Mental Health

Suicide can be prevented

By Shreya Giria

Digital Discourse Foundation

India’s Parliament decriminalised <http://rstv.nic.in/bill-decriminalise-suicide-attempt-mentally-ill-passed.html> suicide on 27th March 2017 - reasoning that those attempting suicide are too stressed and are far from inflicting pain on others or committing crime Undoubtedly when people attempt suicide they need mental health care and counselling, instead of being booked as criminals! This progressive Indian legislation is a trend-setter, aver experts. “Decriminalisation of persons attempting suicide is a welcome move.

“Without the added stigma of criminalisation of (a) 'cry for help or suicidal attempts' they can now seek help for the distress they are facing, - bravely” says Associate Professor, Department of Mental Health Education in the National Institute of Mental Health and Neuro Sciences [NIMHANS] (http://mentalhealtheducationnimhans.org/) an Institute of National Importance in Bangalore, India Dr. K. S. Meena in an email to Digital Discourse.

A crisp quote by Bangalore City Police Commissioner on the significance of decriminalising suicide will be pertinent here. He may wish to add what needs to be done to prevent suicide.

According to 2012 estimates of the World Health Organisation of the United Nations’ 8,00,000 people commit suicide globally every year which amounts to one suicide death every 40 seconds. (http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/. The constructive contribution of 800000 people to humanity and the world as well as their right to a dignified life are lost: Largely because of lack of preventive mechanisms in today’s stress prone anonymous lifestyle. People who have been rescued from the throes of death admit their sense of guilt, despair, alienation and helplessness which drove them to attempt suicide although they were aware that it was not the most sensible solution.

Studies have shown that those attempting suicide cry for attention before they take the extreme step. Suicide is often termed as “a cry for help”, “attention seeking behaviour”, or “impulsive action”. The suicidal person is ambivalent - part of them wants to live and part of them wants not so much death, as an end to the stress. (https://www.metanoia.org/suicide/whattodo.htm) Some also use it as a threat to blackmail and secure what they want; this last trait is because of inadequate life skills pointing to faulty parental skills during the adolescence. Faulty parenting skills, it has been found is a recurrent cause for suicide rates increasing say mental health experts leading experts to emphasise the critical emotional security that family offers.

Statistics for India suggest that the suicide rate was highest in the 15-29 years age group - 38 per 100,000 populations, followed by the 30-44 years group 34 per 100,000 population according to the <study> (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554961/) “Epidemiology of Suicides in Bangalore” 2001 by Gururaj G, et al.

PS (name changed) - a counsellor in Chennai who had once attempted suicide, says “I know the powerful call tempting them to yield to oblivion, the feeling that the hands on the clock have reversed direction; time is going backwards, because living every minute is full of painful anguish...Suicide can be seductive. Being crushed by depression, killing oneself can seem like the only escape from unrelenting physical and psychic pain”.

Risk factors:

Factors that increase the risk for suicidal people are:

  • Depression,

  • Substance abuse,

  • A family history of suicide,

  • Depression,

  • Anxiety,

  • Substance abuse,

  • Self-mutilation / harm and

  • Borderline personality disorder

Family history of suicide can also put people at elevated risk for suicide. Other contributing factors, though not conclusive, are:

  • Violence and abuse at home or in significant relationships,

  • Bullying,

  • Conflict regarding sexual identity,

  • Illness or disease,

  • Relationship/ marriage failures,

  • Bankruptcy or indebtedness,

  • Failure in examinations,

  • Fall in social reputation, unemployment,

  • Suspected illicit relation of significant other,

  • Illegitimate pregnancy, and

  • Family conflicts.

Suicide pact is an agreement between two or more people to commit suicide together at a given place and time. Partners in crime, unable to face the consequences of their misdeeds also enter into suicide pacts. Suicide pact is also entered into by people who have faced or are facing the consequences of an event beyond their control, but are plagued by guilt like say survivors of a terrorist event, or a natural calamity.

‘Cyber-suicide’ refers to suicides or suicide attempts influenced or factored by the internet. Technology companies like Facebook have their job cut out to create filters to prevent live-streaming of suicide.

“The need for policing the internet to prevent publishing / webcasting the dark secrets of the way to hell is the need of the hour”.

Often this topic is not broached as people believe talking about suicide itself can give ideas to commit suicide. This is a highly erroneous assumption as talking about suicide and self harm can lead others to seek help. Data consistently shows us that those who attempt suicide have often spoken to people about it before the event. This leads us to conclude that it is, in fact, preventable. (Contact with mental health and primary care providers before suicide: a review of the evidence. Luoma JB1, et al. (https://www.ncbi.nlm.nih.gov/pubmed/12042175)

To-Do List to prevent suicide:

The most effective first step to address suicidal thoughts in one’s loved ones is simple and yet requires immense courage - asking them directly whether they are thinking of it. Once someone shows signs of suicide …

1. It helps to engage them in conversation asking what drives them to despair.

2. It is then paramount to be with them - to continue engaging them in a conversation and ensure the person is never left alone.

3. Connect humanely to the person; simultaneously call the Emergency Services discretely.

4. Once the imminent danger is passed, convince the suicidal person to seek psychotherapy.

5. Addressing the person contemplating suicide Dr. K.S. Meena from NIMHANS adds “Talk to someone you trust, establish rapport and confide in a mental health professional, If nothing works, ask for medication, stay connected with family and other support systems, give auto suggestions that this is a passing phase and you are not going to throw away your life”.

Please check https://www.metanoia.org/suicide/whattodo.htm to familiarise yourself with a to-do list in case you know someone who is prone to suicide. The site lists a credible to-do list to prevent suicide. Another site to learn suicide prevention is: https://www.helpguide.org/articles/suicide-prevention/suicide-prevention-helping-someone-who-is-suicidal.htm

All human beings have a right to lead a dignified life the Human Rights dictates the UNIVERSAL DECLARATION OF HUMAN RIGHTS (http://www.hrweb.org/legal/udhr.html) in the Geneva Convention; so does simple logic. It is our humane duty to prevent someone we know from attempting suicide. It is also our moral duty to help the person overcome the emotional challenges he or she faces that prompted him / her to attempt suicide.