All is not lost

Don't take that extreme step. Develop a positive attitude; help is always around the corner.

September 14, 2014 05:25 pm | Updated 05:31 pm IST

15EPBS Suicide

15EPBS Suicide

A student posts on Facebook about being alone and feeling hopeless. He proceeds to send SMSs to his friends that carry a tone of farewell. Alarmed, his friends go to visit him in his hostel room and convince him that things are not so bad, and then they leave. Within the next few hours, the boy does as he had threatened — he ends it all.

This is a tragic story, but, unfortunately, more common than we would like to believe. A story, in fact, which busts myth and misunderstanding about the way suicides happen and do not happen. “People who say it, do not do it,” is the most often heard statement about suicide attempts. However, it is untrue, as demonstrated by the story just narrated.

This is also a story that points to a crying need for awareness and education on suicide prevention and setting up a whole ecosystem of enlightened peers, teachers, professional counselors, psychiatrists and other “gatekeepers” who will support the person who is on the brink.

When I narrated this story to Dr. Lakshmi Vijayakumar, Director, Sneha — an organisation that works to help those with suicidal instincts — she reacted with a gentle nod of her head. It is wrong to think that the suicidal instinct will last only for that moment, she said, cracking one more myth that people believe in. “The above case is not unique, there have been several like that. In such a situation, where the suicidal person announces his or her intention, the right action would be for the friends, or confidante, to get professional help to deal with the person. He or she may need medical attention for two to three weeks until he or she recovers,” she says.

There is a well established link between suicide attempts and mental disorders; however, not all suicides are prompted by these issues. There is a need to study the context in which every suicide or an attempt to suicide happens. Risk factors vary. In many countries, those who are minorities or are marginalised experience a higher risk.

Suicide prevention

September 10 is world suicide prevention day. WHO has released a report entitled, “Preventing suicide: a global imperative” which contains not only shocking data on the numbers and percentages of suicides across the world but also definite plans for putting into place a national suicide prevention strategy.

The most shocking information contained in the report is that the rate of suicides, which is defined as the number of suicides per 100,000 population, was highest for the age group 15-29 years in 2012 (35.5 per 100,000). The number was 36.1 for females and 34.9 for males. The figures for the rates when you take all of the world, for all ages, are 11.4 per 100,000 (15.0 for males, 8.0 for females).

This is shocking not only because many of these could have been prevented but also because for every one of these deaths by suicide, there would have been about 20 people who attempted suicide.

The WHO report stresses the importance of a nationwide action to prevent this from happening. What does this include?

Strategies

Only 28 countries around the world have a national suicide prevention strategy. India, significantly, is NOT one of them. This is despite the fact that this is one of the highest causes of violent death in its population.

Surveillance, means restriction, media guidelines, stigma reduction and raising of public awareness and training of healthworkers, educators, police and others are the first things to develop in a national strategy for prevention of suicide.

The validity of the above suggested strategies has been tested in different countries. To give an example, when responsible media reporting, such as not giving details of suicidal acts, not sensationalising the news, educating the public, etc, was practised, the rates of suicide did go down in Austria and Australia.

Legal aspects

Attempting suicide is a crime in India. It was once the case in many countries around the world. However, in the last fifty years, a majority of countries have changed their laws to decriminalise suicide attempts. Of the 192 countries and states mentioned as having been investigated in the WHO report, only 25, including India, have specific laws and punishments for attempting suicide. Ten other countries follow Sharia law and in these countries also, people who attempt suicide may be punished.

This is also an important point. For “no data or case-reports indicate that decriminalization increases suicides. In fact, suicide rates tend to decline in countries after decriminalisation…” according to the report.

Supporting sufferers

“Young people, just like those of any age group, suffer doubly after a suicide attempt. They are burdened with the guilt of what they have tried and also the problem which prompted them to attempt suicide, which will not just disappear,” says Dr. Vasuki Mathivanan who is a counseling psychologist in Chennai. For two to three weeks after the attempt, the person has to be given good company and watched over with warmth, she says. Awareness of how to recognise symptoms, such as isolating oneself, depression, sharp loss of or increase in food intake, depressed statements, and how to handle and approach the affected person and also, most importantly, how to get help needs to be developed.

Parents and peers play a crucial role in helping someone who has attempted suicide and survived, to get back on his or her feet. It is important at this stage not to further humiliate them but to make them aware that there are people who care for them. Most often it is the feeling, or idea, that a problem has no solution that makes one take the step towards suicide. This needs to be dispelled and hope must be given to them.

The most important thing is to make positive attitude a way of life. September 10 is just one day in a year; working at preventing suicide calls for being active everyday.

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