Suicide and its prevention
IN what has been hailed as “landmark” study, the World Health Organisation (WHO) has brought out a report on the global scenario on suicides. It gives us a glimpse into why people decide to end their lives, reasons for and what national governments are doing about it. Although details about this form of self-destruction are sketchy in lower to middle income countries, it is estimated that some 804,000 people killed themselves in 2012 worldwide, with men outnumbering men at a ratio of 2:1. What we didn't know that it the 15th-most common cause of death “and it is the second-highest for young people age 15-29.” Indeed 3/4th of these deaths come from low or middle-income countries.
What has come to light is that collective action is needed to prevent what is being termed as a “preventable death”. And since no age group is above committing such an act, countries around the world need to do more in terms of public policy to prevent suicides. Unfortunately, only 28 countries out of 194 nations that are member of WHO have a national suicide prevention plan. And unless the issue is brought to the fore, the problem will remain largely unaddressed. It is interesting to find that in many nations, suicide is deemed illegal under law. Yet data show that the number of deaths in these countries is no less. There is no “one size fits all” solution to this conundrum. As put by Professor Rory O'Connor of the University of Glasgow's Suicidal Behaviour Research Laboratory, “there is so much more that can be done at the local, community and national levels to tackle the problems of suicide and minimise the needless loss of life”.
In a country like Bangladesh there were an estimated 10,000 suicides in 2012. These are the “reported” deaths. When one takes into account that society largely ignores a large number of people in the population due mental disorders and families generally tend to neglect them, we are essentially turning our backs to a great many people who could be saved. The same may be said about those who are addicts and suffer from substance abuse. The need to hide away those who do not conform to society's perceptions about what is “normal” or “acceptable” may well be precipitating these groups of people to feel abandoned and turn them vulnerable to the point that death seems a welcome release. As there is stigma attached to “suicide”, it remains under-reported and so the actual numbers of deaths may actually be much higher. And why shouldn't the figure be higher in any case? Have we done anything to restrict the means to suicide? Pesticides and poisons are easily available over the counter and sold to anyone who can afford them. Our bridges remain unprotected and it is easy to jump off any one of them.
As stated before, to combat a phenomenon such as suicide, the issue must be prioritised as a public health issue that will involve both state and non-state actors. It would require resource allocation in the annual budget that would pay for health services and educational materials, physical impediments that would actively prevent access to risky areas such as bridges, social networks like self-help groups where people with suicidal inclinations could and would reach out for help; raising awareness amongst the general populace with the aid of national media, which has its role cut out in being responsible when it comes to reporting on suicide. There is no room for sensationalism and “responsibility” comes with not prioritising such news items, rather, educating the masses by providing information on where and how to get help. Media can, in effect, break the negative attitudes surrounding mental disorders by running awareness campaigns. Though there is no hard evidence with regards to such campaigns having impacting positively on reduction on of suicides, they have however served well to raise community awareness. The idea is to encourage public debate on the issue through print and electronic media, the internet, social media, posters, etc.
To put things in perspective, one can cite the example of Japan which is a country that experienced suicides exceeding 32,000, which had previously recorded a national average of about 25,000 over the previous decade. Japan at the time was suffering from socioeconomic problems and suicide rates were off the charts for all age groups. Until that time the suicide phenomenon was considered to be a personal problem. The change came with parents speaking out in media about the loss of their children to media. The ministry of health responded by in 2002 by holding an 'expert roundtable on suicide prevention measures' That led to a suicide prevention policy to effectively address mental health issues coupled with “a multifaceted examination of psychological, social, cultural and economic factors.” It paved the way for treating suicide as a “social” problem rather than a “personal” one. It helped build public opinion leading to government funding. The Regional fund was geared specifically towards suicide prevention activities that brought under one umbrella various activities like intensive public awareness campaigns.
At the end of the day, like Japan or any of the other 27 countries that have developed policies and concrete actions on the ground through secure government funding, Bangladesh will have to first recognise suicide as a public health issue and then go about taking the aid of national and international agencies, involve state and non-state actors in combating a condition that is more than just medical in nature.
The writer is Assistant Editor, The Daily Star.