Every year, World Mental Health Day is observed on October 10th to create awareness of mental health issues. This year the theme is Suicide Prevention.
Suicide is a serious mental-health issue. It is a permanent solution to (often) temporary problems.
Having suicidal thoughts is a red flag. It indicates some form of serious underlying issues. Such thoughts should not be ignored and must not be considered normal. Anyone and everyone can be affected by them. No age, gender or background is immune to it.
As per World Health Organization, suicide is the second leading cause of death among 15-29-year-olds globally. Nearly 8,00,000 people die due to suicide every year, which is one person every 40 seconds.
The National Crime Records Bureau (NCRB) in its 2015 data made a shocking revelation that, in India, one student commits suicide every hour.
And yet these are entirely avoidable deaths. Help given at the right time can prevent suicide.
But how do we know someone is at the risk of suicide?
By statements they make, such as:
– I am feeling trapped
– I have no reason to live
– I want to kill myself/ I am going to kill myself
– I am experiencing unbearable pain
– I am a burden on others
– I wish I were dead
– I wish I hadn’t been born
By their behaviour, such as:
– Withdrawing from activities
– Isolating from family and friends
– Inability to concentrate
– Being aggressive
– Giving away prized possessions
– Visiting or calling people to say goodbye
– Looking for ways to kill themselves, such as searching online for ways and materials, collecting and saving pills, buying a weapon
– Sleeping a lot or not at all
– Acting recklessly such as using drugs or alcohol, or driving recklessly
– Tying up loose ends, paying off debts, organizing personal papers
By their mood:
– Sad and depressed
– Lack of interest and confidence
– Rage and anger
– Feelings of hopelessness and helplessness
Are some people more at risk than others?
These RED FLAGS may not always be obvious. They occur in different intensities in different people. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret. But there are certain risk factors in certain sections of the population, such as:
– Previous attempted suicide (major risk factor)
– In terms of gender, more women than men attempt suicide, but more men than women complete the suicide because they typically use more lethal methods, such as firearms.
– Stressful life events, such as the loss of a loved one, military service, a breakup, or financial or legal problems, and so on
– A substance-abuse problem — alcohol and drug abuse can worsen thoughts of suicide and increase the chances to act on your thoughts
– Access to firearms at home
– Suffering from psychiatric disorder, such as major depression, post-traumatic stress disorder or bipolar disorder
– Medical condition like chronic disease, chronic pain or terminal illness
– For lesbian, gay, bisexual or transgender persons, having an unsupportive family or a hostile environment
– A family history of mental disorders, substance abuse, suicide, or violence, including physical or sexual abuse
– Suicide in children and teenagers can follow stressful life events. Something very minor for adults may be a huge deal for the child or teenager — such as problems in school, the loss of a friendship, bullying, fear of failing, break-ups and so on. Most of the time, they are not able to express what they are feeling. Any change in the child’s regular behaviour when he / she is not himself / herself is a RED FLAG and must be addressed at once.
What do you do when you recognize the signs?
Calm yourself first: You may feel anxious discussing suicidal thoughts. Take five minutes before approaching the person. Do not let your anxiety and nervousness become evident or affect them. Do not fidget and do not pace in front of them.
Be open and honest: Be sympathetic, non-judgmental, patient, calm, and accepting. The person will pick up your attitude and begin to mirror this.
Always ask: “Do you want to kill yourself?”
“Do you have a PLAN as to how you will kill yourself?”
“Do you know when will you do it?”
No matter how uncomfortable it makes you feel, always ask. Studies have shown that asking this does not increase the suicides or suicidal thoughts.
Fortunately, most will either say, “They have no definite plans or that they don’t have the nerve to do it themselves or that committing suicide is wrong.” Take their words as a plea for help, even though there is no immediate danger.
If the answer to anyone of these questions is YES, it is an emergency. Call for help immediately and don’t listen even if they say things like, “You are betraying me,” “You are not my friend,” and so on.
Listen actively: it is important that the individual feels heard and validated. Reflect their feelings and try to summarize their thoughts. This shows them that you understand them. DO NOT argue, threaten or raise your voice. DO NOT DEBATE whether if suicide is right or wrong. BE PATIENT. If there are multiple people around, have one person speak at a time. DO NOT offer solutions to their problems. Just compel them to talk more. This will help them relieve the emotional turmoil. They will feel listened to and will be more open to treatment.
Keep them safe: Do not leave them alone at any time. Remove guns, knives and collected pills and drugs from home.
Help them connect: Calmly ask simple and direct question, such as, “Can I help you call your psychiatrist / counsellor?” “Can I help you to take an appointment with a doctor?”
Various suicide helplines are available these days, such as SPIF, AASRA, ROSHNI, and so on. Contact them for help.
Suicide is preventable. Let’s fight together against suicide. Every life is precious.
Dr Jankhana Hakani is a consultant psychiatrist and counselor based in Mumbai.
First published in eShe magazine