Suicide is an act of killing oneself, most often due to depression or other mental illness. As per the latest estimates of the World Health Organisation (WHO) published on June 21, 2021, in “Suicide worldwide in 2019”, unfortunately, suicide remains one of the leading causes of death worldwide. In 2019, more than 700000 people died by suicide, almost one in every hundred deaths. This has prompted WHO to issue new guidelines to helps the nations improve suicide prevention and care.
“We can not and should not ignore suicide. Each one is a tragedy. Our attention to suicide prevention is even more important now, after having experienced the COVID-19 pandemic.” said Dr Tedros Adhanon Ghebreyesus, Director-General of the WHO. Due to the COVID-19 pandemic, people have lost their jobs, many people are under financial stress, and many are isolated. These factors will further add to already existing factors responsible for suicide.
It is very alarming that among young people aged 15-29, suicide was the fourth major cause of death after road injury, tuberculosis and interpersonal violence. However, it varies between regions, countries, males and females. Males rate of suicide was 12.6 per 100 000 males as compared to women 5.4 per 100,000 females. But among the higher income nations rate of males committing suicide was 16.5 per 100,000 males, whereas for the females highest suicide rates were found in lower-middle-income nations, which were 7.1
Though globally, the suicide rate is falling, it is going up by almost 17% among Americans. In Africa, the rate of suicide is 11.2 per 100,000, in European countries, it is 10.5, and in South-Eastern Asia, it is 10.2; all these three regions have higher than the global rate of suicide, which is 9 per 100,000. Only the East Meditarian region has a lower rate than the global rate, which is 6.4 per 100,000.
Significant causes of suicide.
Suicide is a form of deliberate self-harm (DSH) and defined as a human act of self-intentioned and self-inflicted cessation, i.e. death. It ends with a fatal outcome. As per psychology, DSH is an act of intentionally injuring oneself, irrespective of the outcome. As per Niraj Ahuja, MBBS, MD, MRC Psych, A short textbook of Psychiatry, p.223, the presence of the following factors increases the risk of completed suicide:
- Age around 40 years
- Male gender
- Staying single
- Previous suicidal attempt(s)
- Depression increases the risk by almost 25 times.
- Presence of guilt, self-accusation, agitation, nihilistic ideas, worthlessness, severe insomnia, etc.
- Risk is usually higher at the beginning or towards the end of a depressive episode.
- Risk is often higher soon after the response to treatment rather than at the peak of depression,
- There is a higher of suicide in the week after discharge from the psychogeriatric inpatient unit.
- Suicidal preoccupation. Any plan or written statement,
- Alcohol or drug substances
- Severe, disabling, painful or untreatable physical illness.
- The recent loss of a loved one or the happening of a stressful event.
- Social Isolation.
Suicidal warning signals.
As per American Psychological Association, one should be concerned, if someone you know has following early warnings, at least a precious life could be saved.
- Speak generally referring to committing suicide
- If someone has the problem of eating or sleeping
- Shows radical fluctuations in behavior
- Withdrawal from close friends or relatives or social associations.
- Loss of interests in school, work or hobbies
- Do away with most precious belongings
- Takes needless dangers
- Seems anxious with death and disappearing
- Loss of interest in personal self appearance
WHO has released comprehensive guidance for implementing the ‘LIVE-LIFE’ program in letter and spirit to support countries in their efforts. It has four strategies in place to prevent suicide in society. These strategies could be summed as under:
- Restrictive means of approach to the methods of suicide, such as banning of highly hazardous pesticides and firearms. Roughly 20% of total suicide deaths have caused by consuming dangerous pesticides and firearms.
- Educating media on responsible reporting of suicide cases. Media reporting of suicide cases can lead to an increase in cases due to imitation. The media should also highlight the recovery cases from mental illness. Especially social media has to be responsible.
- Fostering social-emotional life skills in support of adolescents (10-20 years of age). This period of life is very critical hence require socio-emotional skills because half of the mental illness cases are below 14 years of age.
- Early identification and follow-up of people at greater risk. Identification, assessment, management, and follow-up cases of attempted suicide or perceived as great danger. An earlier suicide try is one of the most critical risk factors for the future.
Persons at risk for committing suicide often are not readily identifiable. They are frequently depressed. It is a bit difficult to prevent suicide. It is suggested that three steps that may help prevent suicide are:
- Take all suicide threats seriously.
- If someone mentions suicide, do not be afraid to discuss and dissect it in detail.
- Recognize the danger signs well.
- Discourage others from blaming themselves for failure to reach unrealistic goals.
- If a friend or family member shows the danger signs, do not leave that alone under any circumstances.
- Most important of all is to GET HELP.
Suicide can be prevented, but not all people have access to effective treatment and crisis intervention. Because the danger issues associated with suicide are multifaceted and differ across groups, suicide prevention demands comprehensive, evidence-based efforts across many settings. Suicide is often an imprudent act, where an individual is anxious to dismiss their miseries and knows no other way. Suicide hazard can be minimized through recognizing and providing support to address the factors that drive a person to consider suicide. Suicide is also a complication for the lifetime. Knowledge is supremacy and but too much distortion about suicide can have disastrous consequences. Unraveling myth from fact can empower you to help your teen in distress.