title: 'This place is making me more depressed': The organisation of care for suicide attempters in a South African hospital.
abstract: People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.
authors.affiliation: 1 Stellenbosch University, South Africa.
authors.forename: Jason
authors.initials: J
authors.lastname: Bantjes
authors.affiliation: 1 Stellenbosch University, South Africa.
authors.forename: Annemi
authors.initials: A
authors.lastname: Nel
authors.affiliation: 2 University of Cape Town, South Africa.
authors.forename: Kerry-Ann
authors.initials: KA
authors.lastname: Louw
authors.affiliation: 2 University of Cape Town, South Africa.
authors.forename: Louise
authors.initials: L
authors.lastname: Frenkel
authors.affiliation: 2 University of Cape Town, South Africa.
authors.forename: Ereshia
authors.initials: E
authors.lastname: Benjamin
authors.affiliation: 2 University of Cape Town, South Africa.
authors.forename: Ian
authors.initials: I
authors.lastname: Lewis
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D015279:Organizational Culture; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012307:Risk Factors; D013019:South Africa; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology*; D000092864:Suicide Prevention
keywords: critical health psychology; culture; emergency department; healthcare systems; suicide