Stigma, taboo on suicide doing more harm than good

Sep 06, 2015 News

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 “Having suicidal thoughts is not something you feel proud of or something you’re willing to share with anyone, including your family. You feel a bit of shame that you want to kill yourself.”
By Desilon Daniels

Since childhood, Selina Kyle (name changed) would struggle each day with mental health issues; one moment, she would be as happy as any child, bouncing off the walls with excitement. The next, she would be nearly on the brink of tears, solemn but unsure of why.
Now 22-year-old, Selina still struggles with this issue but now she understands what it means. Recently, she was diagnosed by a psychiatrist as suffering from Bipolar Disease, a mental illness characterised by mood swings ranging from depressive lows to manic highs. Bipolar Disease is also known as “manic depression” and can’t be cured but treatment may help. The disease is often for life.
Selina is mostly alone in tackling her problem; she believes that there is a stigma in Guyana surrounding issues of mental illness and feels that while she can speak about it with few persons, she is nowhere near making any public declarations as yet.
According to Selina, the silence initially began in her family. She explained that she often suffered from episodes of depression and suicidal thoughts. These episodes, which had always been present, intensified earlier this year and were debilitating.
However, her experiences were never broached with her family despite the fact that others in her family suffered from mental illness.
“Depression runs in my family but it’s not something we talk about unless it’s very obvious, like if you ‘trip out’; we all just keep it to ourselves,” she said.

She said too that once she had mentioned her depression to her mother but was told, “You just have to get prayers and get those thoughts out of your head.”
Selina said that she eventually sought the help of a psychiatrist and though it was expensive she found a way to afford it. She attended sessions for months and even began taking medication but her family never knew.
“Having suicidal thoughts is not something you feel proud of or something you’re willing to share with anyone, including your family,” Selina said. “You feel a bit of shame that you want to kill yourself.”
However, despite the previous failures at raising the topic, Selina tried once more with her mother. She explained to her mother that she had been receiving help and had been diagnosed with Bipolar Disease. In turn, her mother expressed concern at her taking medication and worried about possible addiction. There was a positive outcome, however, Selina said.
“My Dad suffers from it [Bipolar Disease] as well and he knew my struggles so when I told her she said she understood more than I think she does,” Selina said. “At first she didn’t understand though. She still doesn’t understand my feelings completely but I’m not upset about that because she’s not the one in my head.”
For Selina, opening up about her illness and suicidal thoughts with her mother helped her tremendously. She added that not much has changed in the way her mother relates to her and she said she was thankful that her mother was not “babying” her.
“I thought she needed to know in case I went over the edge and she needed an explanation for my behaviour,” she said. She continued, “I feel relieved now because I know if I ever get into a really dark place she’ll understand; if I kill myself I feel a sense of peace knowing that she’ll understand where it all came from.”
Selina added that she had also raised the issue with another relative but is still keeping her problems close to the chest from other relatives.
Outside of her family, her mental illness is not raised. She said that typically the issue is a hushed up one. She explained that she had known someone who had failed at suicide, however, after the suicide attempt, this friend never spoke about it. She added that the issue of suicide is sometimes trivialised.
“Everyone is going to think you’re an attention seeker or a weak person who doesn’t have a problem but who is just exaggerating things,” she said. She said this is particularly true with Bipolar Disease since you often cannot track the source of the depression.
Suicide, the unmentionable
Bibi Ahamad, Managing Director of the non-governmental organisation (NGO), The Caribbean Voice, agreed that suicide is indeed a taboo subject in Guyana.
She explained that Caribbean Voice had visited Black Bush Polder, East Berbice and its four main areas, Lesbeholden, Johanna, Mibicuri and Yakusari. There, the NGO met with people in the community and interacted with them on suicide prevention and the issues surrounding suicide such as depression. She added that there was a wide cross-section of participants including teenagers, young children and adults.
She said that the area was decided upon based on statistics which showed alarmingly high rates of suicide in the area.
Ahamad said that coming out of these visits were a lot of issues plaguing the residents, particularly the youths. She said those youths who were out of school expressed that they had nothing to do in those areas for recreation or even work.
“They have a TV but not with much access, there’s no internet, no recreational activity so a lot of them are depressed.  Some might go to work with their fathers in the field but that’s it,” Ahamad said.
She further said that a common trend was noticed; many of the young persons who attended did not speak in front of their parents.
According to Ahamad, she did follow-ups with at least 12 persons from the consultations and, out of that those who sought help, all of them had been under the age of 25. Many of these persons, she said, had been afraid to speak about the issue in front of their parents. Others who were older and were independent still did not feel comfortable about addressing the issue in front of others.
“Many of them took our contact number and spoke with us after and some of these young people had children or were even married,” she said. She went on, “The thing about it though is that people have a tendency that they don’t want to discuss mental health issues openly. There’s a stigma so not everyone is prepared to do that [speak openly].”
She said that during the private chats the youths were much more open and spoke about their issues with depression and their experiences with suicide attempts.
She stressed that in modern day Guyana the archaic stigma surrounding suicide and mental health issues is still prevalent.
“I know for a fact some people who have a relative that committed suicide yet are tight-lipped on the issue,” she said. She further said that the key to eradicating this stigma is awareness.
She emphasised that the stigma and taboo originate from Guyana’s reserved culture and can be linked back to family life.
“There are so many reasons why people don’t want to talk about suicide but it boils down to the type of home the individual grows up in. If the parents or other relatives are shut out to talk about it, a young person is going to be the same way,” she said. She added that while some may seek a confidante outside of their families, the stigma is deterring many others from doing the same.
However, while there are persons out there who are willing to provide professional help, both Ahamad and Selina emphasised that these persons must be adequately trained.
Ahamad said that the shortage of skilled professionals under the current system of care was a serious deterrent to suicide prevention efforts. Currently, there are only five psychologists in the government healthcare system while there are woefully inadequate social workers and counsellors.
“We just don’t have enough qualified persons in the mental health field; that’s something severely lacking in Guyana,” she emphasised.
Furthermore, Ahamad stated that even when the qualified persons are available, the cost of seeing them is difficult for many Guyanese to afford. She said too that these trained professionals are often based in Georgetown.
For Selina, this high price is one she must pay for the sake of her health. She said that with help from a trained professional she was able to open up and cope somewhat.
“It’s good to talk to someone about your feelings. When you speak to someone without fear of being judged, the truth just comes out and there’s no fear or holding back,” she said.
However, she said, this openness is difficult for her with persons who are clearly not adequately trained.
“I would have met social workers or government counsellors who talk your business with other people,” Selina said. She added, “They’re poorly trained and some people are just not cut out for counselling. They can actually make you more depressed and suicidal.”
She stressed that these people need a higher level of professionalism.
“It’s a life they’re playing with; suicide is no joking matter and we need to take it very seriously in Guyana.”

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