Non-fatal self-poisoning in Sri Lanka: associated triggers and motivationsReport as inadecuate

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BMC Public Health

, 15:1167

First Online: 24 November 2015Received: 04 April 2015Accepted: 20 October 2015DOI: 10.1186-s12889-015-2435-5

Cite this article as: Rajapakse, T., Griffiths, K.M., Christensen, H. et al. BMC Public Health 2015 15: 1167. doi:10.1186-s12889-015-2435-5


BackgroundAttempted or non-fatal self-poisoning is common in Sri Lanka. To date, most preventive strategies have focused on limitation of access to toxic pesticides, which has reduced the rates of fatal self-poisoning. However the ongoing phenomenon of non-fatal self-poisoning indicates the need for exploration of alternate preventive strategies. Self-poisoning in Sri Lanka has been described as impulsive, with little premeditation, but the motivations associated with this act have not been studied in depth. This research describes the triggers and motivations associated with non-fatal self-poisoning in Sri Lanka. It is anticipated that the findings would help guide future preventive strategies.

MethodsTwo studies were carried out, at Teaching Hospital Peradeniya, Sri Lanka, each using a different methodology – Study 1 consisted of qualitative semi-structured interviews, and Study 2 was a cross sectional survey. Both studies were conducted among those who had recently attempted self-poisoning, and explored associated triggers and motivations associated with the act of self-poisoning. There was no overlap between participants of the two studies.

ResultsA total of 24 persons participated in the semi-structured interviews Study 1, and 921 took part in the cross-sectional survey Study 2. Interpersonal conflict was the most common trigger prior to the act of non-fatal self-poisoning. A mixture of motivations was associated with the act of self-poisoning, including intent to die, to escape, and difficulty tolerating distress associated with interpersonal conflict.

ConclusionsDevelopment of interpersonal skills and interpersonal problem solving skills, particularly in adolescents and young people, emerges as a key primary preventive strategy. Further, there is value in exploring and helping people to develop more adaptive strategies to cope with emotional distress associated with interpersonal conflict. While distress tolerance and interpersonal skill training strategies used in the West may be considered, it is also important to adapt and develop strategies suited to the local cultural background. Further research is needed to develop and evaluate such strategies, and findings may have implications not only to Sri Lanka but also for other countries in South Asia.

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Author: Thilini Rajapakse - Kathleen Margaret Griffiths - Helen Christensen - Sue Cotton


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