Experiences of adults who survived suicide attempts in rural Uganda: Stigma, support systems and reintegration

乌干达农村地区自杀未遂幸存者的经历:污名、支持系统和重返社会

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Abstract

Suicide disproportionately burdens low- and middle-income countries. In Uganda, attempt survivors encounter intense stigma, minimal mental-health services and social exclusion, elevating their risk of future attempts. Rural African data on post-attempt experiences are scarce. From June to August 2023, we conducted semi-structured, in-depth interviews in Buyende District with 18 attempt survivors, 17 relatives, 10 healthcare workers and 9 community health workers. Transcripts were translated into English and thematically analyzed using the framework method within a phenomenologically informed qualitative design. Three interlinked themes emerged. (1) Stigma-shaped immediate responses: cultural, religious and legal norms fostered moral judgment, social distancing, bureaucratic delays and occasionally police involvement. (2) Informal, uneven support: survivors relied on family aid, religious counseling and ad-hoc community advocacy; effectiveness varied widely. (3) Conditional reintegration: sustained practical help, employment and communal acceptance promoted recovery, whereas their absence perpetuated economic hardship and marginalization. Post-attempt trajectories in rural Uganda are governed by multilevel stigma and fragile support systems. Priority actions include provider training, family-community psychoeducation, stigma-reduction initiatives, structured follow-up care and decriminalization of suicide to foster compassionate responses and reduce repeat attempts.

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