Take Your Life Back!
In the past 25 years, suicide has emerged as an important public health problem in many countries. The World Health Organisation estimates that each year approximately one million people die from suicide, which represents a global mortality rate of 16 people per 100,000.
Going by the statistics of Sri Lanka Police, 3,025 people died by suicide in 2016. It is about 14 people per 100,000 population. In 1995, we experienced 8,449 reported suicides and although it has now decreased considerably, the figure is still alarming when compared with other countries. Sri Lanka Police statistics also reveal that 27 per cent of the total suicides are of young people aged 17 – 30 years.
A recent report detailing the mental health of adolescents in Sri Lanka, the World Health Organisation South-East Asia Region has revealed that seven percent of adolescents aged between 13 and 17 have attempted suicide one or more times. The report also shows that nine percent of young people have considered committing suicide.
It is clear that Sri Lanka still has a crisis of suicidal behaviour among its young people. Doing something about this situation is the responsibility of every part of Sri Lankan society, be it private or public.
In every case we are aware of where rates of death by suicide have been lowered, assertive and sustained government actions have played a critical role. It means that the government, too, has an important role to play as well – as do Provincial Councils and other public representative bodies to reach the desired goal.
Mental health problems
Research findings suggest that a range of social, personality, childhood and related factors make contributions to risks of suicidal behaviour. However, by far the largest contribution comes from mental health problems. Recently the WHO disclosed that 800,000 Sri Lankans, mostly young people, suffer from depression.
These findings imply that any pragmatic suicide prevention strategy must involve approaches that aim to improve the detection, treatment, management and prevention of these disorders in the population.
Research findings also suggest that an important step in reducing the number of young people who are vulnerable to suicidal behaviours is through programmes that reduce their exposure to disadvantaged environments that lead to the risk of later suicide attempt.
There are a number of strategies by which this target might be achieved, including population-based programmes designed to reduce social inequity and social discrimination. Although they are long-term projects, such programmes may make an effective contribution to suicide prevention by providing an equitable social environment in which other, more targeted, approaches to suicide prevention would have their best chance of success.
Three more approaches are also available: first one, focuses on the development of general mental health programmes, which aim to foster good mental health skills particularly among young people to promote resiliency and address the psycho-social needs of those exposed to stress and adversity; second one lies in school-based competency-promoting and stress-reducing programmes to reduce the risks of mental disorders and behaviours with which suicidal behaviour is associated; and the third one is the provision of family support and early intervention programmes targeting at-risk families and designed to improve early-childhood exposure to family disadvantage.
According to American Academy of Child and Adolescent Psychiatry, in addition to depression, there are other risk factors for youth suicide which include: (1) social isolation and loneliness, (2) intense loss and grief feelings caused by the death of a loved one or the break-up of a relationship, (3) sever family ties, work, financial, legal or social problems, (4) alcohol or other substance abuse, (5) Severe chronic stress, (6) victims of domestic violence, (7) Post-Traumatic Stress Disorder, (8) low self-esteem, (9) difficulties dealing with life changes, (9) serious illness, (10) intense embarrassment or humiliation before family, friends, colleagues.
As we can see from the list, it isn’t just young people with mental illness who commit suicide.
One of the areas often overlooked because we are so focused on the risk factors is youth suicide-seeker’s motivation. His major motivation is to avoid or end pain. But there are others such as (1) gain attention, (2) perceive as a martyr for a cause, (3) avenge a perceived wrong, (4) express grief over a relationship, (5) escape an intolerable situation, (6) respond to an internal impulse (like hearing voices telling you to kill yourself), and (7) avoid humiliation.
American Academy of Child and Adolescent Psychiatry advises the parents and elders to be watchful for the warning signs that a young person may be considering suicide: (1) change in eating and sleeping habits, (2) withdrawal from friends, family, and regular activities, (3) violent or rebellious behaviour, (4) drug and alcohol use, (5) unusual neglect of personal appearance, (6) persistent boredom, difficulty concentrating, or a decline in the quality of work, (7) frequent complaints about physical symptoms, often related to emotions, such as stomach-aches, headaches, fatigue, etc. If one or more are persisting, it is time seek help.
A suicidal youth may not ask for help, but that doesn’t mean that help isn’t wanted. Most young people who commit suicide do not want to die – they just want to stop hurting. Youth suicide prevention starts with recognizing the warning signs and taking them seriously.
There are a number of prevention measures, which can be helpful for reducing the rate of suicides of young people. The responsibility of implementing them lie among parents, schools and the Government authorities.
Responsibilities of parents
Parents should promote mental resilience and connectedness of their children. Also, they should educate the children about suicide, including risk factors, warning signs, and the availability of help. Parents would not be aware how to do it and it’s the Government’s responsibility to offer training.
Parents also should strengthen the family as a strong with high emotional bonding and support and under no circumstances, compel the children to fulfil your own dreams.
Most importantly, parents should give attention towards changing behaviour of their children and provide help and support to handle the difficulties of life especially emotional ups and downs.
Responsibilities of school
School authorities should implement intervention programmes – emotional education in schoolchildren. Also, teachers need to be guided to be vigilant in detecting depression among children.
The Government has a fair amount of responsibilities. They must increase the proficiency of health and welfare services in responding to youth in need. This includes better training for health professionals and establishing crisis counselling units in every city. They must promote comprehensive community care services to provide services to youth stricken with mental illness.
Continuous professional training of selected teacher groups in each electorate about assessment, diagnosis and treatment support of high-risk group’s detection. At the same time, provision of special short training course is needed for gatekeepers like parents, teachers, counsellors and other professional helpers who must provide emotional support to meet the needs of different age groups.
Another important matter is the formulation of responsible media policy for suicide prevention. Finally, the Government should create enhanced access to mental health services (such as hot/on line services).
Specialised health professionals are presently playing an effective role in preventing, managing or rehabilitating young persons with suicidal tendencies and those who have committed a suicidal act. More support needs to be given to them, in the form of funds, facilities, personnel and appreciation.
Yet, in the long run, our structured education system needs to put in more emphasis in building value systems and coping strategies in its curriculum of studies. The objective is to set acceptable individual aspirations and indicating appropriate goal-setting mechanism among students. These are of prime importance for preventing the younger age group from attempting suicide. (Lionel Wijesiri-dailynews)