nc-nd/4.0/), which
permits non-commercial re-use,
distribution, and reproduction in
any medium, provided the ori-
ginal work is unaltered and is
properly cited. The written per-
mission of Cambridge University
Press must be obtained for com-
mercial re-use or in order to cre-
ate a derivative work.
64 BJPSYCH INTERNATIONAL VOLUME 18 NUMBER 3 AUGUST 2021
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but in our investigation, only one student was
reported to have ended her life for this reason.
Romantic problems are a frequent cause of sui-
cide among Ugandan university students, with 6
out of 21 in our sample reported as having had
such a challenge. These findings are consistent
with previous studies among students.
5,6,8
Throughout a student’s education, mental prep-
aration for academic challenges occurs, with
exams at every step of academia. This is not the
case for romantic relationship challenges. The
transition to adulthood comes with many social
expectations, and no student would want to fail
in maintaining an emotional attachment that
they have personally chosen. The bond formed
with most individuals’first love is so strong and
we believe that some individuals cannot view
their life without that person, and at times,
some may opt for suicide. A break-up is one of
the major and sometimes the first disappointment
in these students’lives. The exploratory nature of
this stage of life makes many students try out
numerous risks, such as betting/gambling. These
easy schemes of money harvesting have made
many students prey to systems owned by master
tricksters. Many students in other parts of the
world have taken their lives because of
gambling.
10,11
Substance use
Studies report use of addictive substances among
university students as an etiological factor for
Table 1
Characteristics of the participants
Year and
month Time Gender
Age,
years College/course/programme
Year of
study Mode of suicide Reason for suicide
Location of
suicide
2010
November
Night Male –Business and management
sciences
3 Burning End of a relationship Hostel
2010
November
Night Female –Business and management
sciences
3–– Hostel
2011 April Night Male 23 Humanities and social sciences 3 Jumping from a
height
Family problems Hostel
2012 October Night Male 22 Business and management
sciences
2 Hanging Misused
tuition by betting
Rental
2012
November
Night Male –Education and external studies 2 Jumping from a
height
Family problems Hostel
2012
November
–Male –Computing and information
science
2 Jumping from a
height
–Hostel
2013 –Female –Business and management
sciences
–Hanging Academic failure Rental
2013 Day Female 21 –1 Burning Family problems Home
2014 –Male 19 Business and management
sciences
1 Hanging HIV positive Rental
2014 May Night Male –Education and external studies 2 –Betting –
2016 –Male –Medicine 5 Poison ingestion End of a relationship –
2016
September
Day Male –Business and management
sciences
1–End of a relationship Hostel
2016 August –Male 23 Engineering, designing, art and
technology
2 Poison ingestion Betting Rental
2017 Night Male –Business and management
sciences
3 Hanging Family problems Hostel
2018 October Night Female 25 Computing and information
science
–Hanging Loss of laptop Rental
2018 March –Male 23 Law 1 –End of a relationship –
2018
September
Night Male –Forestry 4 Poison ingestion End of a relationship Hostel
2019 March Night Male –Business and management
sciences
–– End of a relationship Hostel
2019
September
Day Male 22 Radiology 4 Hanging Bitcoin internet scam Hostel
2020 February Night Male –Computing and information
science
2 Stab in the chest Family problems Hostel
2020 March –Male –Business and management
sciences
2 Poison ingestion Betting Hostel
2020
September
–Male –Business and management
sciences
2 Hanging Being arrested Police cell
2020 –Male –– 2 Poison ingestion Betting Hostel
BJPSYCH INTERNATIONAL VOLUME 18 NUMBER 3 AUGUST 2021 65
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suicide completion,
12
attributing it to the psych-
otic symptoms experienced during intoxication
or withdrawal.
2,12
However, substance use was
not identified in this study, and we attribute this
mainly to the study design of using press/media
houses, which rarely report such information in
Uganda. For this same reason, mental illness,
especially depression, a common cause of suicide,
was not reported in most cases. Most media
houses lack the expertise to deductively report
the cause of suicide but do a great job in notifying
the community about what is happening to the
students.
The aftermath of student suicide
The majority of the suicides occurred in hostels,
rentals or the home –places where students feel
comfortable. Suicide is a signal or message to indi-
viduals important to the person,
13
thus causing
most people to carry out the act at home to inform
an individual or the community about their stress.
For this reason, some individuals leave a suicide
note with specific messages, addressed to an indi-
vidual. With the advancement in technology,
communication is via social media; and the
trend or tradition of written suicide notes is chan-
ging to social media posts or messaging to the tar-
get group.
14
Despite advanced technology, some aspects of
suicide may take long to change, such as the
method used. As in other studies, hanging was
the most commonly used method by the
students.
5,6
Despite many alternatives, many
individuals still find this the best method of end-
ing their lives. We suggest that this might be
attributed to the unintentional advertisement of
this method by showing a rope as a sign of suicide
or social media emoji that communicate suicide
with a rope sign.
The way forward
Despite all universities in Uganda employing
qualified psychologists and counsellors to
improve students’well-being, students are still
dying by suicide, leaving us questioning their
effectiveness. Do we need a new approach? For
a generation so absorbed in their gadgets, would
the use of technology rather than human beings
sitting in offices be a more acceptable –and
more successful –way of improving mental well-
being? We believe that, if possible, all the counsel-
ling services should be made anonymous, not face
to face with a therapist, to increase their uptake by
this generation of students. Many countries have
opted for machine learning in an attempt to iden-
tify individuals at risk of suicide.
15
Maybe this is
the approach universities should employ to cut
the suicide rate.
Strength and limitations
Owing to the lack of an official database, the use
of press reports was the best available approach
to tracking suicide among university students.
The study had limitations: the press may not
have reported all student suicides and the num-
ber of cases identified was too few to make any
generalisations.
Data availability
The data that support the findings of this study
are available from the corresponding author,
M.M.K., upon reasonable request.
Author contributions
M.M.K. and S.M.N. conceived the study; M.M.K., G.Z.R. and E.N.
designed the concept and protocol; I.A., M.K., S.M.N., M.M.K.,
J.K. and M.M. did the literature search; and M.M.K. and E.N.
drafted the initial manuscript. All authors contributed to critical
revision for the intellectual content of the manuscript.
Funding
The research received no specific funding from any organisation,
public or private.
Declaration of interest
None.
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COUNTRY
PROFILE Triage of referrals in a child and
adolescent mental health service in
Qatar: reducing waiting times and
promoting needs-based prioritisation*
Yasser Saeed Khan,
1
Mahmoud Al-Shamlawi,
2
Lazarus Phiri
3
and
Majid Alabdulla
4,5
This paper summarises the impact of a new
triage process on referral prioritisation and
waiting times in a community specialist child
and adolescent mental health service (CAMHS)
in Qatar. The process involves initial review of
referrals by a CAMHS nurse to ensure that
there is adequate clinical information,
obtaining additional information from
patients/families and referring clinicians by the
psychiatric triage team, when necessary,
followed by prioritisation and allocation of
accepted referrals. The new process reduced
the acceptance of inappropriate referrals,
ensured prioritisation of referrals and
significantly improved the service’scompliance
with waiting-time deadlines.
A seminal moment in the transformation of
Qatar’s healthcare system was the launch of the
National Health Strategy 2018–2022 under the
theme ‘Our Health, Our Future’in 2018. One
purpose of this drive was to further improve the
capacity and performance of the healthcare sys-
tem through efficient use of available resources.
The initiative described in this paper was taken,
among many others, to support Qatar’s National
Health Strategy.
Background
Most healthcare services face the challenging task
of reducing waiting times to comply with their
specified time frames. A long waiting time is asso-
ciated with a higher rate of non-attendance in
out-patient clinics.
1
It is not uncommon for out-
patient child and adolescent mental health ser-
vices (CAMHS) to have long waiting lists, which
can become a source of significant distress for chil-
dren, young people and their families. A number
of initiatives have been described to reduce
waiting times and improve attendance at
CAMHS out-patient clinics.
2–4
Triage of referrals is the most common entry
point into a healthcare service and is considered
a crucial component in the care pathway. When
adopted effectively, the process of triage cuts wait-
ing times significantly and ensures that the needs
of patients and their families are met safely and
appropriately. A UK study showed that triage
for CAMHS is feasible and that it resulted in
reduced waiting times for a first appointment.
5
Referral quality is also crucial to efficient patient
flow and it should therefore be necessary, appro-
priate, timely and well communicated.
6
The CAMHS of Hamad Medical Corporation in
Qatar is a community-based out-patient service
providing help and support to children and
young people with mental and behavioural disor-
ders and their families. The CAMHS team has
adopted the multidisciplinary way of working to
ensure that the needs of patients and families are
addressed holistically. It comprises psychiatrists,
psychologists, psychiatric nurses, occupational
therapists, speech and language therapists, dieti-
tians and social workers. The service received 912
new referrals during 2018 and it was anticipated
that, owing to rising demand, this number would
increase further in the following years. The chal-
lenge of meeting the waiting times, both for routine
and urgent appointments, was consequently grow-
ing considerably.
Historical practice and creation of
triage team
The need to develop an effective triage team
within the CAMHS was identified in early 2019
to ensure the suitability of accepted referrals,
needs-based prioritisation and compliance with
waiting times. A broad consensus was reached
regarding the need to shift from the historical
1
Consultant Child and Adolescent
Psychiatrist and Medical Lead,
Child and Adolescent Mental
Health Service, Hamad Medical
Corporation, Doha, Qatar. Email
ykhan5@hamad.qa
2
Charge Nurse, Child and
Adolescent Mental Health
Service, Hamad Medical
Corporation, Doha, Qatar
3
Clinical Nurse Specialist, Child
and Adolescent Mental Health
Service, Hamad Medical
Corporation, Doha, Qatar
4
Senior Consultant Psychiatrist
and Chair of Mental Health
Services, Hamad Medical
Corporation, Doha, Qatar
5
College of Medicine, Qatar
University, Doha, Qatar
*A video abstract for this article is
available at https://vimeo.com/
bjpsych/bji-2021-10
Keywords. Triage; child and ado-
lescent mental health service;
referrals; out-patient appoint-
ments; waiting list.
First received 27 Jul 2020
Final revision 22 Nov 2020
Accepted 8 Jan 2021
doi:10.1192/bji.2021.10
© The Author(s), 2021. Published
by Cambridge University Press on
behalf of the Royal College of
Psychiatrists. This is an Open
Access article, distributed under
the terms of the Creative
Commons Attribution licence
(http://creativecommons.org/
licenses/by/4.0/), which permits
unrestricted re-use, distribution,
and reproduction in any medium,
provided the original work is
properly cited.
BJPSYCH INTERNATIONAL VOLUME 18 NUMBER 3 AUGUST 2021 67
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ResearchGate has not been able to resolve any citations for this publication.
Purpose:
Although depression has adverse effects on all aspects of university students' quality of life, fewer studies have been conducted in Bangladesh; which was investigated herein.
Design and Methods:
A cross‐sectional study was carried out among 1844 students enrolled at the University of Dhaka, Bangladesh. Hierarchical regression analyses were performed to investigate the explanatory power of the variables predicting depression in this population.
Findings:
Depression prevalence was 28.7%; and female gender, first‐year student status, substance use, past‐year physical and psychological illness, stressful life events, family psychiatric history, and personal suicidal behaviors were the main risk factors. The final model considering all the studied variables explained 23.5% of the variance in depression.
Practical Implications:
Effective psychological help services, awareness and intervention programs, and so on, should be implemented to reduce students' psychological burdens.
Problem
Suicide incidences among adolescents and youths during the Coronavirus Disease 2019 (COVID‐19) lockdowns have been reported across the world. However, no studies have been carried out to investigate cumulative nature, patterns, and causative factors of such suicide incidences.
Methods
A purposive sampling of Google news between 15 February and 6 July was performed. After excluding duplicate reports, the final list comprised a total of 37‐suicide cases across 11 countries.
Findings
More male suicides were reported (21‐cases, i.e., 56.76%), and the mean age of the total victims was 16.6 ± 2.7 years (out of a total of 29 cases). About two‐thirds of the suicides were from three countries named India (11‐cases), UK (8‐cases), and the USA (6‐cases). Out of 23‐student victims, 14 were school‐going students. Hanging was the most common suicide method accounting in 51.4% of cases. The most common suicide causalities were related to mental sufferings such as depression, loneliness, psychological distress, and so forth, whereas either online schooling or overwhelming academic distress was placed as the second most suicide stressors followed by TikTok addiction‐related psychological distress, and tested with the COVID‐19.
Conclusions
The finding of the temporal distribution of suicides concerning lockdowns may help in exploring and evolving public measures to prevent/decrease pandemic‐related suicides in young people.
This case report describes a 17-year-old high school student serious suicide attempt using an injectable composite of veterinary medications (vitamins, vaccines, antibiotics, and antihelminthics) typically used to treat chickens. The use of this particular substance and the route of administration was novel as a method for suicide lethality and there have been no previous cases of this kind. However, this youth also developed chronic self-harming behaviors where she would repeatedly self-inject the veterinarian medication composite which included substances that were largely inert but did have a potential neuropsychiatric side effect profile that complicated her psychiatric presentation. In this context of chronically injecting a substance with unclear psychoactive properties, an interesting set of symptoms and behaviors emerged that required diagnostic clarification and interpretation. Diagnostic considerations for this youth included major depressive disorder with psychotic features, a possible emerging borderline personality disorder, post-traumatic stress disorder (PTSD), as well a possibility of an unknown substance use disorder using the veterinary medication composite. The purpose of this case study is to highlight the clinical course and explore sociocultural factors, including family and interpersonal relationships as contextually important variables.
Objective: Suicide has become the second leading cause of fatality among the 15-29-year-old age group. Bangladeshi statistics indicates 61% of suicides are within this age range. However, the nature of student suicides as well these issues concerning gender differences has been less studied inside the country. Consequently, the present study investigated students suicide cases using examples from the Bangladeshi news media. Methods: Bangladeshi student suicide press reports over an 18-month period were collated using Google search in the present study. After the removal of repeated cases, a total of 56 reported suicides remained for final analysis. Results: Most cases were male (n=40), Muslim (n=43), belonged to public university (n=17), graduated at upper level (n=37) and committed suicide at midnight (n=25). The most common suicide method was hanging (n=42). The most common reasons for suicide included relationship problems (n=11), exam failure (n=10), and family arguments (n=6). Gender differences showed that 9 out of 16 female suicides were medical students whereas male suicide cases were more diverse across educational types and levels. Limitations: This study only included student suicide cases reported by printed news media, so the total number of cases is unknown as because not all such deaths will have been reported. Conclusions: The results reflect global suicide trends (e.g. more cases of male suicide) although, the findings were not consistent with previous Bangladeshi researches which tend to proclaim higher rates of female suicide. Results suggest that suicide prevention programs are needed, particularly among male adolescents and young men.
The suicide victim was an 18-year-old male Bangladeshi second-year commerce student at Dhaka City College who originally came from the village of Kaliganj (in Jhenaidah, Bangladesh). He was the oldest child of a policeman in the Ramna Police Division. The victim shot himself in the right side of his head with his father’s licensed pistol early one Sunday morning (8am) although the bullet was eventually removed from the left side of his brain. He shot himself while his younger brother and younger sister went out for a walk with their father. (It was also reported that his twin brother had died soon after being born). The family were currently living in the Azimpur Government Staff quarters. It was reported in media (based on his family’s accounts and his suicide note) that the victim was a “gentle boy” but said to be very stressed about an upcoming examination because he did not get the highest marks in his previous examination. It was also reported that he suffered from some mental health problems (i.e., depression and distress). It was also claimed by his father that he was addicted to playing videogames. In his bedroom suicide note he wrote that (in reference to the videogames he played) that “even in death, I will be hero”. It was also claimed that he was not happy with his physical appearance (i.e., obesity and being black in skin color).
Background: Although, medical students’ suicide has become hot-cake in suicidology, there is a lack of studies based on actual medical student suicides’ retrospective reports in both the historical and international literature (including Bangladesh). Consequently, the present study aimed to utilize the medical students suicide victims’ cases reported by Bangladeshi news media.
Methods: This retrospective study investigated Bangladeshi medical student suicide reports of 23 months (from January, 2018 to November, 2019) via collecting news reports using Google search. After removal of non-medical student suicide reports, a total of 13 reported suicides remained.
Results: Results showed that among 13 reported cases, most of the victims were from public medical colleges (n=9) and 4 were from either a private medical college, medical technology institute, medical institute, and paramedical institute, 8 were female, one-third (7 of the 10 that reported year of study) were in the final stages (i.e., fourth or fifth) year of medical curriculum, and most of the suicide cases occurred in the first half of the academic year. All but one of the suicides were by hanging (n=12) and the most provided reason for suicide was academic distress.
Limitations: This study negotiated only the reported suicide cases by news media, so there is a possibility of having increase the total number of cases (if any missing reports existed).
Conclusions: The suicide rates were much higher compared to that in other countries. It is recommended that bespoke suicide preventive programs are needed to increase psychological wellbeing for Bangladeshi medical students.
Introduction:
In this study student suicides are classified as a distinct group in Eskisehir-a city located in the western part of our country and famous as a student city. The study aims at describing demographic and suicide specification of cases and compare some important issues between males and females.
Method:
All the judicially deaths in Eskisehir in a 12 year period between 2004 and 2015 have been evaluated. 75 cases that were deemed as suicide cases as a result of criminal investigation have been included in the study.
Results:
It was determined that hanging method was the most frequently used method and the number of male was more. It was determined that the majority of them were the students living away from their families. Definite or possible psychiatric disorder was identified as the most important risk factor. It was observed that there were significant differences in terms of risk factors between male and female students. Males have been found as more prominent in case of definite or possible psychiatric disorders, alcohol and substance abuse, love and romantic tangles; females have been found as more prominent in case of family problems and social pressure, and repeated suicide attempts.
Discussion:
Compared to the general population love and romantic problems are more prevalent in this group. It is observed that university students left suicide notes more than the general population. Sharing this study with the university administrations could be helpful in undertaking the necessary precautions.
Relatively little research has been conducted on religion and suicide in Africa, yet religion has a lot of influence on people's way of life in Africa. To study religious views on suicide among the Baganda, Uganda, we used grounded theory and discourse analysis on a total of 28 focus groups and 30 key informant interviews. Suicide is largely seen as a breach of God's doctrine life is sacred, God's commandment thou shall not kill, and God's rule of agape. The study also focuses on the consequences of breaching God's divine providence: punishment from God and the Church. Religion still has a lot of influence on people's views on suicide in Uganda despite the challenges highlighted in the study. A recommendation from these results is that suicide prevention should cater to divergent views on religion and suicide. More qualitative research should be conducted in this area to facilitate theoretical comparison with this study.
Substance use disorders are among the most frequent psychiatric disorders found in suicides. In psychological autopsy studies between 19% and 63% of all suicides suffered from substance use disorders, mostly from alcohol use disorders. Suicide risk is highly increased in substance use disorders, particularly in alcohol use disorders, and in co-morbid alcoholism and depression. So far, some risk factors for suicide have been identified in alcoholism. Nevertheless, various questions about the relationship between substance use disorders and suicide remain open, which indicate directions for future research.