"When you are alone you have a narrow mind, but when you are with others you think broader into the other aspects". A qualitative study on the role of sense of belonging and mattering in attempted suicide in Uganda.

INTRODUCTION: Suicide is globally a severe problem with an estimated 700.000 deaths annually. Six of the 10 countries with the highest suicide rates worldwide are in Africa, though, reliable statistics are scarce. METHOD: In this qualitative interview study in Uganda, we analysed the stories of 16 people admitted to hospital following a serious suicide attempt. We focussed especially on each person's decision process towards their resolution to attempt suicide. FINDINGS: Despite the huge heterogeneity of the narratives, we could identify problems regarding the sense of belonging and mattering in all the stories. Both the sense of belonging and mattering have been related to suicidal behaviour in earlier theories, but they were never studied together or under consideration of the influence of this specific cultural context. We found that the participants' sense of belonging and mattering to a large degree was influenced by their traditional communalistic context with a worldview where the line between the natural and spiritual world was blurry. CONCLUSION: This kind of knowledge could be a valuable source for health professionals in their treatment of suicidal persons; it could direct their approach to the core of each person's relational problems and meaning-making, which is crucial for their decisions with regard to suicide.