The chronic impact of work on suicides and under-utilization of psychiatric and psychosocial services

JOURNAL OF AFFECTIVE DISORDERS

卷:168

Article

Law, Yik Wa^1,2  Yip, Paul S. F.^1,2  Zhang, Yi^1,2  Caine, Eric D.^3,4 

[1] Univ Hong Kong, Dept Social Work & Social Adm, Hong Kong, Hong Kong, Peoples R China

[2] Univ Hong Kong, Hong Kong Jockey Club Ctr Suicide Res & Prevent, Hong Kong, Hong Kong, Peoples R China

[3] Univ Rochester, Med Ctr, Injury Control Res Ctr Suicide Prevent, Rochester, NY 14642 USA

[4] Univ Rochester, Med Ctr, Dept Psychiat, Rochester, NY 14642 USA

关键词: Employment;    Suicide Depression;    Service utilization;    Non-contact;    Psychological autopsy study;   

DOI  :  10.1016/j.jad.2014.06.031

来源: Elsevier

【 摘 要 】

Background: Work-related stress appears to be a contributing factor in the lives of employed people who kill themselves, particularly during economic downturns. However, few studies have compared them with working community controls who may be experiencing similar strains, in order to explore the role of mental disorders in these deaths and the implication of such strains on their service use pattern. We hypothesized that both work stress and mental illness were associated with suicides, and that mental illness served as the mediator between work stress and suicide. Based on the Behavioral Model, we also assumed work stress associated with their use of services. Methods: A sample of 175 employed individuals (suicides-63; controls =112) drawn from a psychological autopsy (PA) damset was examined based on demographics and socioeconomic factors, psychiatric diagnoses and use of services, psychosocial factors, and lift events. A mediator analysis was conducted to examine the impact of work on suicides. Results: Suicides generally had depression and anxiety debts, higher impulsivity and poorer social support in comparison to controls. Chronic impact from work, which was fully mediated by psychiatric illness, was found higher among those suicides that did not seek contact with clinical service providers. Limitations: PA is a post hoc cross-sectional comparison method which does not allow causal analyses. Conclusion: It is important to develop new approaches for engaging vulnerable individuals in the workplace before they become suicidal, as their depression and social isolation can serve to cut them off from help when they are most in need. Occupational mental health programs should be made available for employees and their families. (C) 2014 Elsevier By. All rights reserved

【 授权许可】

Free