Self-Harm, Suicidal Ideation and Attempts among School-Attending Adolescents in Bamako, Mali.

Suicide and self-harm are major public health concerns for adolescents globally, but there is a dearth of related research in West Africa. This study aims to examine the prevalence and associated factors for self-harm, suicidal ideation and suicide attempts among adolescents in the West African country of Mali. A questionnaire survey was conducted among adolescents attending school or university in August 2019 in Bamako, the capital of Mali. Logistical constraints necessitated convenience sampling. Outcome measures were self-harm and suicide ideation and attempts. Predictor variables included sociodemographic characteristics, bullying and mental health problems. There were 606 respondents who completed questionnaires; their mean age was 16.1 (SD = 2.4); 318 (52.5%) were identified as male; and 44.4% reported self-harm at some point in their life, with 21% reporting suicide ideation and 9.7% actual suicide attempts. For all three outcomes, older age, knowing somebody personally who had experienced self-harm or taken their own life, moderate to severe depression or anxiety, and being a victim of bullying were highly significant risk factors for self-harm, suicidal ideation and suicide attempts in these adolescents, while high self-esteem decreased the risk. The study suggests that self-harm and suicidal behaviour are relatively common in Malian adolescents who are still in education. However, much more research is needed to better understand this phenomenon.

Teachers' Perceptions of Student Mental Health in Eastern China: A Qualitative Study.

In China, primary and secondary school teachers, known as ban zhu ren, have pastoral responsibility for the students in their class. The aim of this preliminary study is to identify how ban zhu ren perceive the mental health of their students, and how they have acted on these perceptions. Content analysis was used to organize the data and distinguish categories or themes derived from in-depth semi-structured interviews conducted with 27 ban zhu ren from Zhejiang and Anhui provinces. Frequencies of informant responses were used to identify the areas of agreement and disagreement across identified categories and themes among the informants. The results illustrate that the informants consider issues, such as not paying attention in class (n = 14), not getting along well with classmates (n = 12), and excessive gaming (n = 11) to be indicative of mental illness, although these would commonly be considered normal adolescent behaviors. Fifteen informants admitted that they found it difficult to work with student mental health issues, and 18 felt they had inadequate or non-existent training. However, all informants stated that they had intervened with what they perceived to be students' mental health issues, although only 9 informants had referred students for professional help. The informants reported that they were reluctant to provide referrals, due to the stigmatization they believed students would experience if given a diagnosis of mental illness. We conclude that among our informants there is a lack of agreement on what behavioral and mental health issues are, and that informants may be confusing what are, in actuality, non-conformist or non-compliant (yet often normal), adolescent behaviors with mental illness due to insufficient mental health training.

Factors Impacting Family Planning Use in Mali and Senegal.

The total fertility rate in Mali (6.2) is the third highest in the world. Despite sociocultural similarities, the total fertility rate in neighboring Senegal is 4.2. The aim of this study is to identify factors which may help to explain the differences between the two countries and which may thereby inform family planning policy in Mali. A cross-sectional study was conducted with a convenience sample of 602 married women aged 16-50 from urban and rural sites in southern Mali and Senegal. A total of 298 respondents from Mali and 304 from Senegal completed a structured questionnaire between July and October 2018. In total, 11.1% of the Malian respondents and 30.9% of the Senegalese respondents were currently using family planning, and 34.6% and 40.5%, respectively, had ever used a modern family planning method. Pressure from husbands was cited as a primary influence for having more children (in 50.3% of Malians and 45.4% of Senegalese, p = 0.000). Women's age, education level, and knowledge of different contraceptive methods were associated with ever use of contraceptives. After adjustment for confounders, discussing family planning with one's husband was the strongest predictor of contraceptive use among both Senegalese (OR = 3.4, 95% CI (1.9-6.3), p = 0.000) and Malian respondents (OR = 7.3, (4.1-13.3), p = 0.000).