Globally, close to 800 000 people die by suicide every year; that’s one person every 40 seconds. For each suicide, there are more than 20 suicide attempts.
Suicide is an emerging and serious public health issue in India. However, it is preventable with timely, evidence-based, and often low-cost interventions. The suicide mortality rate per 100 000 population in 2016 was 16.5, while the global average was 10.5 per 100 000. The most vulnerable are the 15-29 year old’s, the elderly, and persons with special needs.
The Mental Healthcare Act, 2017 decriminalizes suicide, assuring adequate medical relief to those attempting it. This is a landmark development ensuring dignity and a humane perspective to the issue..
A strengthened system for quality data on suicides (attempted and deaths) from vital registration, hospital-based systems and other surveys for formulating policies and subsequent monitoring are effective suicide prevention initiatives. Strengthening life-skill trainings and counselling in educational institutions, workplace etc. further supplement prevention policies.
In India, pesticides, firearms, self-hanging, jumping off bridges and in front of trains are the major means by which suicide is attempted. Policies limiting access to pesticides, firearms and putting barriers on bridges and railway platforms could be some of the preventive options. In addition, counselling services and creating destigmatized platforms for discussion around these taboo subjects could be considered.
World Suicide Prevention Day (WSPD) was established in 2003 by the International Association for Suicide Prevention in conjunction with the World Health Organization (WHO). The 10th of September each year focuses attention on the issue, reduces stigma and raises awareness among organizations, government, and the public, giving a singular message that suicide can be prevented.
“Creating hope through action” is the triennial theme for the World Suicide Prevention Day from 2021 – 2023. This theme is a reminder that there is an alternative to suicide and aims to inspire confidence and light in all of us.
By creating hope through action, we can signal to people experiencing suicidal thoughts that there is hope and that we care and want to support them. It also suggests that our actions, no matter how big or small, may provide hope to those who are struggling. Lastly, it highlights the importance of setting suicide prevention as a priority public health agenda by countries, particularly where access to mental health services and availability of evidence-based interventions are already low. Building on this theme and spreading this message over the three years, a world can be envisioned where suicides are not so prevalent.
We can all play a role in supporting those experiencing a suicidal crisis or those bereaved by suicide whether as a member of society, as a child, as a parent, as a friend, as a colleague or as a person with lived experience. We can all encourage understanding about the issue, reach in to people who are struggling, and share our experiences. We can all create hope through action and be the light.
MYTHS AND FACTS OF SUICIDE
MYTH: Talking about suicide or asking someone if they feel suicidal will encourage suicide attempts.
FACT: Talking about suicide provides the opportunity for communication
- A simple inquiry about whether or not the person is intending to end their life can start the conversation.
- However, talking about suicide should be carefully managed.
MYTH: people who talk about suicide never attempt or die by suicide.
FACT: Talking about suicide can be a plea for help and it can be a late sign in the progression towards a suicide attempt. Those who are most at risk will show other signs apart from talking about suicide. If you have concerns about a young person who talks about suicide:
MYTH: If a person attempts suicide and survives, they will never make a further attempt.
FACT: A suicide attempt is regarded as an indicator of further attempts.
- It is likely that the level of danger will increase with each further suicide attempt.
MYTH: Once a person is intent on suicide, there is no way of stopping them.
FACT: Suicides can be prevented. People can be helped.
- Suicidal crises can be relatively short-lived.
- Immediate practical help such as staying with the person, encouraging them to talk and helping them build plans for the future, can avert the intention to attempt or die by suicide.
MYTH: People who threaten suicide are just seeking attention.
FACT: All suicide attempts must be treated as though the person has the intent to die.
- Do not dismiss a suicide attempt as simply being an attention-gaining device.
- It is likely the young person has tried to gain attention and, therefore, this attention is needed.
- The attention they get may well save their lives.
MYTH: Suicide is painless.
FACT: Many suicide methods are very painful.
- Fictional portrayals of suicide do not usually include the reality of the pain.
MYTH: Marked and sudden improvement in the mental state of an attempter following a suicidal crisis or depressive period signifies the suicide risk is over.
FACT: The opposite may be true. In the three months following an attempt, a young person is at most risk of dying by suicide. The apparent lifting of the problems could mean the person has made a firm decision to die by suicide and feels better because of this decision.
MYTH: Once a person thinks about suicide, they will forever think about suicide.
FACT: Most young people who are considering suicide will only be that way for a limited period of their lives. Given proper assistance and support, they will probably recover and continue to lead meaningful and happy lives unhindered by suicidal concerns.
Most people thinking about suicide never seek or ask for help with their problems.
FACT: Evidence shows that they often tell their school peers of their thoughts and plans. Most adults with thoughts of suicide visit a medical doctor during the three months prior to killing themselves. Adolescents are more likely to ‘ask’ for help through non-verbal gestures than to express their situation verbally to others.
MYTH: Break-ups in relationships happen so frequently, they do not cause suicide.
FACT: Suicide can be precipitated by the loss of a relationship.
MYTH: Young people thinking about suicide are insane or mentally ill.
FACT: Although adolescents thinking about suicide are likely to be extremely unhappy and may be classified as having a mood disorder, such as depression, most are not legally insane. However, there are small numbers of individuals whose mental state meets psychiatric criteria for mental illness and who need psychiatric help.
MYTH: Some people are always suicidal.
FACT: Nobody is suicidal at all times. The risk of suicide for any individual varies across time, as circumstances change. This is why it is important for regular assessments of the level of risk in individuals who are ‘at risk’.
References
1. https://www.who.int/campaigns/world-suicide-prevention-day/2022
2. https://www.who.int/news-room/fact-sheets/detail/suicide
3. https://suicideprevention.nv.gov/Youth/Myths/
Dr. Swapna B | Consultant Psychiatry & Clinical Psychology | Narayana Multispeciality Hospital, HSR Layout, Bangalore