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Background: Individuals who do not adhere to their treatment regimens may be at greater risk of suicide but these issues are relatively unexplored in primary care services. Aim: To explore GPs' views and perspectives on the reasons why patients who were in contact with mental health services in the year prior to suicide was non-adherent to treatment prior to their death. Method: In total, 198 semi-structured face-to-face interviews with GPs of people who had died by suicide. Interviews were transcribed verbatim and analyzed using a thematic approach. Results: The following themes were conceptualized from GP interviews: (i) "Lack of insight or denial?" relates to what GPs perceived as their patients lack of insight into their psychiatric illness; (ii) "Lack of treatment choices" discusses GPs' understanding of patient treatment choices; (iii) "Services for comorbidity and dual diagnosis" refers to treatment availability for suicidal patients with two or more mental health diagnoses. Conclusions: For suicide prevention, it is crucial for health professionals to assess patients and manage the possible causes of non-adherence. Policies for increasing treatment adherence, improving services for dual diagnosis, or providing alternative treatments to meet individual patient needs may help to achieve the best health outcomes and could potentially prevent suicide. [ABSTRACT FROM AUTHOR]

The article comments on the issues raised by the writer and researcher on psychology and counseling that Pittu Laungani had argued during his conversation with William West, a researcher at the University of Manchester in England. The author first related her formal education in Africa and compared it with Laungani's education in Kenya where he was taught on a more traditional English. With this, the author realized that there was a segregation along the way, hierarchy between races and an intersection between race and class. She explained that the conversation of Laungani and West was an example of a contact between two culturally different groups.

Person-centred therapy typically fails to address structural dimensions of inequality such as ‘race’, gender and class. In this paper, I explore why this is, and what can be done about it – at the levels of theory, practice and the organisation of services. Drawing on person-centred theory and practice, I discuss theoretical and practical resources that can inform a critical therapeutic practice that both attends to the individual and connects with social contexts. Focusing on the intersectionality between gendered and ‘raced’ positions mobilised within any therapeutic intervention highlights the inevitability of working across various dimensions of structural difference and power. Rather than obscuring these, I illustrate how a direct engagement with them can enhance person centred theory and practice. In particular, I highlight the role of racialised and gendered conditions of worth (Chantler, 2004) together with concepts of minoritisation and intersectionality (Batsleer et al., 2002). I also indicate ways forward for inclusive counselling services. [ABSTRACT FROM AUTHOR]

In this article we draw on feminist and psychodynamic theory to discuss processes of researching service provision for minoritised women escaping domestic violence. Our aim is to take seriously the ways particular contexts, in this case as produced by the process of researching this topic, elicit specific responses. In particular we offer some conceptual tools for analysing the emotions generated in these geographies. Taking the 'space' of the research team as our focus, we analyse how culturally defined meanings of 'home', community and refuge that were the focus of our research topic also functioned as a lens through which tensions and dynamics within the project team could be understood. Just as secrecy, silence and shame figured in our participants' accounts, so they circulated between the team. Drawing on the motifs of the intersection of 'space' and 'place' (as they occur within discourses and practices around domestic violence and minoritisation) as well as the psychodynamic notions of 'mirroring' and 'parallel process', we consider the extent to which the combined racialised, gendered and institutional relationships structuring the research team constituted it as a 'non-place'. This is because it was a space produced by the research process which, other than this, had no acknowledged tradition of history or memory to anchor it. We discuss how this space functioned paradoxically to foster creativity and innovation in generating discourses and practices working across difference, as well as inevitably at times recapitulating prevailing power (including racialised) relationships. We end by evaluating the usefulness of such concepts for wider analyses of intercultural and antiracist feminist practice. [ABSTRACT FROM AUTHOR]

This paper draws on a ten month British study completed in April 2001 investigating service responses to women of South Asian background who had attempted suicide or who self-harmed. The scope of the study is briefly outlined and an analysis of perspectives documented in the study is presented, drawing on research interviews with 18 staff from a variety of health and social care disciplines and with seven survivors of attempted suicide/self-harm. The implications of this analysis for improving practice are considered. Attitudes surrounding attempted suicide and self-harm are discussed. The issue of 'race anxiety' is also discussed. The factors seen by workers as contributing to South Asian women's attempted suicide are considered, with a particular focus on the difficulties caused in the delivery of services by common-sense accounts of cultural issues. Current approaches to the delivery of services to South Asian women are identified and analysed, showing how their current organisation can lead to circularity in referral systems and consequent non-intentional neglect of the needs of this client group. It is urged that proper consideration be given to the support and professional supervision of staff in this complex area of work. [ABSTRACT FROM AUTHOR]

This article explores systemic service inequalities around attempted suicide and self harm by South Asian women. It focuses on a 10 month study investigating service responses to women of South Asian background who have attempted suicide or have self-harmed. Claims are that South Asian women are positioned in systematically unequal ways in terms of their access to services in relation to non-minoritised women, notwithstanding many commonalities of issues and concerns with other women. Central to the study were the survivor accounts, as perspectives that are often missing from the thinking driving service commissioning and provision. Measuring rates of suicide is complex, but the current measurement is that there are just over 4,000 deaths from suicide a year nationally. The primary purpose of the study was to conduct a qualitative study of suicide and self-harm services in relation to South Asian women in order to: compile a service map of potential sources of help; identify the current level and appropriateness of services being offered to South Asian women who self-harm and/or are suicidal; increase understanding of the specific factors contributing to the distress of South Asian women; identify examples of good practice; to identify gaps in service provision to this service user group; and make recommendations to improve self-harm/suicide services to South Asian women.