Study On The Psychological Needs And The Professional Support Needs Influential Factors Of Chinese Suicide Survivors In Rural

Background: Suicide is the fifth leading cause of death among China. About287,000people committed suicide every year, more than80%of completed suicides andattempted suicides happened in rural. Shneidman conservatively estimated that forevery suicide death, six survivors would suffer severely from grief.Those persons whoare bereaved from suicide called suicide survivors. From abroad studies, thebereavement process could be quite complicated. Apart form the typical bereavementreactions such as cognitive disorganization, dysphoria, somatic distress, and social andoccupational disruptions. In addition, Suicide survivors could have also experiencedother added emotions during their grieving process, likely feelings rejected，guilt, shame,embarrassment, isolation,agonizing questioning by the deceased and feelings of blameand personal responsibility, an exacerbated search for meaning and deception about thecause of death. They will exposed to an elevated risk of developing psychiatric andmedical complications and have a higher risk of suicide if suffered longer. To explorethe psychological need’s types, the professional support needs types and its influentialfactors of suicide survivors are a prerequisite for intervention. The Paper has a strongtheoretical and practical significance.Purpose: This study aims to explore the psychological need’s types, theprofessional support needs and its influential factors of suicide survivors.The studyprovides theoretical research and practical guidance for the building of mental healthintervention and mental health service system for suicide survivors.Methods: We chose8counties of zhuanghe in Liaoning province as our researchsites. Suicide case were selected consecutively from the suicides which happened fromJune1,2006to May30,2011.For each suicide case, we selected1to3intervieweeswho was generally the relatives of suicide and on a voluntary basis. We interview the interviewee face to face using a semi-structured questionnaire, psychologicalassessment and questionnaire.Results:(1)The sample consisted254participants of four groups kinship relationship to202deceased, spouse is the topmost (n=86,33.86%), followed by children (n=68,26.77%),once again is parents (n=54,21.26%), the siblings is least (n=46,18.11%). In thissurvey the suicide survivors aged15-89years old, with an average of55.95±13.12years.The sample with an average length of education is4.11±2.24years.There are65.40%participants is illiteracy or primary school education,32.30%participants are juniorhigh school culture degree, only2.4%participants are senior middle school education.The average length of education of deceased is3.32±3.25year’s.Both suicide survivorsand deceased are less-educated.53.50%of the suicide survivor’s family economicstatus is poor.58.3%(n=148) of the sample has been struck by chronic diseases.39%of the sample suffer from poor health.43.70%of the sample had been living with thedeceased. There are46.9%of the sample reported that the suicide was their spiritualsupport when they encountered hardship.(2) The254participants who were bereaved by suicide indicated the top3professional help source are government (62.2%), country doctor (22.4%), and Hospital(19.7%).Only11.8%of the participants actually received help from the government andmost of the people belong to the country subsistence allowances.4.3%of the samplehad obtained aid from the rural doctors.6.75of the sample get the aid from ruraltownship hospital. There are significantly different between the received and expected.(p<0.05).The survey found that the suicide survivors were never obtained professionalhelp from telephone hotline services, psychological services center, crisis interventionorganizations, court, law firms and other professional support resources, and the usedrate of those formal support sources less than1%.(3) The top5informal support is children (55.1%), neighbors (55.1%), siblings(45.7%), spouse (37.0%) and friends (35.8%).69.3%of the sample hope they can gethelp from their children, but only37.0%of the participants get support,there have asignificant difference(p﹤0.05).45.9%of the participants hope obtains theirsiblings support and45.7%of the participants had satisfied. The neighbor’s assistanceexceeds the suicide survivors’ expectancy.(4) The results showed that the coping style that the survivors develop on their ownalso by self-comfort (79.1%), to do much more farm work (55.9%), communion with their relatives and friends (49.2%), etc.37.8%of the participants reported they had beenalready recovered,48.40%of the participants partly good,11.8%of the participantsreported they were without improvement,2%of the participants said they were moresevere.(5)25.2%of the participants reported they known the psychological consultationand psychological treatment can help them.14.6%of the people know that thetelevision and radio programs have the beneficial information which they needed. Someof the participants (8.3%) known books and other materials are useful for bereavement.But the degree of telephone hotline, psychological service centers, crisis interventionorganizations, psychological rescue site, bereavement mutual aid groups are less than5%.the names of some professional support groups they has never been known ofbefore.(6) The top3barriers to obtaining formal support are “reluctance to ask for help”(55.5%),“lack of information about where to find resources”(39.0%), and “lack offinancial resources”(28.3%).(7) On the premise of all support source is free, the participants like receive one ormore of the professional sources: psychological counseling or psychotherapy by face toface (46.9%), attending the expert lectures about mental health and family happiness(34.6%), accepting some useful music by broadcast on radio or television (32.3%). only14.10%of sample can accept professional psychotropic medication.(8) The need of informal help forms of suicide survivor’s was that they hoped theycan through understanding (60.63%), comfort (33.86%) and companionship (31.50%)of their relatives and friends to restore.(9) There are only0.78%(n=2) had been seeking the professional support,26.8%of the suicide survivors willing to get professional psychological help (n=68), and55.90%of those participants required long-term psychological assistance,22.8%of thesample consider that their family also need formal support,50%of them think thewhole family needs professional support, other50%of the sample think some of thefamilies need professional support, the most people of the professional support needs ismother(n=11), followed by the wife(n=7).(10) the SCL-90total score and the average of the factors of the sample are higherthan the norm, the mental health of the survivor’s who have the needs of professionalpsychological assistance is worse than those without.(11) The multivariate logistic regression model analysis has found the risk factors of the needs of professional support are gender (OR,=3.299), grief experiences level(OR,=1.019), the SCL-90anxiety factor (OR,=1.125), psychosis factor (OR=1.133).Gender can negatively predict the needs of professional support. In addition, female alsoneed professional psychological.Conclusion:(1) The needs of suicide survivors were not satisfied at all in the formal source ofsupport. Participants also relied on a range of informal sources of support; most peopleexpected get help from their children and spouse, but were not satisfied. The supportfrom the siblings are satisfied their needs, the neighbors’ support exceed theirexpectancy.(2) It is have a certain effect by self-adjustment of the survivors, but most of theparticipants still not out of the sadness.(3) The known degree of professional help source information was low. The mostimportant reason of barriers to obtaining formal support is the known degree of formalsupport resource information is low(4) In the aspect of formal sources of support, most of the participants like receive:psychological counseling or psychotherapy by face to face, attending the expert lecturesabout mental health and family happiness, accepting some music which is good for theirmental and physical by broadcast on radio or television. The least is accept professionalpsychotropic medication. In informal source of support, they hope their relatives andfriends can offer understand, comfort, companionship for them.(5) The survey shows that rate of professional support needs is low, and it isinfluenced by the known degree of formal support resource information.(6) The mental health of the people who need help-seeking for professionalpsychological services worse than no need, and its total score of SCL-90and theaverage of the factors of are higher than the norm and the participants who no formalsources support needs.(7) The needs of professional psychological services is directly influenced by thegender, level of grief, anxiety and psychotic. Female also have more professionalsupport needs than male.(8) The suggestion of intervention programs and strategies of suicide survivors inrural: first, Priorities would be given to popularizing the nine-year compulsoryeducation to improve the educational level of the people in rural areas. Second, takeadvantage of the rural areas every household has television or a radio, we should use the government vertical command system, use the counties, towns and villages and theguidance of the health family site of municipal family planning committee, to trumpetedthe knowledge of the mental health, crisis intervention, rural health family promotionprograms, holds regular the expert lectures about mental health and family happiness, tobroadcast some useful music. So that the survivors especially the suicide survivors canget the information of the professional psychological services, and improvement of Lifequality. It is a feasible strategy for suicide prevention and interference, and is a practicalguidance for the building of mental health intervention and mental health service systemfor suicide survivors.