Most people who commit suicide don’t want to die….

Jan 10, 2016 APNU Column, Features / Columnists

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The time has come for there to be a national conversation on suicide and suicide prevention. For far too long we have given lip-service to what is now a public health crisis in Guyana. Suicide is defined as the act of intentionally causing one’s own death. Suicide is often completed as a result of despair, the cause of which is frequently attributed to a mental disorder such as depression, bipolar disorder, schizophrenia, borderline personality disorder, alcoholism, or drug abuse, as well as stress factors such as financial difficulties, troubles with interpersonal relationships and bullying.
In Guyana there were over eighty completed suicides last year, and already two persons have died this year. It is time for this epidemic to be given the attention that it deserves. The first step in addressing this problem is to fully understand and be able to identify the likely triggers that would force someone to take their own life. This is not an easy task, because there is no known underlying pathophysiology for either suicide or depression. It is however believed to result from an interplay of behavioral, socio-environmental and psychiatric factors.
There will therefore be need for a national campaign educating the populace and especially public health and mental health professionals on the etiology of suicide and how to identify the warning signs.
Most suicidal individuals give warning signs or signals of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond if you spot them. If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a competent medical professional or social worker involved.
Major warning signs for suicide include talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as pesticides, weapons and drugs. These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide.
A more subtle but equally dangerous warning sign of suicide is hopelessness. Studies have found that hopelessness is a strong predictor of suicide. Blinded by feelings of self-loathing, hopelessness, and isolation, a suicidal person can’t see any way of finding relief except through death. But despite their desire for the pain to stop, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative to committing suicide, but they just can’t see one.
In Guyana there is an acute need for trained mental health professionals and the infrastructure to support the delivery of psychiatric care. Without a strong cadre of psychiatrists, psychotherapists, psychologists, mental health councillors, nurses and mental health aides, we will continue to be ill-equipped to deal with this scourge.
In our school system, guidance councillors must be recruited and trained to identify at-risk students and be equipped to offer help and support.  There is also a dire need for designated areas in our current public health system for the treatment of mental-health patients suffering from psychiatric disorders. It will also be necessary for mass education, starting at the primary levels, to reverse the negative stigma attached to mental disorders and psychiatric illness.
Suicide hotlines and safe houses play an integral role in suicide prevention. However they will only be effective unless they are manned by highly trained individuals who can empathize with their client’s desperate attempt to escape suffering that has become unbearable.
We may need to examine our current legislation to see if adjustments might be required. In some jurisdictions, persons can be voluntarily held in a crisis stabilization unit, which is an emergency room for psychiatry; frequently dealing with suicidal, violent, or otherwise critical individuals. These persons are held and monitored for seventy-two hours if the authorities fear that they will harm themselves or harm others.  A toll–free poison control help line connects you to a local poison control centre that can help in a poisoning emergency. These lines must be manned by a trained nurse, doctor or pharmacists who can act as a first responder in a chemical crisis.
Many suicidal persons may not ask for help, but that doesn’t mean that help isn’t wanted. Most people who commit suicide don’t want to die—they just want to stop hurting. Suicide prevention starts with recognizing the warning signs and taking them seriously.
We have a suicide epidemic in Guyana. It is a national public health problem that will require a holistic national approach.

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