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World Suicide Prevention Day 2015

World Suicide Prevention Day 2015

2015-09-10

Preventing Suicide: Reaching Out and Saving Lives September 10, 2015

World Health Organization (WHO) recently released report: Preventing Suicide: A Global Imperative, over 800,000 people die by suicide across the world each year. The report notes that this estimate is conservative, with the real figure likely to be higher because of the stigma associated with suicide, lack of reliable death recording procedures, and religious or legal sanctions against suicide in some countries. We may not be able to pinpoint the exact figure, but we do know that each individual suicide is a tragic loss of life. It is hard to imagine the extreme psychological pain that leads someone to decide that suicide is the only course of action. Reaching out to someone who is struggling can make a difference.

As per Nepal Police, there were 4,350 suicide incident recorded in the fiscal Year 2071/072(16th July 2014-15th July 2015). Similarly, the recent devastating earthquake and its repeated frequent aftershocks which killed thousands of people in the country and have increased another dimension of suicidal risk amongst its survivors. Ever since this terrible incident there has been reported completed suicides and also suicidal ideation amongst the now vulnerable Nepalese population. The tragedy and effects of this earthquake has had a psychological impact and there is a fear that as a result a propensity toward suicidal attempts are emerging. This has derailed relief to Nepalese persons on a grassroots level and could potentially have some role for creating frustration or depressive environment amongst the people of Nepal. In this context, there is a prime need for proper relief and psychological counseling to the risk people must be made available to prevent further deprivation and potential suicidal losses.

The International Association for Suicide Prevention (IASP) and the World Health Organization (WHO) are committed to preventing suicide. These organizations recognize World Suicide Prevention Day as an important day in the international calendar. World Suicide Prevention Day brings together individuals and organizations with an interest in suicide prevention, and mobilizes efforts to save lives. Since 2010, Nepal has been also celebrating World Suicide Prevention Day in the country from non government organization in closed coordination and support with WHO and Nepal Government specially Ministry of Health and Population. In the year 2015, Nepal Health Society (NHS) s also taking the leading role to celebrate the World Suicide Prevention Day in 10th September in the country because we feel the prime need to connect one world for suicide prevention activities. In Nepal, activities for prevention of suicide have not been adequately addressed due to a lack of awareness of suicide as major public health issues and the existing taboos in Nepalese society to discuss openly about it. There have not any interventions for suicide preventive and care in the country from government and non government side. It is needed of urgency of national policy of suicide prevention and care. Need based research with scientific evidences also should be addressed to effective suicide prevention intervention in the country.

‘Preventing Suicide: Reaching Out and Saving Lives’ is the theme of the 2015 World Suicide Prevention Day (WSPD), an initiative of the International Association for Suicide Prevention (IASP) and the WHO, a co-sponsor of meetings and events related to WSPD 2015. Since 2003, WSPD has taken place on 10th September each year. It serves as a call to action to individuals and organizations to prevent suicide. This year, the theme encourages us all to consider the role that offering support may play in combating suicide.

The act of showing care and concern to someone who may be vulnerable to suicide can be a game-changer. Asking them whether they are OK, listening to what they have to say in a nonjudgmental way, and letting them know you care, can all have a significant impact? Isolation increases the risk of suicide, and, conversely, having strong social connections is protective against it, so being there for someone who has become disconnected can be life-saving.

Reaching out to the suicide prevention community

There is strength in numbers. Around the globe, many individuals and organizations are involved in efforts to prevent suicide. We can learn from each other, and strengthen the evidence base for effective interventions. Reaching out to those who are travelling the same road increases the likelihood that our collective efforts to reduce the numbers of people who die by suicide, and the numbers of people for whom these deaths have shattering effects, will be successful.

Reaching out to those who have been bereaved by suicide

Suicide is devastating for families; friends and community members who are left behind. They may experience a whole range of emotions, including grief, anger, guilt, disbelief and self blame. They may not feel that they can share these overwhelming feelings with anyone else. Therefore, reaching out to those who have lost someone to suicide is very important. As a result of the stigma surrounding suicide, those who are bereaved by suicide are often perceived differently from those who lose a family member through another cause of death. People who are bereaved may find that they are avoided by people who don’t know how to broach the subject or offer their condolences. Or they may just feel that others do not understand the intensity of their emotional response to the death of their loved one. Once again, a pro-active approach and offering a sympathetic, non-judgmental ear can make all the difference. Giving someone who has been bereaved by suicide the opportunity to talk about their loss, in their own time, on their own terms, can be a precious gift. Allowing them to express their full range of feelings can be cathartic and can help them to take the first small step in moving through their grief. Starting the conversation may be difficult, but it will almost certainly be appreciated.

Reaching out to put people in touch with relevant services

Although the support of friends and relatives is crucial for people who may be at risk of suicide and for people who have lost someone to suicide, it is not always enough. Often more formal help is also needed. Such help can take many forms, and is likely to vary from country to country. In high-income countries, it may include specialist mental health services and primary care providers, both of which offer clinical care. It may also include a range of community organizations which provide non-clinical support, as well as support groups and self-help groups. In low- and middle-income countries, the more clinically-focused services are less readily available, and there is a heavier reliance on community organizations. Part of reaching out to vulnerable individuals can involve helping to link them to relevant services.

Reaching out on World Suicide Prevention Day

On September 10th, join with others around nation and the world who is working towards the common goal of preventing suicide. Check in on someone you may be concerned about, listen to what they say, how they say it and show them kindness and support. Investigate ways of linking in with others who are trying to prevent suicide in our community, our country, or internationally. Show our support by organizing or taking part in a World Suicide Prevention Day activity in our community and/ or join in with IASP’s Cycle Around the Globe

Objective of celebration of World Suicide Prevention Day 2015:

  • To increase awareness for enhanced understanding of the damaging effects of suicide
  • To bring together individuals and organizations with an interest in suicide prevention, and mobilizes efforts to save lives
  • To implement interventions in an effort to prevent suicide in the society
  • To provide services to help survivors deal with their loss
  • To conduct advocacy for strengthening and supportive environment to address the issues of suicide prevention, treatment and care services
  • To influence policy level authorities to address the issues of suicide in the plans and policy
  • To make effort to prevent suicide: one world connected

World scenario suicide incident: Source WHO and IASP

  • Every year, over 800,000 people die from suicide; this roughly corresponds to one death every 40 seconds
  • Suicide is the second leading cause of death in the 15-29 years age group
  • Suicide is the three leading causes of death among those aged 15-44 years
  • Suicide is the 15th leading cause of death globally, accounting for 1.4% of all deaths in 2012.
  • 75% of all global suicide deaths occur in low- middle income countries.
  • The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined.

National scenario of suicide incident: Nepal Police

Fiscal Year 2071/072(16th July 2014-15th July 2015)

  • 4, 350 suicidal incidents were recorded
  • 11-12 person died by suicide per day in an average
Fiscal Year 2060/061 to 2071/072 (16th July 2004- 15th July 2015)
  • 36,394 suicide incidents were recorded

High Risk Groups for Suicide incident

  • Youth and Adolescence
  • Divorced, Single or Living alone
  • Late Life
  • Police and Military Personnel
  • Professional groups: (Lawyer, Advocate, Doctor, Engineer, Politician, Businessperson)
  • Broken Family
  • House wife
  • Family History of Suicide
  • Severe Psychiatric Illness
  • Sexual Abuse
  • Drug User, MSM/MSW/TG, SWs, Prisoners, PLHIV etc.

Major Risk Factors for Suicide incident

  1. Social factor
    • Social taboo,
    • Drug abuse, Alcohol use, Gamble, Card, Dhikuti etc
    • Loneliness, Childhood Trauma esp. sexual and physical abuse
    • Influence of media
    • Stigma and Discrimination
  2. Economic factor
    • Poverty, Unemployment
  3. Family factor
    • Poor relationship with family
    • Domestic violence
    • Failure of love affairs
    • Extra marital affairs
    • Family discrimination
    • Inter-caste marriage
    • Multiple marriage, Early marriage,
    • Divorce, single woman/Man
  4. Psychological factor
    • Mood disorders (depression, anxiety, or mania)
    • Substance abuse
    • Severe type of mental illness
    • Discomfort with sexuality and gender
    • Acute emotion
    • Prior suicide attempt
  5. Physical health factor
    • Chronic illness
    • Disabilities
  6. Others
    • Curiosity
    • Encouragement
    • Competition/Failure of examination

Common Classification of Suicide Methods

  1. Violent Methods: e.g. hanging, burning, use of sharp instruments, drowning, electrocution etc.
  2. Non-violent Methods: e.g. poisoning, drug overdose, suffocation etc.
  3. Passive Methods: e.g. patient choosing to die by refusing to accept treatment.

Some warning Signs for Suicide

These signs may mean someone is at risk for suicide. Risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss or change.

  • Talking about wanting to die or to kill oneself
  • Looking for a way to kill oneself, such as searching online or buying a gun.
  • Talking about feeling hopeless or having no reason to live.
  • Talking about feeling trapped or in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious or agitated; behaving recklessly.
  • Sleeping too little or too much.
  • Withdrawn or feeling isolated.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings behavior

Additional Warning Signs of Suicide

  • Preoccupation with death.
  • Suddenly happier, calmer.
  • Loss of interest in things one cares about.
  • Visiting or calling people to say goodbye.
  • Making arrangements; setting one's affairs in order.
  • Giving things away, such as prized possessions.

Needs for Suicide Prevention Sector in Nepal

  1. Clearly defined national policy and strategy for action
  2. Massive preventive interventions along with crisis management services such as:
    • Awareness raising, orientation and sensitization, advocacy, training etc
    • Early detection of warning signs and symptoms
    • Effective mental health care: early treatment and care for Mental illnesses
    • Hot-line services and Crisis Management.
    • Sensitization of family members to create enabling environment for suicide victims
    • Provide problem solving skills
    • Part of reaching out to vulnerable individuals can involve helping to link them to relevant services.
    • Provision of adequate treatment and follow-up for people who attempted suicide.
    • Incorporation of innovative and comprehensive multi-sectoral approaches in both health and non-health sectors such as: education, labor, police, justice, religion, law, politics, civil society, media etc.
    • Application of connectedness of one world for suicide prevention
  3. Responsibility of the Government
    • Develop national policy and strategy for national suicide prevention.
    • Give priority for allocation of budget for program
    • Generate empirical evidence through scientific research for designing intervention and plans
    • Facilitation for international organization for addressing and supporting of issue and program
    • Support and coordinate with non government organizations
  4. Local Level
    • Policy statements and research outcomes need to be translated into preventive programs and activities in the community.
    • Creating enabling environment to implement the suicide prevention interventions in the community
    • Prevention and crisis management intervention in the community in the theme of World Suicide Prevention Day 2015" Preventing Suicide: Reaching Out and Saving Lives"

References:

  • Nepal Police
  • World Health Organization (WHO)
  • The International Association for Suicide Prevention (IASP)
  • American Foundation for Suicide Prevention
  • Nepal Health Society
  • National Association for Suicide Prevention and Research (NASPAR)

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