On surviving suicide in South India – exploring support mechanisms from the perspectives of survivors and service providers

The suicide rate in India (15.84) currently exceeds the global average (11.23) making suicide a significant public health concern. Although suicides in India are debated on medico-legal, socio-cultural, economic and political fronts, the help that is offered to people during times of crisis, before and after the attempt is very minimal. The paper aims to explore support mechanisms from the perspectives of 15 survivors, eight mental health professionals and seven traditional healers in south India. The data were analysed thematically and explored using Bourdieu’s theoretical concepts. Data indicated medical intervention as a prominent method with reservations towards psychological therapies. Reliance upon religious and traditional healing systems was culturally accepted source of support. The social and cultural power experienced by service users and service providers demonstrated a potential to influence behaviours, attitudes, decisions, approaches to services and strategies for support.     

Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder

To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II). Detailed developmental and medical history was obtained from all participants. Diagnosis was based on clinical consensus of at least two expert clinicians, using test results, clinical observations, and parent report. 23% of participants with a reported community diagnosis of ASD were classified as non-spectrum based on our consensus diagnosis. ASD and non-spectrum participants did not differ on age at evaluation and age of first community diagnosis. Non-verbal IQ scores and Adaptive Behavior Composite scores were significantly higher in the non-spectrum group compared to the ASD group (104.5?±?21.7 vs. 80.1?±?21.6, p?<?.01; 71.1?±?15 versus 79.5?±?17.6, p?<?.05, respectively). Participants enrolled with community diagnosis of PDD-NOS were significantly more likely to be classified as non-spectrum on the study consensus diagnosis than Participants with Autism or Asperger (36% versus 9.5%, Odds Ratio?=?5.4, p?<?.05). This study shows suboptimal agreement between community diagnoses of ASD and consensus diagnosis using standardized instruments. These findings are based on limited data, and should be further studied, taking into consideration the influence of DSM 5 diagnostic criteria on ASD prevalence.