September 10, 2021

The World Suicide Prevention Day is observed each year on September 10. Death by suicide is a growing problem and the increasing numbers tell a shocking story!

Every 40 seconds someone takes their own life according to the World Health Organization (WHO) report. That’s about 800,000 people worldwide every year a staggering number— although some estimates put that number closer to 1 million people who die of suicide each year. This is because many cases go unreported. Suicide is the leading cause of death for people aged 15 to 29 and for every suicide that results in death, there are as many as 40 attempted suicides. Statistically women attempt more. But more men commit suicide than women.

During this global Covid pandemic mental health problems and suicide are likely to increase. People are battling with loneliness, shrinking incomes and poor health. Stressors only increase risk of suicide. There is a need to improve awareness about mental health, mental illness and suicide. Suicide is preventable through right and timely action.
Correctly the theme for World Suicide Prevention Day 2021-2023 is “Creating Hope Through Action”.

What are the causes for someone to attempt suicide?

Though persons of all genders, ages, and ethnicities can be at risk for suicide, there are some specific risk factors for suicide.

The main risk factors for suicide are:
• A history of suicide attempts. If someone has attempted in the past, he/she is more likely to attempt again.
• Depression, other mental disorders, or substance use disorder. These illnesses when treated, risk of suicide decreases dramatically. Hence, it is very important to treat psychiatric illnesses.
• Chronic pain. Pain of terminal cancers, arthritis all increase suicidal risk.
• Family history of a mental disorder or substance use and suicide also is a strong indicator in attempters.
• Exposure to family violence, including physical or sexual abuse also predisposes to suicide.
• Presence of guns or other firearms in the home also worsens suicide risk. In India consumption of pesticide is the leading method of suicide attempt. Being an agricultural economy, availability of these means contributes to the way suicide is attempted.
• Exposure, either directly or indirectly, to others’ suicidal behaviour, such as that of family members, peers, or celebrities increase suicidal behaviour in suggestible individuals. Copy-cat suicide attempts are known to occur in fans when their celebrity dies of suicide.

What are the warning signs of suicide?

It is a known fact that people who plan to take their life often communicate it to others in verbal and nonverbal manner i.e. through their actions.

• Talking about dying or wanting to die is a common symptom.
• Talking about feeling empty, hopeless, or having no way out of problems is another warning sign of impending suicide.
• Mentioning strong feelings of guilt and shame in which an individual holds him or herself unduly responsible is also a red flag.
• Talking about not having a reason to live or that others would be better off without them or that God should take him away.
• Social withdrawal and isolation is another.
• Giving away personal items and wrapping up loose ends. Making a will.
• Saying goodbye to friends and family on social media or in person. Deleting social media accounts can also mean something sinister is about to happen.

What to Do If Someone Seems suicidal?

First and foremost, if someone is actually threatening suicide, talking about doing it, or is actively asking for lethal means, mobilise help. Think family, friends, and local guardians. Do not leave him/ her alone.
If the situation is not that immediate, but you suspect someone is suicidal, talk to them about it.

Discussing suicide is not going to push anyone over the edge and make them take their own life. Talk to this person privately, listen without judgment, and be compassionate. Ask directly about what he/she has planned. It’s important not to leave the person alone and also very important to remove means of self-harm.

Be aware that there are many helplines which are available to persons who are suicidal. Some of them are a 24 hour service. They offer early screening, psychological first-aid, psychological support, distress management, mental well-being, psychological crisis management and referrals to mental health experts. Eventually the person should be seen by a mental health professional, preferably a psychiatrist.

The Kiran helpline 1800-599-0019 of the Department of Empowerment of Persons with Disabilities (DEPwD) is one such suicide helpline

When a person with suicidal ideation is referred to a mental health professional a detailed assessment is done. A definite psychiatric diagnosis is arrived at. Treatment is initiated. Sometimes admission and in-patient treatment may be required. Family members are educated about the risks involved and means to reduce harm.

Many a times, patients are brought in after a suicide attempt. In such a case a psychiatrist assesses intentionality and lethality of suicide attempt. Sometimes a person may have a strong desire or intention to die but they may not have any serious means to do so. Such as cutting the wrist superficially. In some other cases the patient may have used a very lethal means of self-harm such as a firearm but the intention to die may be less or under intoxication. Treatment is decided keeping multiple factors in mind. Patients diagnose psychosocial stressors, whether it was attempted in an intoxicated state. All these factors have to be considered. The aim of the treatment is to prevent another suicide attempt.

Depression is an illness and can be treated. Substance dependence can be treated. Coping mechanisms can be taught. Crisis can be managed. Many inter personal problems can be solved. Difficult times don’t last forever.

Hence, Suicide can be prevented.