Suicide: Why are we not taking this issue seriously?

Suicide

Why are we not taking this issue seriously?

Suicide is a major happening particularly in Sri Lanka. In the mid-nineties Sri Lanka had a dreadful record showing a stand of “World’s No. 1 suicide rate”. At that time over forty people died out of every 100,000 within a year. The cause of death was due to suicide.

Imagine over 8,000 people per year using suicide as their way out of living? That was 20 or more people a day.

In this context, the then President of Sri Lanka appointed a Presidential Task Force (PTF) for Prevention of Suicide. This task force studied the situation scientifically and gave its recommendations, which were readily accepted. Since then the suicide rate of Sri Lanka has declined. Each year numbers of people taking their life have decreased. And, numbers have decreased steadily.

Less than half the rate we had in 1990s is now shown.

This situation we are indeed mighty proud of but it’s not satisfactory. Sri Lanka still has one of the highest suicide rates in the world.
Spelling out the situation further for those of you don’t understand or don’t want to face the subject, here in Sri Lanka we still have more than ten times self-harm attempts (compared to suicides) every year.

Let us look further into the recommendations of the PTF, made in mid 1990s. They were after all effective in turning around statistics, and it may be interesting to know and understand, even guess, what those recommendations were.

How were suicides reduced in Sri Lanka?

One guess is the priority given to mental health services. I agree, support, care and intervention methods have multiplied. In this context “Counselling” has become fashionable. Yet is it available to all communities and families?

Training the community and families in ‘Coping skills’ is most definitely a serious and effective way to handle the stresses and anxieties of living.
But, this was not what the PTF suggested.

We need more Psychiatrists” many scream out thinking that the subject of suicide is within mental illnesses.

However PTF is not very supportive of this way of thinking. Another common remedy people suggest to reduce suicides in a country such as ours is to look deeply at the root causes. Then, having studied those, provision of solutions to eliminate the root causes should be set in place.

However, the underlying theory/ thinking still remains the same: People ‘commit’ suicide due to certain problems, which may be financial challenges, relationship problems or some other issue.

Finding out the root cause and ‘fixing’ them, again, is not favoured by the PTF recommendations.

Poverty, economic constraints, lack of basic services to the people are arguable and brought up as reasons why people want to take their own life and leave this world.

Provision of more welfare services or increasing salaries are ways to reduces suicide according to the above argument.
The PTF recommendations certainly do not advise this.

Japan, a country where economy is very strong, has a very high suicide rate in the world!

Recommendations of the Presidential Task Force for Prevention of Suicides

Now if we turn to the recommendations made by the PTF in 1996, we can’t help but notice that that they are very different to what we have been thinking of.
A very prominent recommendation they made was to ‘reduce easy access to lethal methods of suicide’.

One such common method is the ingestion of agrochemicals. Several agrochemicals were banned and many were ordered to be sold in diluted forms. And, apparently, it worked, together with other interventions. Although this seemed to be a simple solution for a complex problem, it worked.

Scientific studies have repeatedly shown that restricting access to means of suicide is a very effective way of reducing suicide in a country/ area. One may argue that people might now switch to another method in the absence of the previous method, but it does not happen to that extent.

The small increase in suicides due to other methods after the restriction is noted, but overall the decline is quite marked.

Removing carbon monoxide, a toxic gas, from domestic gas supply in Europe over a half-a-century ago, installing physical barriers at many famous places of suicide jumps, restriction of dispensing of certain medications are few of the well-known examples from the world over.
Another important recommendation was to change the suicide culture.

Suicide culture means a system of thinking/ talking/ behaving about suicide in a way to promote it. This is really serious, please read on……..

For example, a person might lament saying “I would rather have taken a poison, than taking up this job.”

Another example: a mother may ask her daughter “Why you thought of taking your life when we all really love you sooo much?”

The underlying thinking of above dialogues highlights the core features of the suicide culture. “I would rather have taken a poison, than taking up this job.” means that it is better to commit suicide when faced with very difficult situations.

“Why you thought of taking your life when we all really love you sooo much?” means that if somebody is not loved that much, it is okay to take his/her life.

The core theme here is that when faced with difficulties/stresses/ problems/unhappiness, suicide is an option, or not?

Another core theme of the suicide culture is that suicide is a heroic action and THE thing to do.

There is the saying “He must have been a tough guy to shoot himself like that, no?”.

Meaning, this means only tough people could kill themselves. More commonly, this is done in an indirect way. “She was the best girl in our school!” laments a teacher, following the suicide of a school girl. This is called glorification of the one who committed suicide.

The act of suicide itself could be not only glorified but also honoured!

Discussing fine details of how the act was planned and carried out, showing others the pictures and sharing the details, writing elaborate obituaries are some ways people react and handle the taking of a person’s life, which is suicide.

Many artistic creations, novels, and movies glorify suicide in many ways.

Let’s look more closely at changing ‘suicide culture’

Changing suicide culture
is fundamental to the reversal of suicide trends in Sri Lanka.

This was clearly recognised and highlighted by the PTF, way back in 1996. Since then the media took a keen interest to change its way of reporting to minimise, if not eliminate, its role in glorification of suicides by harmful reporting.

Suicide culture alone, or harmful reporting that promotes suicide culture, does not cause suicides directly.

The suicide culture greatly increases the chances of committing the act of suicide in people. All over the world ethical journalists have come up with various documents to guide their own reporting on suicide. These are applicable to our setting as well.

It is high time that our local media renew their attention to these well-accepted guidelines.

These guidelines caution journalists against the common harms media reporting may bring about. One such well-known harm is ‘presenting simplistic explanations for suicide’, such as the headline ‘father hangs himself after daughter fails A/Levels’.

Presenting suicide as a tool for accomplishing certain ends is another related harm. For an example, a news report may tell us that after a certain person killed himself in protest of a certain decision of a local authority, they reversed the decision.

‘Engaging in repetitive, on-going, or excessive reporting of suicide in the news’ together with ‘providing sensational coverage’ are other harms media may promote inadvertently. These directly promote the suicide culture. None of these isolated reports may cause a suicide, but they contribute in general to the suicide culture and then to actual suicide in the end.

Sometimes these news reports give us “how-to” descriptions of committing suicide,  teaching us the method.

It is time that we, society in general, wake up. Come on!

  • We have to shake our social consciousness.
  • We have to look into the depths of our mind and see whether ‘Responsibility  Matters’ in our life and of others.
  • People involved with media in particular, must pay serious attention to the suicide problem in our country.

It is true that we halved the number of people who died of suicide in this country. We have to do more. We need to do more because still ten or more of our own brothers, sisters, daughters, sons, friends, mothers, and fathers die every day.

By Mahesh Rajasuriya
Dr. Mahesh Rajasuriya is Senior Lecturer at the Department of Psychological Medicine, Faculty of Medicine, University of Colombo, and Consultant Psychiatrist at the University Psychiatry Unit, Ward 59, National Hospital of Sri Lanka, Colombo, Sri Lanka.