Suicide and Culture

Sep 10, 2011 Features / Columnists, Ravi Dev

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Yesterday Guyana observed World Suicide Prevention Day. Yes, suicide is a worldwide problem. Today the US will be mourning the deaths of almost 3000 persons in the tragedy of 9/11 – but every year ten times that number commit suicide. And it’s practically unremarked. The WHO claims that globally there are 1 million suicides annually.
This year, the theme for the commemoration activities is “Preventing Suicide in Multicultural Societies” and in this innocuous statement there is much food for thought. When suicide is discussed by policy makers, they usually toss out figures on the national rates prevalent in their respective countries. The US, for instance, with their 30,000 suicides annually works out to 10.8 per 100,000 (pht) while Guyana with its 180 comes in at 24 pht. Compared with the US, our suicide rate is obviously much higher and in fact is among the highest in the world.
But over the course of the last few decades as statistics were collected, it became apparent that within countries there were striking differences in suicide rates among different ethnic groups. For instance in the US, Blacks committed suicide at only half the rate of Whites and the suicide rate for the latter group is actually 17.6 pht. This is more in line with the global suicide rate of 16 per pht. This suggested that efforts to mitigate suicide rates had to be directed to the affected communities.
In Guyana, working in the Indian community since my return in 1988, I could not help being struck by the high incidence of suicide among Indians in general and Hindus in particular. In 1997, working along with Swami Aksharananda among Hindu youths, we organised a seminar on suicide at the Cove and John Ashram. As part of that exercise, we conducted a pilot survey of suicide in several communities on the West Coast of Demerara. It confirmed our anecdotal evidence of suicide occurring in epidemic proportions among Indians as specifically Hindus. From that time we began to make annual calls for a national suicide programme to be initiated.
The Ministry of Health (MOH), through its Minister, candidly acknowledged the existence of the suicide problem in our country and gradually the bureaucracy swung into action. But as bureaucracies are impelled by their rules and tradition their response was measured. The release of a study in 2001 commissioned by Dr Frank Beckles, a clinical and forensic psychiatrist, whose son – himself a doctor who had committed suicide – was salutary. In addition to garnering publicity to highlight the suicide menace, it provided concrete data that could guide the policy makers.
It was shown that with approximately 200 suicides annually, Guyana’s suicide rate was above 20 pht but just as significantly it confirmed our early findings of the ethnic specificity of the problem. Three out of every four suicides were by Indian Guyanese and it was therefore not surprising that Regions 2 and 6, dominated by Indians, suffered the highest suicide rates: Berbice alone had 52.7% of all cases. Another finding that jumped out was that 8 out of ten suicides were committed by males – and young males at that. Two-thirds of all persons that committed suicide in Guyana were also below the age of 35. When the numbers were disaggregated it suggested that the suicide rate for Indians was 41 pht and for Indian males, a staggering 66 pht.
I remember being at the launching of the Beckles study and the subsequent discussion that honed in on the ethnic specificity of the phenomenon. It was pointed out by one interlocutor, (I believe it was Swami Aksharananda) that while there was a high correlation between Hindus and suicide in Guyana it could not be assume that Hinduism was a causative factor. The predominantly Hindu village-India that the Indians had left, had an extremely low rate of 6.3 pht.
Another important point made by a female health worker (I believe) was that while the high rate of suicide among Indians might be due to societal pressures it did not mean that other groups did not face those pressures. They simply had different pathological reactions.
Since that time, the MOH had gradually intensified its programmes to deal with suicide. A National Committee for Suicide Prevention (NCSP) was formed in 2007; there have been collaborative initiatives with international institutions that deal with suicide; a crisis hotline pilot programme was unfolded in Berbice; health workers and other stakeholders have been given training to be more aware, pro-active and sensitive to deal with suicide; programmes for public awareness and a “follow-back” methodology instituted.
But in my estimation the initiative that holds the greatest potential for reducing the incidence of suicide is the Gatekeepers Programme. Here, individuals from communities concerned about the scourge are trained by professionals so that suicidal persons will have culturally compatible persons to whom they can turn. All communities must become Gatekeepers.

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