Working together to prevent suicide

Suicides are preventable, yet over 8,00,000 people end their lives worldwide every year, one every minute. For every self-ended life, there are 25 others who had attempted. Recently two suicides — that of a US financier in New York prison and a businessman in Karnataka — hit the headlines bringing the issue to the fore again.

‘Working together to prevent suicide’ was the theme of the 2019 World Suicide Prevention Day (September 10). It was the same last year, and will be the same for 2020 too.

Joining together is critical to preventing suicide. Every individual, institution and organisation has a role to play. Suicide is a complex problem with several interrelated contributing factors like genetic, psychological and social etc. It claims more victims than murder, violence and war put together every year.

Nearly 80% of global suicides occur in low and middle-income countries which have limited resources and manpower to tackle it. The situation is grim in India; World Health Organization (WHO) data shows that India contributes almost 17% of the total suicides worldwide. There is a gross under-reporting too.

In many countries and societies, suicide and attempted suicide are stigmatised and condemned which hinders help-seeking and provision of services to the needy. It’s a criminal offence in some countries, though India has decriminalised it. Awareness about the causes of suicide, warning signs and caring for those in distress can help prevent suicides.

A comprehensive National Suicide Prevention Strategy is needed to promote, coordinate and enlist the support of various sections of the society. Suicide prevention requires integrative strategies that encompass work at the individual, systems and community stages to provide necessary interventions.

At national level policy changes, public health strategies, incorporating measure with strong evidence of efficacy, such as restriction of access to lethal means can be planned. It is estimated that around 20% of global suicides are due to pesticide self-poisoning. Regulating formulations and sale of pesticides is necessary.

Similar restrictions are needed for over-the-counter medications. Guidelines must be formulated for the mass media for reporting suicide. Suicide portrayal in the film and entertainment is an important area of concern.

Redesigning medical curriculum by expanding psychiatric training for medical students goes a long way in preparing them to tackle the emergency situation.

Community-level and NGO interventions like increasing public awareness about common warning signals and enlisting sources for help to people in distress can help people in need. At many places, crisis intervention services, counselling centres and telephone hotlines are established but the gulf between what is being done and what needs to be done is huge.

Everyone can join hands in preventing suicidal behaviour, by lending a patient ear and reaching out to someone in the community. Sensitising and training some special group of people (training gatekeepers) like teachers, primary care physicians, the staff of correctional facilities, traditional healers, priests, etc. will help in prevention.

There is no simple solution to reduce suicide rates. It takes multiple approaches to implement and produce the desired results. The task is a universal challenge.

(The writers are academics from the departments of Psychiatry and Community Medicine, BLDE.DU, B M Patil Medical College, Vijayapur.)