Mental Illness, Suicidal
Conditions
Keywords
suicide disclosure
Brief summary
To characterize how disclosure of suicide or severe emotional distress functions socially in rural eastern Uganda: who people have disclosed to, what happened, what harms resulted, who they would want involved in future support, and under what conditions they would want support activated on their behalf.
Detailed description
This study aims to understand how disclosing suicidal thoughts or severe emotional distress leads to either social support or social harm in rural eastern Uganda, and to identify how support can be activated safely and according to individuals' preferences. Using a cross-sectional mixed-methods design, researchers will administer structured surveys to 80-100 adults with lived experience of suicidality or severe distress and conduct 20-30 in-depth interviews with participants representing helpful, harmful or forced, mixed, and non-disclosure experiences. The study will examine disclosure pathways, adverse social consequences, preferred support persons, acceptable conditions for contacting others, and willingness to undergo suicide screening, with safeguarding procedures integrated throughout data collection
Interventions
OTHERSurvey Questionnaire
Survey capturing disclosure history (who was told, when, why, how), disclosure outcomes (what happened, what harms resulted), disclosure comfort (willingness to tell specific people under specific conditions), social harm inventory (lifetime and recent harms following disclosure), preferred support persons and conditions for activation, and willingness to be screened
Sponsors
Yale University
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Meets at least one of the following: 1. self-reports a history of suicidal ideation or attempt, 2. self-reports a period of severe depressive distress (persistent sadness, hopelessness, withdrawal lasting ≥2 weeks), or 3. has previously disclosed suicidal thoughts or severe distress to another person * Able and willing to provide informed consent
Exclusion criteria
* Currently in acute suicidal crisis with intent or plan (activate safeguarding protocol, defer enrollment to after stabilization) * Unable to engage in a 25-30 minute survey without significant distress
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Social Harm Inventory | Through 60 minute survey and interview | A 10-item inventory of adverse social harms experienced after disclosure: family anger/punishment, community gossip, police involvement, confinement/restraint, forced traditional healing, loss of employment or income, relationship termination, public humiliation, unwanted religious intervention, and other. Each endorsed item rated on a likert scale for severity (mild, moderate, severe) and recency (past month, past year, over a year ago). These likert scales maybe be interpreted numerically (1-mild, 2- moderate, 3- severe and 1-over a year ago, 2- past year, 3- past month) with a higher score indicating higher severity and recency of each of the measured social harms. Scores range from 1 to 3 on each severity and recency scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disclosure Comfort | Through 60 min Interview and survey period | Willingness to disclose suicidal thoughts or severe distress to each of 9 potential support persons (spouse, parent, sibling, close friend, religious leader, CHW, health worker, traditional healer, employer/teacher) rated on a 4-point scale (1-definitely would, 2- might, 3- probably not, 4- definitely not). Scores on this Likert Scale range from 1-4 with lower scores indicating high comfort disclosing to a sub-group of support persons and higher scores indicating low comfort of disclosure. |
| Support Activation Preferences | Through 60 minute interview and survey period | The core Connection Prescription module. For each potential support person, participants indicate: (a) whether they would want that person contacted if they were in crisis, (b) under what conditions (only with my permission, if I'm in danger, anytime), (c) what they would want that person to do (listen, stay with me, take me to clinic, pray with me, nothing), and (d) who should NEVER be told. This directly parameterizes the Connection Prescription. Question (a) is a discrete choice response with yes scored as '1' and no scored as '0'. TQuestion (b) is rated on a likert scale ranging 1-3 with 1 indicating more consistent comfort with supporter activation and 3 indicating activation in only particular circumstances. Question (c) will allow participants to select mutli-items form the scale and question (d) will allow participants to fill in the blank thus not being scored. |
Countries
Uganda
Contacts
CONTACTYang Jae Lee, MD
PRINCIPAL_INVESTIGATORYang Jae Lee, MD
Yale University
Outcome results
None listed