Suicide Funnel: Ideation, Planning and Attempting

Introduction: Psychiatric disorders are getting the top ranks of disease burden in recent years. One of these disorders or actually emergencies; suicide, is a complex and multi-factorial health phenomenon. It has a continuum from suicide ideation (SI), suicide planning (SP) and suicide attempting (SA). Very little evidence has focused on this continuum specially in self-inflicted burns. The aim of this study was to evaluate suicide continuum in self-inflicted burns.Methods: All intentionally self-inflicted burn patients who were admitted to Imam Reza Burn Center from March 2018 to October 2018 were studied prospectively. A standard checklist about previous SI, SP and SA was filled for patients after taking the informed consent. Data was analyzed using SPSS version 25 with chi-square test.Results: Mean age at first SI, SP and SA was 19.1±6.2, 19.4±8.7 and 20.2±5.0, respectively. Fifty-two percent (12 out of 23 individuals) declared that they had serious SI in the past 12 months, 39% had serious SP in the past 12 months. Long life SA was 1.2±2.3 (range: 0-10). Thirty -nine percent had previous SA which was with drug (4 individuals) followed by poison (2 individuals), hanging (1 individual), self-mutilation (1 individual) and other methods (1 individual). Sixty-seven percent of individuals with prior SI had SP (p=0.009), and 78% of individuals with prior SP had SA (p=0.007). However, the start and end of this continuum was not related: only 58% of individuals with prior SI had SA (p=0.08). Seventy percent (16 individuals) had not used any psychiatric services before that.Conclusion: These results show that the chain of ideation, planning and attempting suicide can be broken by proper health interventions. Breaking the taboo of psychiatric stigma can encourage lay people to seek help from professionals.