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Study on Prevalence, Underlying Causes, Risk and Protective Factors in Respect to Suicides and Attempted Suicides in Kazakhstan

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Study on Prevalence, Underlying Causes, Risk and Protective Factors in Respect to Suicides and Attempted Suicides in Kazakhstan STUDY ON PREVALENCE, UNDERLYING CAUSES, RISK AND PROTECTIVE FACTORS IN RESPECT TO SUICIDES AND ATTEMPTED SUICIDES IN KAZAKHSTAN UDIO Y ST RUM IT M RS E O V L I IS I N I U • S Department of Medicine • C I I T E A N T C I and Health Sciences, E L I N T T U I A E University of Molise R A U C I M L A B U U P G I M E R E S N I T UDC 159.9 LBC 88.4 S89 «Study on prevalence, underlying causes, risk and protective factors in respect to suicides and S89 attempted suicides in Kazakhstan», Astana: The UN Children’s Fund (UNICEF) in the Republic of Kazakhstan, 2014. - 104 р. ISBN 978-601-7523-13-8 The opinions and views expressed in this document are those of the authors and do not necessarily represent the views and positions of UNICEF. The designations employed in this publication and the presentation of the materials do not imply on the part of UNICEF the expression of any opinion whatsoever concerning the legal status of children in Kazakhstan or of any country or territory, or of its authorities, or the delimitation of its boundaries. Any information from this publication may be freely reproduced, but proper acknowledgement of the source must be provided. The publication is not for sale. Prepared in cooperation with the Ministry of Health of the Republic of Kazakhstan UDC 159.9 LBC 88.4 ISBN 978-601-7523-13-8 The UN Children’s Fund (UNICEF) in the Republic of Kazakhstan 10 A Beibitshilik 010 000 Astana, the Republic of Kazakhstan Tel: +7 (7172) 32 17 97, 32 29 69, 32 28 78 Fax: +7 (7172) 321803 www.unicef.kz www.unicef.org Astana, 2014 UDIO Y ST RUM IT M RS E O V L I IS I N I U • S • C Department of Medicine I I T E A N T C I E L and Health Sciences, I N T T U I A E R A University of Molise U C I M L A B U U P G I M E R E S N I T STUDY ON PREVALENCE, UNDERLYING CAUSES, RISK AND PROTECTIVE FACTORS IN RESPECT TO SUICIDES AND ATTEMPTED SUICIDES IN KAZAKHSTAN Table of contents Acknowledgements 3 Subproject 3: Evaluation of prevalence 45 International research team members: 6 and risk factors associated with suicidal ideation and attempted suicide in East Executive summary 8 Kazakhstan Region Recommendations 11 Aim and objectives 45 Theoretical concepts and definition of 16 Catchment area 45 terms Data collection materials 46 Epidemiology of suicide in Kazakhstan 18 Training 46 Research problem, objectives and 22 components Sample selection 46 Subproject 1 - Development of a 22 Data collection 48 system for case reporting and analysis Identification and management of 48 of completed suicides based on the risk and high risk cases psychological autopsy in 4-5 regions of Data entry procedures 48 Kazakhstan: Final sample and data analysis 49 Aim and objectives 24 Main results 49 Catchment area 25 Conclusions 55 Akmola Region: 25 References 57 East Kazakhstan Region: 25 Table of tables 59 Karaganda Region: 25 Table of figures 60 Kostanay Region: 25 Table of annexes 61 West Kazakhstan Region: 25 ANNEX 1: 62 Data collection materials 26 ANNEX 2: 64 Training 27 ANNEX 3: 82 Sample selection 27 ANNEX 4: 88 Data collection 28 ANNEX 5: 92 Data entry procedures 28 ANNEX 6: 95 Final sample and data analysis 29 ANNEX 7: 102 Main results 29 Subproject 2: 38 Establishment of an epidemiological observatory on suicide attempts Aim and objectives 38 Catchment area 38 Data collection materials 39 Training 39 Data collection 40 Data entry procedures 40 Final sample and data analysis 41 Main results 41 STUDY ON PREVALENCE, UNDERLYING CAUSES, 2 RISK AND PROTECTIVE FACTORS IN RESPECT TO SUICIDES AND ATTEMPTED SUICIDES IN KAZAKHSTAN Acknowledgements he present report was prepared for UNICEF nia Batskel, Svetlana Ivanova, Inna Mokhova, Kazakhstan by a team of international ex- Aiman Abylkasimova, Kenzhegul Kumarzhano- Tperts led by Professor Marco Sarchiapone va, Olga Agapova, Saule Sagandykova, Nurgul from the Department of Medicine and Health Berdygozhaeva, Gulnara Manaspaeva, Olga Sciences, University of Molise, Italy. The report Sapovatova, Natalia Anan’eva, Yulia Mukhina, is the product of cooperation between UNICEF Nazym Magzumova, Natalia Lebed, Olga Stol- Kazakhstan and the Ministry of Health of the Re- yarova, Valentina Zinchenko. public of Kazakhstan. It contains the results of Thanks also goes to the team of psychiatrists and a large and very comprehensive project, which medical psychologists who, working under the would not have been possible without the hard supervision of East Kazakhstan Medial Health work and commitment of many people who Centre, extended their valuable support to the dedicated their time and efforts to gather data, schools that participated in the project: Elena visit families, work with adolescents, and much Rozenfel’d, Svetlana Pogrebnyakova, Sania Ke- more. nalieva, Ksenia Trosheva, Aliya Shagabudinova, We would especially like to acknowledge and Tamara Rakhymzhanova. thank the families and students who kindly This project benefited greatly from the strong agreed to give their time to take part in the pro- support from East Kazakhstan Child Protection ject and provided us with invaluable data for this Department and its Head, Anatoly Issaev, as study. We are particularly grateful to the excel- well as from the departments of education and lent team of psychologists from 30 educational health. organisations of East Kazakhstan Region, led by Liliya Kuzemko, Methodologist of Ust-Kame- We would particularly like to acknowledge those nogorsk Department of Education, and continu- psychologists and psychiatrists who committed ously supported by the fantastic staff of NGO themselves wholeheartedly to travel through- “Perspectiva” and its head, Natalia Astakhova. out their respective regions to visit hundreds of families to perform very complex and in-depth Recognition is due to all the educational organi- interviews for the first subproject of the study – sations of East Kazakhstan Region, the full list of psychological autopsy. They include: which is provided in Table 12 and the team of psychologists who administered the interviews Coordinators for the interview teams of over 3,000 students and exerted enormous for psychological autopsy in five efforts to extend their support and follow stu- regions: dents who were found at risk of suicide. They are: Antonina Pleshkova, Irina Kaufman, Na- Tatiana Skripochenko, Psychologist of Mental talia Kosolapova, Marzhan Serikbaeva, Dinara Health Centre of Akmola Region, Coordinator of Abilkassimova, Elena Melent’eva, Elena Sukh- the team of interviewers for Akmola Region; Na- anova, Inna Khlystova, Zhanna Mandaibaeva, talia Samarskaya, Psychologist of Mental Health Zulfia Dautova, Elena Svahina, Viktoria Biryu- Centre of West Kazakhstan Region, Coordinator kova, Zhadyra Sadykova, Olga Efremova, Evge- of the team of interviewers for West Kazakhstan 3 STUDY ON PREVALENCE, UNDERLYING CAUSES, RISK AND PROTECTIVE FACTORS IN RESPECT TO SUICIDES AND ATTEMPTED SUICIDES IN KAZAKHSTAN Region; Tamara Nasyrova, Psychiatrist of Men- • National Centre for Forensic Medicine of the tal Health Centre of East Kazakhstan Region, Ministry of Health of the Republic of Kazakh- Coordinator of the team of interviewers for East stan, Director Alpamys Eskulov Kazakhstan Region; Ms. Adima Shonova, Psy- • East Kazakhstan filial of Centre for Forensic chologist of Mental Health Centre of Kostanay Medicine of the Ministry of Health of the Re- Region, Coordinator of the team of interview- public of Kazakhstan, Director Timur Baibu- ers for Kostanay Region; and Ms. Anastasia Ba- latov benko, Psychiatrist of Mental Health Centre of Karaganda Region, Coordinator of the team of • Semey city filial of Centre for Forensic Medi- interviewers for Karaganda Region. cine of the Ministry of Health of the Republic of Kazakhstan, Director Galymzhan Adilkh- Members of psychological autopsy anov interviewers’ team from the regional • Department of Police of East Kazakhstan Re- mental health centers: gion and Tatiana Plotnikova, the Head of the Section on Public Security. Akmola Region: Azina Syzdykova, Berik Abishev, Almagul Ibraeva; West Kazakhstan Region: Ai- The local research team who was deeply in- nagul Dzhubanova; Kostanay Region: Zhanna volved in all phases of preparation and training, Rysukhina, Inna Petri; Karaganda Region: Dana implementation and monitoring, data collection Arinova, Gulden Alubaeva, Galina Zhidikova; and data cleaning, and enormously contributed East Kazakhstan Region: Indira Zhakibayeva, to the completion of this report comprised: Eugenia Krivich; and from Semey City Mental • Sergey Sklyar, Senior Staff Scientist of the Health Centre: Zhuldyz Altyngazina and Dilshod Centre of Suicidology and Epidemiology of Kosimov. the National Mental Health Centre Our thanks are extended to the managers of the regional mental health centres who provided full • Elena Stankina, Psychologist of the Centre and daily support to interviewers of psychologi- of Suicidology and Epidemiology of the Na- cal autopsy: tional Mental Health Centre Akmola Region: Svetalana Khasenova, Kamil • Liliya Kuzemko, Methodologist of Ust-Ka- Raskulov, Natalia Voronovskaya and Alma menogorsk Department of Education Iskakova; West Kazakhstan Region: Beket • Natalia Astakhova, Head of NGO “Perspec- Murzhakhmetov; Kostanay Region: Rashida tiva” Sandybayeva; Karaganda Region: Kairat Abdra- khmanov, Olga Trushkova, Anargul Kuldibaeva; • Alena Arestova, manager of NGO “Perspec- Zhibek Nurzhanova; East Kazakhstan Region: tiva” Nadezhda Vlassova; and from Semey City Men- • Natalia Raspopova, Head of the Centre of tal Health Centre: Aigul Sharapatova. Suicidology and Epidemiology of the Na- Acknowledgement also goes to the team of tional Mental Health Centre mental health workers led by Tamara Nasyrova, The international and local research teams were who conducted the epidemiological observatory greatly supported by the team of excellent in- on suicide attempts (subproject 2): Elena Kryaz- terpreters: Alyona Zditovetskaya and Dauren heva, Vera Petaeva, Nadezhda Cherepanova, Zhumabayev. Thanks also go to Sarah Jones for Saule Musabaeva, Sania Kenalieva, Didar Atazh- her role in proofreading and text editing of the anova.
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