How to prevent suicides

In India, suicide rates are higher in southern states. Suicides rates in Kerala were the highest at 32 about a decade ago.
How to prevent suicides

KOCHI: Since 1992, October 10 is observed as the World Mental Health Day. The main focus this year is ‘Suicide prevention’. Close to eight lakh people commit suicide every year. It cuts across sociodemographics and all regions of the world. Suicide is not only a matter for medicine and psychiatry but also for religion, philosophy, sociology, psychology, bioethics and humanities.

Myths and facts
Myth: People who talk about suicide do not mean to do it. Fact: People who talk about suicide may be reaching out for help or support.
A significant number of people contemplating suicide are experiencing anxiety, depression and hopelessness and may feel that there is no other option.
Myth: Most suicides happen suddenly without warning. Fact: The majority of suicides are preceded by warning signs, whether verbal or behavioural. It is important to understand what the warning signs are and look out for them.
Myth: Talking about suicide is a bad idea and can be interpreted as encouragement. Fact: Given the widespread stigma around suicide, most people who are contemplating suicide do not know who to speak to. Talking openly can give an individual other options or the time to rethink his/her decision, thereby preventing suicide, rather than encouraging suicidal behaviour

The Indian scenario
In India, suicide rates are higher in southern states. Suicides rates in Kerala were the highest at 32 about a decade ago. This has been brought down to around 25, through sustained efforts by government, mental health professionals and civil society organisations.

Management of suicidal problems
Depression and suicidal tendencies are treatable mental disorders. The child or adolescent needs to have his or her illness recognised and diagnosed and appropriately treated with a treatment plan. Most people who engage in suicidal behaviour are ambivalent about wanting to die at the time of the act, and some suicidal acts are impulsive responses to acute psychosocial stressors.
 
Prevention
Unfortunately, prevention is too often a low priority for governments and policy-makers. It needs to be prioritised on global public health policy agendas. Prevention should engage the attention of mental health professionals, organisations of families and carers, non-governmental organisations and educational institutions. The role of media -- print, audiovisual as well as social media -- is paramount as they can serve as powerful platforms to propagate positive ideas on suicide prevention. Coversely, they can play a negative role as well, by giving unwarranted publicity and portraying acts of suicides as some form of heroism.

Conclusion
Suicide is a major public health problem of our time. It is one of the 10 leading causes of death. It is the third major cause of ‘Life Years Lost’, next only to heart disease and cancer. The highest risk is among adolescents and old people. People who are divorced, separated or living alone also show high incidence. The rates in young people are strikingly high in Southern India. Most of them commit suicide on an impulse. Hence bringing help to them, during times of crisis will be life-saving. Prevention is a collective responsibility and must be spearheaded by governments and civil society together.

(The author is secretary-general, World Psychiatric Association, Geneva and a professor and Psychiatry department head at Pushpagiri Institute of Medical Sciences, Thiruvalla)

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