Attitudes toward Suicide among Individuals involved in Suicide Care in Chiang Mai and Khon Kaen provinces, Thailand

Main Article Content

Thuvachit Kriengtuntiwong
Chaowanee Longchoopol
Darawan Thapinta
Wanida Butrin
Sangob Poodankang
Putthichada Janthakun
Sirirat Piyaphattarakul

Abstract

Objective: To study the attitudes toward suicide among individuals involved in the care of people with suicidal behavior in Chiang Mai and Khon Kaen Provinces, Thailand


Methods: This qualitative study employed semi-structured in-depth interviews. Informants from each province included public health personnel, religious leaders, and caregivers of individuals who had attempted suicide. Data were collected in Chiang Mai at Sansai Hospital (13 participants) and in Khon Kaen at Khon Kaen Rajanagarindra Psychiatric Hospital (14 participants) between July and September 2023. The questionnaire was developed by the researchers based on a review of relevant literature and was validated by experts. Data were analyzed using content analysis.


Results: The causes of suicide were perceived to stem either from impulsive emotions or from well-considered decisions. Some participants believed that suicide is a personal right, while others thought that no one has the right to take their own life. When a family member dies by suicide, it leaves emotional wounds and a sense of guilt among those left behind. The role of religion in preventing suicide was seen as dependent on individual perspectives. Family members can help prevent suicide by engaging in conversation and offering emotional support to the person at risk.


Conclusion: Different attitudes and religious beliefs toward suicide can influence its prevention. Public health personnel should provide caregivers with accurate perspectives to enhance the effectiveness of suicide prevention efforts outside of hospital settings.

Article Details

How to Cite
Kriengtuntiwong, T., Longchoopol, C., Thapinta, D. ., Butrin, W. . ., Poodankang , S. . ., Janthakun , P. . ., & Piyaphattarakul , S. . . (2025). Attitudes toward Suicide among Individuals involved in Suicide Care in Chiang Mai and Khon Kaen provinces, Thailand. Academic Psychiatry and Psychology Journal, 41(2), 60–74. retrieved from https://he01.tci-thaijo.org/index.php/APPJ/article/view/278254
Section
Original article (นิพนธ์ต้นฉบับ)

References

World Health Organization. Suicide [Internet]. Geneva: World Health Organization; 2024 [cited 2025 May 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide

National Center of Suicide Prevention. Reported suicide situation in Thailand 2023 [Internet]. Khon Kaen: National Center of Suicide Prevention; 2024 [cited 2025 May 12]. Available from: https://suicide.dmh.go.th/news/view.asp?id=92. Thai.

Leesawat C. Epidemiology of suicide in Thailand, 2019–2020. J Health Sci. 2022;31(4):623–37.

National Center of Suicide Prevention. Commit suicide rate separated by province 2020–2022 [Internet]. Khon Kaen: National Center of Suicide Prevention; 2024 [cited 2025 May 12]. Available from: https://suicide.dmh.go.th/report/suicide/download/view.asp?id=29. Thai.

Cerel J, Maple M, van de Venne J, Moore M, Flaherty C, Brown M. Exposure to suicide in the community: prevalence and correlates in one U.S. state. Public Health Rep. 2016;131(1):100–7.

Pitman A, Osborn D, King M, Erlangsen A. Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry. 2014;1(1):86–94.

Maple M, Cerel J, Sanford R, Pearce T, Jordan J. Is exposure to suicide beyond kin associated with risk for suicidal behavior? A systematic review of the evidence. Suicide Life Threat Behav. 2017;47(4):461–74.

Cerel J, McIntosh JL, Neimeyer RA, Maple M, Marshall D. The continuum of "survivorship": definitional issues in the aftermath of suicide. Suicide Life Threat Behav. 2014;44(6):591–600.

Berman EM, Heru A, Grunebaum H, Rolland J, Sargent J, Wamboldt M, et al. Family-oriented patient care through the residency training cycle. Acad Psychiatry. 2008;32(2):111–8.

Ara M, Uddin M, Kabir M. The causes of suicide and impact of society in Bangladesh. Int Res J Soc Sci. 2016;5:25–35.

Edwards TM, Patterson JE, Griffith JL. Suicide prevention: the role of families and carers. Asia Pac Psychiatry. 2021;13(3):e12453.

Hooley JM. Expressed emotion and relapse of psychopathology. Annu Rev Clin Psychol. 2007;3:329–52.

Miklowitz D. The bipolar disorder survival guide: what you and your family need to know. 3rd ed. New York: Guilford Press; year unknown.

Dervic K, Oquendo MA, Grunebaum MF, Ellis S, Burke AK, Mann JJ. Religious affiliation and suicide attempt. Am J Psychiatry. 2004;161(12):2303–8.

Dervic K, Oquendo MA, Currier D, Grunebaum MF, Burke AK, Mann JJ. Moral objections to suicide: can they counteract suicidality in patients with cluster B psychopathology? J Clin Psychiatry. 2006;67(4):620–5.

Dervic K, Carballo JJ, Baca-Garcia E, Galfalvy HC, Mann JJ, Brent DA, et al. Moral or religious objections to suicide may protect against suicidal behavior in bipolar disorder. J Clin Psychiatry. 2011;72(10):1390–6.

Carli V, Mandelli L, Zaninotto L, Iosue M, Hadlaczky G, Wasserman D, et al. Serious suicidal behaviors: socio-demographic and clinical features in a multinational, multicenter sample. Nord J Psychiatry. 2014;68(1):44–52.

Kralovec K, Fartacek C, Fartacek R, Plöderl M. Religion and suicide risk in lesbian, gay and bisexual Austrians. J Relig Health. 2014;53(2):413–23.

Szanto K, Kalmar S, Hendin H, Rihmer Z, Mann JJ. A suicide prevention program in a region with a very high suicide rate. Arch Gen Psychiatry. 2007;64(8):914–20.

McKinlay A, Couston M, Cowan S. Nurses' behavioural intentions towards self-poisoning patients: a theory of reasoned action, comparison of attitudes and subjective norms as predictive variables. J Adv Nurs. 2001;34(1):107–16.

Wolk-Wasserman D. Some problems connected with the treatment of suicide attempt patients: transference and countertransference aspects. Crisis. 1987;8(1):69–82.

Maltsberger JT, Buie DH. Countertransference hates in the treatment of suicidal patients. Arch Gen Psychiatry. 1974;30(5):625–33.

Hegerl U, Althaus D, Schmidtke A, Niklewski G. The alliance against depression: 2-year evaluation of a community-based intervention to reduce suicidality. Psychol Med. 2006;36(9):1225–33.

Wahab S, Shah NE, Sivachandran S, Shahruddin I, Ismail NNS, Mohan LD, et al. Attitude towards suicide and help-seeking behavior among medical undergraduates in a Malaysian university. Acad Psychiatry. 2021;45(6):672–80.

Midorikawa H, Tachikawa H, Nemoto K, Morita N, Shiratori Y, Endo G, et al. Mental health of gatekeepers may influence their own attitudes toward suicide: a questionnaire survey from a suicide-prevention gatekeeper training program. Asian J Psychiatry. 2020;47:101842.

Rudd MD, Berman AL, Joiner TE Jr, Nock MK, Silverman MM, Mandrusiak M, et al. Warning signs for suicide: theory, research, and clinical applications. Suicide Life Threat Behav. 2006;36(3):255–62.

Math SB, Chaturvedi SK. Euthanasia: right to life vs right to die. Indian J Med Res. 2012;136(6):899–902.

Brådvik L, Mattisson C, Bogren M, Nettelbladt P. Long-term suicide risk of depression in the Lundby cohort 1947–1997: severity and gender. Acta Psychiatr Scand. 2008;117(3):185–91.

Campbell C, Fahy T. Suicide and schizophrenia. Psychiatry. 2005;4(11):65–7.

Ramchand R, Griffin BA, Harris KM, McCaffrey DF, Morral AR. A prospective investigation of suicide ideation, attempts, and use of mental health service among adolescents in substance abuse treatment. Psychol Addict Behav. 2008;22(4):524–32.

Bongar BM, editor. Suicide: guidelines for assessment, management, and treatment. New York: Oxford University Press; 1992.

Lönnqvist J. The Oxford textbook of suicidology and suicide prevention. Oxford: Oxford University Press; 2009.

López-Narváez ML, Escobar-Chan YM, Sánchez de la Cruz JP, Tovilla-Zárate CA, Juárez-Rojop IE, Fresan A, et al. Differences in attitude toward prevention of suicide between nursing and medicine students: a study in Mexican population. Arch Psychiatr Nurs. 2020;34(3):159–63.

Otsuka H, Anamizu S, Fujiwara S, Ito R, Enomoto M, Furukawa M, et al. Japanese young adults' attitudes toward suicide and its influencing factors. Asian J Psychiatry. 2020;47:101831.

Pitman AL, Osborn DP, Rantell K, King MB. The stigma perceived by people bereaved by suicide and other sudden deaths: a cross-sectional UK study of 3432 bereaved adults. J Psychosom Res. 2016;87:22–9.

Pitman A, Osborn D, King M, Erlangsen A. Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry. 2014;1(1):86–94.

Benute GR, Nomura RM, Jorge VM, Nonnenmacher D, Fráguas Junior R, Lucia MC, et al. Risk of suicide in high-risk pregnancy: an exploratory study. Rev Assoc Med Bras. 2011;57(5):583–7.

Dervic K, Oquendo MA, Grunebaum MF, Ellis S, Burke AK, Mann JJ. Religious affiliation and suicide attempt. Am J Psychiatry. 2004;161(12):2303–8.

Kukoyi OY, Shuaib FM, Campbell-Forrester S, Crossman L, Jolly PE. Suicidal ideation and suicide attempt among adolescents in Western Jamaica: a preliminary study. Crisis. 2010;31(6):317–27.

Thanh HTT, Tran TN, Jiang GX, Leenaars A, Wasserman D. Lifetime suicidal thoughts in an urban community in Hanoi, Vietnam. BMC Public Health. 2006;6:76.

National Action Alliance for Suicide Prevention. Buddhist [Internet]. Waltham: National Action Alliance for Suicide Prevention; date unknown [cited 2025 May 12]. Available from: https://theactionalliance.org/faith-hope-life/religion-specific-materials/buddhist

Thomas AL, Brausch AM. Family and peer support moderates the relationship between distress tolerance and suicide risk in Black college students. J Am Coll Health. 2022;70(4):1138–45.

Pereira AS, Willhelm AR, Koller SH, Almeida RMM. Risk and protective factors for suicide attempt in emerging adulthood. Cien Saude Colet. 2018;23(11):3767–77.

Chamberlin J. User/consumer involvement in mental health service delivery. Epidemiol Psichiatr Soc. 2005;14(1):10–4.

Fulginiti A, Pahwa R, Frey LM, Rice E, Brekke JS. What factors influence the decision to share suicidal thoughts? A multilevel social network analysis of disclosure among individuals with serious mental illness. Suicide Life Threat Behav. 2016;46(4):398–412.

Wilcox HC, Kuramoto SJ, Lichtenstein P, Långström N, Brent DA, Runeson B. Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. J Am Acad Child Adolesc Psychiatry. 2010;49(5):514–23;quiz 530.

Ngamthipwatthana T, Phattharayuttawat S. Suicidal ideation and attitude towards suicidal behavior: a survey. J Psychiatr Assoc Thailand. 1999;44(4):329–43. Thai.

National Center of Suicide Prevention. Overview reporting data of suicide behavior in Thailand [Internet]. Khon Kaen: National Center of Suicide Prevention; 2025 [cited 2025 Apr 27]. Available from: https://suicidethai.org/report/app/dashboard-home/. . Thai.

University of South Carolina. Suicide prevention warning sign [Internet]. Columbia: University of South Carolina; date unknown [cited 2024 Oct 19]. Available from: https://sc.edu/about/offices_and_divisions/student-health-well-being/mental-health/suicide-prevention/warning-signs/

Kongsuk T. TK’s 5 factors model for explaining the incidence of suicide and suicide attempt. Srinagarind Med J. 2024;39(2):209–18.

Moutier C, Mortali MG. Suicide warning signs and what to do. Vet Clin North Am Small Anim Pract. 2021;51(5):1053–60.