Presentation Information
[O-7-01]Maternal suicidality in Pakistan: Developing a critical feminist grounded theory to inform suicide prevention programs
*Gul Aimen Saeed1, Sidra Mumtaz2, Javeria Tanveer2, Erum Hamid2, Sidra Jehan2, Maria Atiq2, Maria Kanwal2, Siham Sikander2,3, Ashley Hagaman1 (1.Yale University (United States of America), 2.Global Institute of Human Development (Pakistan), 3.University of Liverpool(UK))
Keywords:
Culturally grounded suicide prevention research,Grounded theory,Maternal health,Global mental health,Pakistan
Background: South Asia has the highest rate of suicide fatalities globally. Evidence from Pakistan suggests that suicide has been on the rise since 2016, particularly among women of reproductive age. However, the underlying factors contributing to suicidal behavior among women in Pakistan remain underexplored. This study aimed to decolonize existing western-based theories of suicide and generate a theory informed by women in Pakistan’s lived experiences of suicide.
Methods: We employed a decolonized form of grounded theory, informed by critical feminist theory and Pakistani feminist scholarship, to explore the experiences of suicide among 12 women with a chronic history of suicidality in Punjab, Pakistan. Data were collected using in-depth interviews and analyzed in Urdu by female Pakistani scholars.
Results: We generated a grounded theory of suicide among women in Pakistan. Women's suicidal thoughts and behaviors were largely influenced by their positionality within their husbands’ households and relationship dynamics, which were characterized by emotional and physical abuse, neglect from their husbands, and invalidation from their in-laws. Resulting from these dynamics, in the context of women grieving their loss of agency and natal-home lives, were feelings of abandonment, resentment, and helplessness, which reduced women’s threshold for maintaining patience, a key moral protective role identified by most women. While anger and desire to escape abuse prompted suicide attempts, suicidal death threatened women’s relationship with Allah and peace in their afterlife. Among women’s reasons for living, trust in Allah's plan was the strongest reason followed by a unique duty for their children.
Conclusion: This study challenges Western interpersonal theories of suicide and provides insights into the complex and context-specific factors that influence suicide among women in Pakistan. Our findings can guide the development of culturally appropriate suicide prevention interventions sensitive to Pakistan’s unique sociocultural and religious context and ultimately, reduce the national burden of suicide.
Methods: We employed a decolonized form of grounded theory, informed by critical feminist theory and Pakistani feminist scholarship, to explore the experiences of suicide among 12 women with a chronic history of suicidality in Punjab, Pakistan. Data were collected using in-depth interviews and analyzed in Urdu by female Pakistani scholars.
Results: We generated a grounded theory of suicide among women in Pakistan. Women's suicidal thoughts and behaviors were largely influenced by their positionality within their husbands’ households and relationship dynamics, which were characterized by emotional and physical abuse, neglect from their husbands, and invalidation from their in-laws. Resulting from these dynamics, in the context of women grieving their loss of agency and natal-home lives, were feelings of abandonment, resentment, and helplessness, which reduced women’s threshold for maintaining patience, a key moral protective role identified by most women. While anger and desire to escape abuse prompted suicide attempts, suicidal death threatened women’s relationship with Allah and peace in their afterlife. Among women’s reasons for living, trust in Allah's plan was the strongest reason followed by a unique duty for their children.
Conclusion: This study challenges Western interpersonal theories of suicide and provides insights into the complex and context-specific factors that influence suicide among women in Pakistan. Our findings can guide the development of culturally appropriate suicide prevention interventions sensitive to Pakistan’s unique sociocultural and religious context and ultimately, reduce the national burden of suicide.