Sunday Times 2
We can prevent suicides
View(s):World Suicide Prevention Day – September 10
By Dr. Chithramalee de Silva
The World Suicide prevention Day falls on September 10 every year. “Connect, communicate, care” is the theme of the 2016 World Suicide Prevention Day. These three words are at the heart of suicide prevention. They will raise public awareness about the importance of having a conversation and, most importantly, how.
The World Health Organisation says one person commits suicide every 40 seconds. Pic courtesy Reuters
Suicide is a major public health problem worldwide and moreover it is considered as a social problem.
Every suicidal death is a tragedy bringing the life of the person to a sudden end; consequently, it has an unbearable effect on families, individuals and friends. The significant number of deaths and hospitalisations place a heavy burden on health systems and the socio economic impact is often huge.
In the world, one person dies every 40 seconds due to suicide. According to the first suicide prevention report by the World Health Organisation, more than 800,000 people lose their life to suicide every year, corresponding to an annual global age standardised suicide rate of 11.4 per 100,000 population with 15 for males and 8 for females.
In Sri Lanka nearly 3,000 people died in 2015 due to suicide with a death rate of 14.7 per 100,000 population (Department of Police. 2015). The rate of suicide is four times higher among men compared
to women.
The reasons
In Sri Lanka, harassment by the spouse and family disputes were reported as the most common reason in 2014 while matters associated with love affairs ranked second. Chronic diseases and physical disabilities, underlying mental illness, economic reasons were the next common underlying factors for suicidal deaths, according to police reports.
Some mental health conditions such as depression, schizophrenia and substance use disorders are major recognised risk factors for suicides and addressing these risk factors will result in suicide reduction. Many suicides are the result of an impulsive act, therefore identifying the people who are at high risk and attending to their psychological, physical, mental and socioeconomic needs are of paramount important.
Impact
Those who attempted suicide or died of suicide and their families experience considerable stigma, and may not seek care. This in turn affects the mental health of survivors and their families. Therefore, those who attempted suicide and their family members require continued support from health care providers for long a period as they face enormous difficulties in leading their life.
Interventions available in Sri Lankan health system for suicide prevention:
- Promoting competencies of school children through curriculum changes and life skills enhancing programmes
- Awareness programmes for schoolchildren on study techniques, anger management, coping with stress and for parents on good parenting through school health programmes
- De-criminalising suicides in health system (not referred to as criminal acts) and provision of better care for those who admitted to hospitals with attempted suicides
- Screening for depression and suicidal risk – especially for mothers during post-partum period
- Provision of psychotherapy and psycho-social interventions for patients with mental illnesses
- Availability of hotline for counselling – 1333
- Strengthening community based mental health services to detect those at risk and provide them care
Media Influence
Both print and electronic media have an enormous impact on the lives of people and therefore responsible media reporting is important in suicidal deaths. The vulnerability and susceptibility of the people often acts as a platform for individuals who are at a greater risk and media events that sensationalise and describe the act in its various dimensions can trigger these acts.
Media can play an effective proactive role in suicide prevention by minimising the prominence given to suicide reports, informing public about sources of help and emergency helpline numbers, encouraging people to take action and seek care, conveying positive stories of people who have overcome suicidal thoughts and ideations.
Actions to minimize suicides:
- Encourage good social support for adolescents, youth and elderly who are at a higher risk
- Good parenting care especially for young persons
- Establishing counselling services in schools, community and work places
- Identifying those who are at higher risk and provide care especially psychosocial care
- Ensure correct medical treatment and follow up of patients with depression and other mental health problems
- Establish hotlines for counselling and popularise among the community
- Restrict the easy access to means of suicides (safe storage of pesticides, chemicals and drugs at both individual and community levels)
- Supporting and strengthening emergency care (including first aid care), in hospital care (including management and referral services) and,
- supportive after care services (psycho-social and counselling services)
- Reduce the stigma associated with suicides and attempted suicides
- Control use of alcohol and drugs
- Strengthen good marital relationship while minimising the gender-based violence
- Mental health promotion and suicide prevention are complementary to each other and policies and programmes addressed for mental health will also contribute for suicide prevention.
“Suicides are preventable… and requires coordinated and sustained effort from multiple sectors of society, both public and private, including health and non-health sectors such as education, labour, agriculture, industry, justice, law, defence, politics and the media. These efforts must be comprehensive, integrated and synergistic as no single approach can impact alone on an issue as complex as suicide “(WHO 2014).
(The writer is Director Mental Health, Ministry of Health, Nutrition and Indigenous Medicine)