Social Work Nepal

Chapter 1

Introduction

1.1 Introduction to Research

Research must be systematic and follow a series of steps and a rigid standard protocol. These

Rules are broadly similar but may vary slightly between the different field of science. The scientific definition of research generally state that a variable must be manipulated, although case studies and purely observational science do not always comply with this Systematic investigative process employed to increase or revise current knowledge by discovering New fact. It is divided into two general categories: (1) Basic research is inquiry aimed at increasing Scientific knowledge, and (2) Applied research is effort aimed at using basic research for solving Problems or developing new processes, products, or techniques.

Research is a careful and detailed study into a specific problem, concern, or issued using the Scientific method. It’s the adult form of the science fair projects back in elementary school, where you try and learn something by performing an experiment. This is best accomplished by Turning the issue into a question, with the intent of the research to answer the question.

According to Merriam-Webster, Studious inquiry or examination; especially: investigation or experimentation aimed at the discovery and interpretation of facts, revision of accepted theories or law in the light of the new facts, or practical application of such new or revised theories or law.

According to Wikipedia, Research comprises “creative work undertaken on a systematic basis in order to increase the stock of knowledge, of humans, culture and society, and the use of this stock of knowledge to devise new application.” It is used to established or confirm facts, reaffirm the result of previous work, solve new or existing problems, support theorem, or develop new theories.

Research is a systematic inquiry to describe, Explain, predict and control the observed phenomenon. Research involves inductive and deductive methods (Babbie, 1988). Inductive method analyze the observed phenomenon and identify the general principles, structures, or processes underlying the phenomenon observed; deductive method verify the hypothesized principles through observation.

Background

The topic Suicide tendency among teenager in Laitpur area is done by BASW 2^ND Year students. This research is done in order to find out suicidal tendency among teenagers in Lalitpur area.

The term suicide describes the act of taking one’s own life. There are various kind of suicides,

So our first task is to clarify our use of the term. Within this article, we are referring to suicide in the conventional sense, in which someone plans out or acts upon self-destructive thoughts and feelings, often while they are experiencing overwhelming stress.

Suicide is the third leading cause of death in 15 to 24 year olds. According to the National Institute of Mental health, reliable n scientific research has found the following:

a) There are 25 attempted suicides to one complete suicide- with the ratio even higher in

Youth.

b) The strongest risk factors for attempted suicide in youth are depression, substance abuse, and aggressive or disruptive behavior.

c) The reason behind a teen’s suicide or attempted suicide can be complex. Although suicide is relatively rare among children, the rate of suicide attempts increases greatly during adolescences.

Suicides among young people continue to be a serious problem. Each year in the U.S Thousand of teenagers commit suicide. Suicide is the third leading causes of death for 15-to-24 year olds, and the sixth leading cause of death for 5-to-14 year old.

Teenage suicide designated the act by which a teenage voluntarily brings about his death. In most cases, this is not simply a wish to die, but the ultimate means of escaping from great suffering or from a situation from which the teenage can find no exit. A suicide attempt is defined as an act, which is not successful, through which a teenage express a wish to a harm himself or herself, putting him or her in danger with the intention of brining danger to his or her life.

World Health Organization (WHO) has given a comprehensive definition of attempted suicide as, “an act with a non-fatal outcome in which an individual deliberately initiates a non-habitual behavior that, without intervention from others, will cause self-harm, or deliberately ingest a substance in excess of the prescribed or generally recognized therapeutic dosage, and which is aimed at realizing changes which the subject desired via the actual or expected physical consequence.” Pattison and Kahan (1983) have defined deliberate self-harm (DSH) as harming oneself intentionally, with or without suicidal intent.

Globally every 40 seconds, a suicide case happens. Deliberate self-harm or suicide attempts are universal phenomenon and may be having various underlying causes including socio cultural, psychiatric and personality disorders (PDs). A previous suicide attempt and its severity are considered as one of the strongest predictors of future completed suicide. Suicide is the tenth leading cause of death worldwide, accounting for 1-5% of all deaths, and has an estimated global figure of a million deaths per year. Estimated annual mortality is 14-5 deaths per 100,000 people which may differ across the world, based on age, sex, time, ethnicity and legal and administrative practices. In 2013, suicide was the second leading cause of death among persons aged 15-24 years, the second among persons aged 25-34 years, the fourth among person aged 35-54 years, the eighth among persons aged 55-64 years, the seventeenth among persons 65 years and older, and the tenth leading cause of death across all ages. Sri Lanka has a suicide rate of 20 (2009, Police Department statistics), Bangladesh 7.0 (2009, from news agencies report), and 10.9 per 100,000 of population a year in India with annually over 100,000 people killing themselves (2009). There is paucity of such studies in Nepal though one of the national daily English newspaper, “The Kathmandu post” reported that the number of suicides as per police statistics was of 2789 suicides in s2007 translating into an annual suicide rate of 12 per 100,000 of population and a community-based study conducted in Lalitpur district of Nepal by Thapa and Carlough found a suicide rate of 3.7 per 100,000 population per annum. According to a study conducted in Nepal during 2008/2009, Maternal Mortality Ratio (MMR) has clearly indicated higher rate of suicidal attempts among women of reproductive age (Pradhan A, Suvedi B K, Barnett S et al., 2009). Various media reports have shown increased rate of suicide among disaster survivors i.e. April earthquake in Nepal last year. According to Home Ministry (Nepal), the suicide rate among the earthquake survivors in Nepal has increased by 41%. Hagaman, Maharjan, and Kohrt (2016) have sought for anti-stigma and community related early detection awareness programs in Nepal as majority of the people including government organizations are not well equipped for tackling with this issue. The current proposal aims to fulfill that gap by organizing various activities related to suicide prevention.

1.4 Statement of the study

The research paper is based on teenage suicide and their tendency to commit suicide. It attempts to find out which sex group commits more suicide and which group have more suicidal tendency.

We “Suicidal ideationa among teenagers among lalitpur districts.”

1.5 Significance of the study

The aim of the study is to find out thoughts of suicidal tendency among teenagers in Kathmandu Valley.

· Academic sector

· Development sector

Academic sector

As a child spends a long time in school so it is the responsibility of school staff to provide better interaction to the child to stop or at least minimize the rate of suicide. The attitudes of frontline school staff (i.e. teachers, counselor, nurses, social workers and administrators) toward suicide prevention programs are important in developing a richer understanding of how to effectively implement these programs across a school.

Preventing youth suicide is an issue that naturally garners support from everyone including parents, policy makers and youth directly and indirectly affected. Schools can play a positive role in suicide prevention because they offer consistent, direct contact time with large population of young people.

The essential role of teachers in the implementation of gatekeeper model is particularly important to explore, given that teachers spend more time with students than any other school staff. They are uniquely positioned to detect students at risk for suicide, yet little is known about their perspectives regarding the implementation of the gatekeeper model, the assumption of an enhanced “gatekeeper” role or their own ability to accurately identify, approach and refer at-risk students. This issue is of particular interest in middle schools, given the drastic change from the student-teacher relationship in elementary school, where students stay with one teacher for the entire school day.

In middle school, students typically rotate classes throughout the day, giving each teacher only a brief window in which to observe individual student behavior. In addition, middle school well recognized as a vulnerable time for the onset of mental health and academic difficulties. Gatekeeper training programs appear to impact teacher attitudes, knowledge and ability to identify potentially suicidal students.

2.5.2 Development sector

Development sector come to know that when addressing new policies where could be placed in proper manner. This seminar paper helps to the INGOs, NGOs and GOs which is working on the field related to suicidal tendency among adolescents. The rate of suicide has increase too much in Nepal and this trend is the outcome of increasing mental illness or depression among the youths. Therefore, suicide is increasing in rapid form. Despite of being the major public mental health issue people do not want to talk about mental illness. Suicide is every day issue for youths in Nepal although exact number are unavailable the problem is on rise & demand change.

Why in adolescent?

Adolescent is stage of life where there are rapid changes in their physical body, psychological & social roles. At the same time the prevalence of suicide is seen high in adolescent. In spite of high prevalence many studies have been done so. Such types of study help to assess the knowledge regarding suicide.

Adolescence is the period during which the individual undergoes extensive physical, psychological, emotional and personality changes. Adolescent period is often believed to be a difficult period and very critical stage of transition. Most adolescent stress is related to lack of identity which usually arises because they start to think about who they are and what they want to become and this tend to put them under a pressure to discover their real identity.

1.6 Objective

· To identify the knowledge about teen suicide.

· To review the available research and literature regarding causes of suicide among teenagers.

· To find the factors associated with teen suicide.

· To assess the status of suicidal tendency among the adolescents.

· To find out how they perceive about suicide.

· To assess the status of suicide among the teenager.

· To identify knowledge about teenager suicide.

1.7 Hypothesis

Tendency of suicide is higher in teenage girls than that of boys.

1.8 Limitation

· This research aid to minimize suicide but it doesn’t bring complete end to a suicide.

· The study was conducted only in Lalitpur district so; it may not be applicable in other rural area of Nepal as the problem faces by them may be different.

· Biasness has occurred as researcher has chosen non probability sampling type.

Chapter 2

Literature Review

2.1 South Asian Context

Teens are under enormous pressure and stress. They are competing in school for good grades, they are faced with college application and job hunting. Teen suicide is an unfortunate result of all the pressure and stresses. Knowing how to help with teen suicide prevention can save lives because it focuses on helping teens realize that life is too special too commit suicide by minimizing through the positive and risk factors during the adolescent period.

The risk of suicide increases dramatically when kids and teens have access to firearms at home, and nearly 60% of all suicides in the United States are committed with a gun. That's why any gun and arms in the house should be unloaded, locked, and kept out of the reach of children and teens. Globally every 40 seconds, a suicide case happens. Deliberate self-harm or suicide attempts are universal phenomenon and may be having various underlying causes including socio cultural, psychiatric and personality disorders (PDs). A previous suicide attempt and its severity are considered as one of the strongest predictors of future completed suicide. Suicide is the tenth leading cause of death worldwide, accounting for 1-5% of all deaths, and has an estimated global figure of a million deaths per year.In 2013, suicide was the second leading cause of death among persons aged 15-24 years.

According to WHO global suicide report, suicide in the world amounted to just over 800,000 deaths in 2012, representing 1.5 percent of total mortality and about 16 percent of injury mortality. The worldwide suicide rate is estimated at 11.4 per 100,000 inhabitants, similar to the average rate reported for 2008, making it the 15^th most common cause of death worldwide. Indeed, a recent review of suicide in Asia demonstrates higher average suicide rates in Asia compared to high-income countries. In many low- and middle-income countries (LMIC), no national suicide data is available or their reliability is questioned.

Each year worldwide approximately one million individuals die of suicide, 10-20 million attempt suicides, and 50-120 million are profoundly affected by the suicide or attempted suicide of a close relative or associate. Asia accounts for 60 percent of the world’s suicides, so at least 60 million people are affected by suicide or attempted suicide in Asia each year (Beautrais, 2006).

Despite this, suicide has received relatively less attention in Asia than it has in Europe and North America. Lack of resources and competing priorities in many Asian countries have contributed to this under-emphasis. Cultural influences, religious sanctions, stigmatization of the mentally ill, political imperatives, and socio-economic factors have also played a significant role. As a result, the magnitude of the problem is unknown in some Asian countries and – although there are some highlights in terms of preventive initiatives – overall efforts are uncoordinated, under-resourced, and generally unevaluated (Vijayakumar et al., 2005a; Beautrais, 2006; WHO, 2007).

2.2 In Nepal

The rate of suicide in Nepal has been reported to be as low as 3.7/100, 00 because of under reporting caused by issues of legality, social stigma, and logistical problems.

Suicide is illegal in Nepal and is punishable by fines and imprisonment. According to the director of Samanta, a Nepalese organization for women’s rights, "most families will never report suicide cases as they are afraid of being entangled in police cases." In attempts to avoid legal trouble, suicidal patients and their families may avoid going to hospitals for treatment. Even after death, victims of suicide may have their deaths misattributed to avoid legal problems for their families.

Families may also avoid reporting suicides due to social stigma and discrimination against people with mental health problems. Despite the recent abundance of articles discussing suicide in Nepal, issues related to suicide are largely avoided, both as the result and perpetuation of a powerful social stigma against mental illness. For women in particular, the under reporting of suicides and suicide-attempts may be caused in part by a "culture of silence", especially in cases related to domestic abuse.

Finally, logistical issues pose a threat to accurate reporting and record keeping. According to the Nepal Health Sector Support Programme, due to "poor record keeping by police and hospitals" as well as the fact that "registration systems are inaccurate and of poor quality," suicide may continue to be under reported even if social and legal issues were to be resolved.

Chapter 3

Methodology

3.1 Research Design

The sample consist 100 people (50 male, 50 female) living in Lalitpur District. Participants will be selected randomly from the people living in Lalitpur District by Quota Sampling.

Male	Female
50	50

Fig1: Distribution of Sample on Basis of Gender

Factorial Design

Gender(A) – Male(A1), Female(A2)

A
A1	A2

Fig 2: Factorial Design

3.2 Sampling

Sample refers to the subsets of the overall population selected in order to be representative of the population. Sampling is the .process of selecting of the sample.

Sampling was done in order to select respondent for the survey.

Sampling Method: Quota Sampling

This research use Quota sampling. Quota sampling refers to non-probability sampling where sample are selected in order to fit certain quotas.

Sample Size

The sample size is 100 people who are adolescents. Out of them 50 were male and 50 of them are female.

3.3 Tools

The question was designed by Dr. Devendra Singh Sisodia and Dr. Vibhuti Bhatnagar which was published by National Psychological Corporation, Agra. It consist of 25 items. It have 5 points of rating scale. Each items has five option for response, which are strongly agree, agree, uncertain, disagree and strongly disagree. Instruction provided are remembered to give your response to all the statement, no response is wrong or right and your response will take confidentiality.

Ways of Scoring

Statement	Strongly Agree	Agree	Uncertain	Disagree	Strongly Disagree
Positive	5	4	3	2	1
Negative	1	2	3	4	5

Fig 3: Ways of Scoring

Reliability

The reliability of scale was determined by (a) test-retest method and (b) internal consistency method. The test-retest reliability was 0.78 and consistency value for the scale is 0.81.

Validity

Besides face validity as all the items of the scale are concerned with the variable under focus, the scale has high content validity. The scale was validated against the external criteria and coefficient obtained was 0.74.

Data Collection Method and Analysis Procedure

Survey method was used in the study using questionnaire. Researcher used individual and group approach for data collection. Individual approach include individual filling of questionnaire and group approach includes going to different school of Lalitpur district. Then we calculated mean from their fill up questionnaire and we used Ms. Excel is used for Presentation of Data, Calculation.

Research Design:

Procedure: First of all things needed for the survey is collected. Questioners are prepared. 100 participants of age group 13 to 19 combining both studying and working teenagers are selected. Then suitable research method and designs are selected.

Methodology

The study area and rational of selection out of different area was the sample area for this study. We choose respondent of age 13 to 19 staying in Lalitpur area. This study based on primary data which are collected from teenage people staying in Lalitpur area and students studying in Lalitpur school and secondary data collected from internet.

3.1.1 Primary Methods

Primary method are those that are collected or seen firsthand, it is not handed or passed from one person to another and the information is not distorted or changed as the information is collected firsthand.

· Questionnaire

We visited the different areas and school of lalitpur with prepared questionnaire. Each correspondent took around 5 minutes to complete the survey.

3.1.2 Secondary Data

Secondary method are those kinds of methods that are collected or seen secondhand, it is not collected or seen finished. This information can sometimes be wrong or changed due to being handed from one person to another.

· Net Surfing:

The student collected relevant information regarding the chosen topic as according to the objective set beforehand. Student visited different sites with different information to better understand about the subject and learn more about topic. Student found various information and data which was very informative and helpful. Student read and collected information and data by reading various reports, article, books, etc.

Chapter 4

Presentation and analysis

4.1 Differences in Mean Score according to Gender

Respondent	Mean Score
Boys	62.66
Girls	62.48
Total	63.57

Fig 4: Mean difference of boys and girl

In the above bar-diagram we can see the average mean of the boy is 62.56% whereas girl average mean is 64.5%. The score of the girl is higher than that of the boys. In total mean score is 63.57%. There is average suicidal tendency for the teenage boys and girls but there is higher risk or chance that the suicidal tendency is more in the girl than that of the boys.

Average Mean Score of Boys and Girls

	Mean Score
Boys	62.66
Girls	64.48

Fig 5: Mean Scores of Boys and Girls

From the above figure, it can be said that thought of suicidal tendency among the teenagers is greater in girls as compare to boys. Boys mean score is 62.66 whereas girls means score is 64.48.

4.2 Overall analysis

As we can see that the tendency of suicide in teenager girl is higher than that of the boys. And as for the research the teenagers who are between the 16-19 have the high tendency to suicide as shown in their scores. Between this period the teenagers have more knowledge about outer world than the 13-15 and the girls are more risk towards the suicide as they go through the series of biological changes within their body as well as the adjustment in their society for which they find it emotionally disturbed, stress, mental pressure which are leads to the suicidal thoughts, and death as the ultimate choice of the life for which they choose suicide. And as for

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