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APPENDIX 20 RECORDS DISPOSITION SCHEDULE 20 SINGLE FAMILY HOME MORTGAGE INSURANCE PROGRAM RECORDS Item No. Description 'of-Record 10. Closed Case Card Record File consists of insured case record cards, FHA Form 9100.3, Mortgage Insurance Certificate, and FHA Form 20868, Non-Insured Case Card. Subdivision Reports File.
Abstract Background Suicide among young people has emerged as a major public health issue in many low- and middle-income (LAMI) countries. Suicidal behaviour including ideation and attempt are the most important predictors of completed suicide and offer critical points for intervention. The aim of this study is to estimate the prevalence and risk factors for suicidal behaviour in young people in India. Method and findings Cross-sectional study of 3662 youth (16–24 years) from rural and urban communities in Goa, India. Suicidal behaviour during the recent 3 months and associated factors were assessed using a structured interview. Overall 144; 3.9% [95% confidence interval (CI) 3.3–4.6] youth reported any suicidal behaviour in the previous 3 months. Suicidal behaviour was found to be associated with female gender Odds ratio (OR) 6.5 (95% CI 3.9–10.8), not attending school or college OR 1.6 (95% CI, 1.01–2.6), independent decision making OR 2.5 (95% CI 1.5–4.3), premarital sex OR 3.2 (95% CI 1.6–6.3), physical abuse at home OR 3.3 (95% CI 1.8–6.1), life time experience of sexual abuse OR 3.3 (95% CI 1.8-6.0) and probable common mental disorders (CMD) OR 9.5 (95% CI 6.3–14.5).
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Gender segregated analysis found independent decision making ( P = 0.68 for interaction), rural residence ( P = 0.01 for interaction) and premarital sex ( P = 0.41 for interaction) retained association with suicidal behaviour only among females ( P. ,,, Introduction Global mortality data indicates suicide as the fourth leading cause of death among young males and the third for young females. Reliable statistics on completed suicides are uncommon in many low- and middle-income (LAMI) countries including India.
Official data from India demonstrates a 27.7% increase in recorded number of suicides between 1995 and 2005 with a current suicide rate of 10.5/1 000 000. About 35% of suicides occur amongst youth (15–29 years). Two recent studies from south India, using a verbal autopsy method show that official rates are likely to be gross underestimates of the true rates.
One study, for example, reported a rate of 152/100 000 for girls and 69/100 000 for boys aged 15–19 years between 1992 and 2001. Compared with the rates from high-income countries, these rates are about 50–70 times higher for girls and about four times higher for boys., Thus, suicide among young people has emerged as a major public health issue in India.
Suicidal behaviours, including ideation and attempt are a harbinger of completed suicide. Suicidal ideation refers to thoughts of harming or killing oneself and attempted suicide is a non-fatal, self-inflicted destructive act with explicit or inferred intent to die. A cross-national study comparing suicidal behaviour among adults found life-time prevalence of suicidal ideation ranging from 2.1 to 18.5/100 while suicidal attempts ranged from 0.7 to 5.9/100 with lowest rates reported from Asian countries. However, the completion rates of suicide attempts may be higher in India, and other Asian countries, due to the use of relatively lethal methods of self-harm, such as pesticides. A recent study of completed suicide among youth in China that found 24% had attempted suicide previously. Escalation of suicidal behaviour from ideation to first suicidal attempt occurs within 1 year of the onset of ideation in 60% of cases.
Thus, about one in every 50–200 suicide attempts among youth ultimately has a fatal outcome and the most important correlate for youth suicide is prior suicidal behaviour. Suicidal behaviour in adolescence is also a predictor of compromised functioning, indicating the need for early identification and intervention.
Suicidal behaviours are influenced by a number of factors; identifying these factors and understanding their roles are essential for preventing suicides. Studies employing community samples, mostly from high-income countries, have found mental illness as a major factor associated with suicide, though anecdotal reports suggest that they may be a less common cause of suicide in developing countries. Family conflicts, social maladjustments, breakdown of intimate relationships and exam failure are some of the social factors associated with suicide in developing countries. Indeed, the National Crime Record Bureau reports suggest that family problems is the major reason (22.6%) for suicide among 15–29 age groups in India, while mental illness is attributed to 5% of cases; reasons are recorded as unknown in 16% of completed suicides. Adversities including physical violence, emotional and sexual abuse can lead to substantially higher risk for suicide.