Influence of Spiritual Dimensions on Suicide Risk: The Role of Regional Differences.

The field of suicide prevention has been enriched by research on the association between spirituality and suicide. Many authors have suggested focusing on the various dimensions of religiosity in order to better understand the association between religion and suicidal risk, but it is unclear whether the relationship between spirituality and suicidality differs between countries with different cultures, life values, and sociohistorical experiences. To explore this, the aim of this multicenter study was to investigate the possible relationship between suicide and spirituality in Italy and Austria. In the two countries, two different groups of subjects participated: psychiatric patients and university students. The patients were evaluated with the Mini International Neuropsychiatric Interview. In addition, the following measures were used: a sociodemographic questionnaire, the Columbia-Suicide Severity Rating Scale-B, the Symptom-Checklist-90-Standard, and the Multidimensional Inventory for Religious/Spiritual Well-Being. Our results confirmed the multifactorial nature of the relation between suicide risk and the various religious/spiritual dimensions, including religious/spiritual well-being and hope immanent. However, regional differences moderated this relationship in both the clinical and nonclinical samples.

The association between suicide and the utilization of mental health services in South Tirol, Italy: a psychological autopsy study.

AIMS: The aim of the present study was to investigate potential differences between suicide decedents who had contact with a psychologist or psychiatrist before committing suicide and those individuals who had not had previous contact with a mental health professional prior to ending their lives. METHODS: Psychological autopsy interviews (N = 396) were conducted for individuals who died by suicide between 1997 and 2007 in South Tirol, Italy. RESULTS: The study found that suicide decedents known to mental health professionals were more frequently women and more frequently unemployed or with unstable employment. These decedents were significantly more likely than those unknown to mental health professionals to have a family history of mental illness, one or more past suicide attempts, and more frequent substance abuse, and likely to have frequent alcohol abuse. They more often had visited a physician in the last four weeks before dying and more frequently complained about psychological symptoms. In the prediction of group membership, individuals whom were known to mental health professionals prior to their suicidal act were 3 times more likely to have a family history of mental illness, 5.8 times more likely to have one past suicide attempt, 9.7 times more likely to have two or more past suicide attempts and 3.5 times more likely to have visited a physician in the four weeks prior to their death. CONCLUSION: Our findings indicate that suicide decedents who had contact with mental health services can be distinguished from those who were not known to mental health professionals.

Italian psychiatric reform 1978: milestones for Italy and Europe in 2010?

The Italian psychiatric reform of 1978 was one of the most radical attempts in history to abolish the practise of custodial psychiatry using legislation. The work of the charismatic reformer Franco Basaglia had four main objectives, which have taken more than 30 years to achieve. Although the creation of outpatient mental health centres and a reduction in involuntary commitments occurred rapidly, the expensive development of small acute psychiatric departments in general hospitals as an alternative to psychiatric hospitals was implemented very slowly. According to a national survey by the Italian Ministry of Health, in 2001, there were a total of 9,300 acute beds for all of Italy, of which as many as 4,000 were in private facilities. With 1.72 acute beds per 10,000 inhabitants, Italy has one of the lowest figures in Europe of psychiatric beds. However, Italy's apparent and often praised low bed requirement places a large burden on families. The implementation of the reform process was most delayed and occurred at its worst in South Tyrol, in North Italy. In an effort to achieve a modern and progressive community-based psychiatric service, in particular one with more specialised services, mental health providers in this region have examined German, Austrian and Swiss models of psychiatric practice.

[Psychiatric care in South Tyrol -- an example of coordination]. / Psychiatrische Versorgung aus einer Hand: Das Beispiel Südtirol.

The Tyrol's division after the two World Wars cut the South Tyrol off from every relevant aspect of psychiatric care. First attempts towards a community psychiatric system weren't sufficiently sustained by politicians. Only in the 90 ty's was the association of relatives of mentally ill people able to sensitize public and politicians to the need for an adequate psychiatric care system. Since 1996 an excellent psychiatric plan has been in existence, 80 % of which has to date been able to be put into practice. Since 1997 mentally ill people have founded their own self-help-organization and influenced the planning process.