Suicide: A growing phenomenon

A reader who happens to be a psychologist wrote to me that he is concerned about the growing  suicide in our society, and that over the years in Nigeria as a practitioner, he has counseled many people with the tendency of committing suicide due to at times emotional problems such as stress, depression and other […]

A reader who happens to be a psychologist wrote to me that he is concerned about the growing  suicide in our society, and that over the years in Nigeria as a practitioner, he has counseled many people with the tendency of committing suicide due to at times emotional problems such as stress, depression and other mental problems. He was of the opinion that I should please create a space in my weekly column to talk about it especially its health implications.
Today I take the column away from “political health” to provide simple and useful information about suicide which World Health Organization defined as “the act of deliberately killing oneself. Risk factors for suicide include mental disorder (such as depression, personality disorder, alcohol dependence, or schizophrenia), and some physical illnesses, such as neurological disorders, cancer, and HIV infection.”
By way of introduction it has being documented that every year more than 800 000 people take their own life and there are many more people who attempt suicide. Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind. Suicide occurs throughout the lifespan and was the second leading cause of death among 15–29-year-olds globally in 2012.Suicide does not just occur in high-income countries, but is a global phenomenon in all regions of the world. In fact, 75% of global suicides occurred in low- and middle-income countries in 2012.Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions.
In a report by WHO termed ‘Preventive Suicide, A Global Imperative’ it was reported that in May 2013, the Sixty-sixth World Health Assembly adopted the first-ever Mental Health Action Plan of the World Health Organization (WHO) of which suicide prevention is an integral part of the plan, with the goal of reducing the rate of suicide in countries by 10% by 2020
The reported revealed that “Global epidemiology of suicide and suicide attempts an estimated 804 000 suicide deaths occurred worldwide in 2012, representing an annual global age-standardized suicide rate of 11.4 per 100 000 population (15.0 for males and 8.0 for females).
However, since suicide is a sensitive issue, and even illegal in some countries, it is very likely that it is under-reported. In countries with good vital registration data, suicide may often be misclassified as an accident or another cause of death.
Registering a suicide is a complicated procedure involving several different authorities, often including law enforcement. And in countries without reliable registration of deaths, suicides simply die uncounted. In richer countries, three times as many men die of suicide than women do, but in low- and middle-income countries the male-to-female ratio is much lower at 1.5 men to each woman.”
Who is at risk?
While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness.
In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour. Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, intersex (LGBTI) persons; and prisoners. By far the strongest risk factor for suicide is a previous suicide attempt.
“It is estimated that around 30% of global suicides are due to pesticide self-poisoning, most of which occur in rural agricultural areas in low- and middle-income countries. Other common methods of suicide are hanging and firearms.Knowledge of the most commonly used suicide methods is important to devise prevention strategies which have shown to be effective, such as restriction of access to means of suicide.”
How to prevent and control suicide;
1. Reducing access to the means of suicide (e.g. pesticides, firearms, certain medications).
2. Reporting by media in a responsible way.
3. Introducing alcohol policies to reduce the harmful use of alcohol.
4. Early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress.
5. Training of non-specialized health workers in the assessment and management of suicidal behaviour;
6. Follow-up care for people who attempted suicide and provision of community support.
Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labour, agriculture, business, justice, law, defense, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide.
Some challenges and obstacles
Stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and are therefore not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem, and the taboo in many societies to openly discuss it.
In conclusion, any society that wants to reduce the incidence of suicide has to commit resources and time in raising community awareness, training of social workers with skills to identify risk factors of suicide and provide support to those at risks.
All comments to Dr Aminu Magashi , publisher Health Reporters ([email protected])