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Suicide Prevention

Sep 13, 2010 Editorial

Last Friday, September 10th, was observed as “World Suicide Prevention Day,” under the theme “Many Faces, Many Places: Suicide Prevention across the World”.
All Guyanese should know by now that suicide is a major problem in our country – constituting, as it does, one of the top ten causes of death. In the crucial, productive 15-24 age bracket, it is the leading cause of death while it is the third leading cause in the 25-44 age bracket. A whole lot of young people kill themselves.
According to figures released by the Ministry of Health, there were 946 suicides reported in Guyana between 2003-2007, for an average of 189 per year. The qualifier “reported” is important since it is likely that some cases might have slipped through the reporting system. What this means is that the 25 suicides per 100,000 that is our national rate, is on the low side.
However, since 80% of suicide victims are males, it means that their rate jumps to 43 per 100,000. And while the Ministry does not offer a precise breakdown by ethnic groups – save to say that “the vast majority of the cases occurred among persons of East Indian ancestry – the rate for male East Indians has to be quite hair-raising. The rate of 50 per 100,000 for Region Six, which is dominated by East Indians, support our surmise.
We tease out these figures because it is important that our efforts to prevent suicide are not diluted by assertions that our national suicide rate is comparable to the world figures of 16 per 100,000. The subtheme “Many Faces”, in fact is meant to emphasise the “significant differences in the profiles and circumstances of suicidal individuals in different parts of the world”. Suicide rates, as reported to the WHO, are highest in Eastern European countries including Lithuania, Estonia, Belarus and the Russian Federation.
These countries have suicide rates of the order of 45 to 75 per 100 000. Reported suicide rates are lowest in the countries of Mediterranean Europe and the predominantly Catholic countries of Latin America (Colombia, Paraguay) and Asia (such as the Philippines) and in Muslim countries (such as Pakistan).
These countries have suicide rates of less than 6 per 100 000. India has a rate of 10 per 100,000. In the developed countries of North America, Europe and Australasia, suicide rates tend to lie between these two extremes, ranging from 10-35 per 100 000. It is crucial we hone in on any significant variable that our investigations may reveal. To its credit, the Ministry of Health has focused a proportionate effort to Region Six.
At the “Suicide Prevention Day” programme a year ago, the Minister of Health had been very candid in asserting that neither the government, the Region nor PAHO had deployed the requisite budgetary allocation to deal with suicide, even as they all acknowledged the gravity of the problem locally. Since that time, there has been a flurry of activities involving national and international actors to first get a handle of the phenomena and simultaneously to make targeted interventions.
There has been a training session in suicide prevention that involved the International Association of Suicide Prevention, Pan American Health Organisation (PAHO) and Dalhousie University Department of Psychiatry to get both health care professionals and communities on board. Persons have been trained in a crisis hotline programme and GT&T is supposed to install the requisite communications infrastructure.
Simultaneously with the intervention aspects of the pilot programme, a detailed history of suicide victims (“psychological autopsy”) will be compiled to discover specific causative factors in the Guyanese milieu. A “gatekeeper” (influential persons in the community that may intervene to prevent suicide) programme has already been kicked off. Since pesticides (especially gramoxone) are one of the most popular means to commit suicide, the Ministry has also initiated a programme to institute a more secure method of storing the poisonous substance.
While the efforts might be a bit late in coming, we have to all get on board to ensure that this scourge does not escalate.

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