Background: One of the authors (PM) did a study of parasuicide patients at Voortrekker Hospital in the Waterberg District of Limpopo Province, South Africa. The aim of the study was to develop a deeper understanding of the parasuicide patients' perceptions regarding their reasons for attempting suicide.

Method: A qualitative descriptive study was conducted using free attitude interviews in English with eight purposefully selected participants. Participants were recruited from patients admitted to Voortrekker Hospital during the study period after attempting suicide. The interviews were audio-recorded and transcribed verbatim. Themes were identified through the McMillan method. A combined list of themes was compiled. The results were interpreted, conclusions were drawn and recommendations were made.

Results: Reasons identified were multi-factorial and can effectively be summarised by the term bio-psychosocial, which gives an indication of the range of problems. Included were predisposing economic and health-related factors, substance abuse and disturbed interpersonal relationships. Other contributory factors were emotional reactions, unpleasant feelings and thoughts of self-killing with the expectation to die and rest in peace. These factors were interrelated and connected to each other in various ways. The process of parasuicide consisted of a combination of these factors, but was different for each participant.

Conclusions and recommendations: A range of psychosocial risk factors contributes to parasuicide. Patients said that they had attempted suicide predominantly because there were faced by too many overwhelming physical or social problems, they felt isolated and that their lives were meaningless and purposeless. In addition to the findings obtained from the research, the process of qualitative free attitude interviewing were helpful in that the process of learning the interview techniques improved the researcher's skills and therefore the quality of care given to patients (participants in the study and others). The participants also felt that ventilating and sharing their problems were beneficial to them.