The Efficacy of Community-Based Intervention in Prevention of Self-Immolation

Suicide by burning oneself is rare in developed countries, but more frequent in developing countries. Based on Iranian official data, 27% to 36% of patients may who committed suicide were via deliberate self-burning. Self-immolation caused up to 37% of all admissions to in Iran burn centers. Approximately 80 % of hospitalized self-immolation patients die. All descriptive self-immolation studies in Iran emphasize the need for implementing prevention programs. The Objective of this study was describing the effectiveness of a community based program targeting prevention of self-immolation.
Methods and Material: In a Quasi experimental project, the populations of two Iranian cities; Gilangharb (Intervention) and Sarpolzahab (Reference); were participants in this intervention study. Hospital data collection on self-immolation patients and suicide attempts (all mechanisms) was made from March 21 1999 to March 20 2003. The first 12 months of the study provided baseline data, while the last 3 years comprised of a community based intervention, using a mix of passive and active interventions. Videos showing victim stories were an important component in the prevention program.
Results: Compared to baseline, the mean self-immolation attempts rate decreased by 57 % after the implementation of the intervention in Gilangharb (P<0.05). Moreover, in Gilangharb a 19 % decrease of suicide attempts (all mechanisms) was observed while the corresponding reference city rate increased by 24% (n.s.). While the suicide attempt rates were similar in the two populations during baseline, the mean rates observed during the intervention period differed significantly (p<0.001).
Conclusions: A community prevention program targeting self-immolation can be effective. Local data and the showing of videos depicting victim stories from self-immolation attempts provided a stimulus for community action.