Attitudinal beliefs concerning suicidal behavior among healthcare professionals in the Western Costa del Sol healthcare district (Spain)

Abstract

Introduction. Suicide continues to be the leading external cause of death in Spain, according to the latest report on deaths by cause of death published by the National Statistics Institute (INE, for its initials in Spanish) in December 20191 . According to this report, there were 3,539 deaths by suicide recorded in 2018. Ten people voluntarily ending their lives each day. Málaga province recorded 134 deaths by suicide in 2018, being therefore one of the provinces with the highest incidence in the autonomous community of Andalucía and the eighth nationally.

Method. This descriptive, cross-sectional survey of healthcare professionals was carried out in one healthcare district in Málaga (Spain). The main outcome variable was attitudinal beliefs, which were evaluated using the Questionnaire on Attitudinal Beliefs Regarding Suicidal Behavior (CCCS-18). The questionnaire includes four factors: legitimization of suicide, suicide in terminally ill patients, moral dimension of suicide, and suicide itself, each measured via an average of responses to different items on a scale of 1 to 7 points. Stigmatizing attitudes or beliefs are defined as those with average scores of less than 3.5.

Results. 135 health professionals completed the questionnaire: 58.5% were nurses, 25.9% were physicians, and 15.6% were medical social workers. The mean score on the CCCS-18 scale was 3.6 (SD: 1.17) points, with significant differences depending on the profession (p = .043). A mean of 3.22 (SD: 1.17) was found among physicians, 3.66 (SD: 1.02) among nurses, and 3.99 (SD: 1.52) among medical social workers. In an analysis by factors, mean scores below 3.5 were found for “legitimization of suicide” (mean: 2.59; SD: 1.28) and “suicide itself” (mean: 2.9; SD: 1.47).

Conclusions. Healthcare professionals in the Western Costa del Sol Health District expressed unfavorable attitudes and beliefs in dimensions related to legitimization of suicide and suicide itself, with worse overall attitudes found among physicians.