Suicide preventive measures – a Kandifo Institute perspective

In the last 45 years, suicide has increased by 60% worldwide. The interpersonal theory of suicide explains that there needs to be the desire and ability to kill oneself for suicidal behavior to occur. Joiner further explains that social disconnection or alienation and perception of being a burden to others are reasons why suicide occurs.

According to the theory, social disconnection and burdensomeness impacts the mental state of individuals, and this leads to suicidal ideation. Various studies have examined the reasons for suicide as reported by attempt survivors and significant persons around them such as health workers and families.

Some studies have as well examined perspectives on why suicide occurred and in one of such study, a majority of the patients reported impulsivity and loss of a sense of control as reasons for their action, but some health experts viewed the act as impulsive.

Also, patients described anxiety and panic before the attempt, which was least mentioned by the doctors; the doctors and nurses reported despair and hopelessness before the attempt. In another study, general practitioners and psychiatrists favoured medical explanations, but the general population and suicide attempt survivors favoured psychosocial explanations for attempting suicide. Thus, suicide attempt survivors understand their attempt differently than mental health professionals who treat them.

Suicidal behaviour disrupts the family system. There are however limited studies on families’ experiences or reactions after a suicide attempt. Examining the perspective of family members is essential to better understand the treatment and prevention of suicidality in at-risk individuals. This is important because the family system also plays a role in the development of suicidal behavior.

Studies in Ghana have reported reasons for suicide including shame, faith crisis, stigma, social exclusion, perceived infidelity, social taunting, betrayal, financial problems, neglect, and existential crisis. Until now, studies examining reasons for suicide have focused only on attempt survivors or mental health professionals, without any narratives from the family.

Although attempt survivors’ view on the reason/s for suicidal behaviour might not be contested, it will, however, be relevant to find out what their families also think about this for purposes of gauging the latter’s readiness for support and early intervention.

Further, the views of the families are relevant in understanding suicide because they highlight the importance of early identification of warning signs in prevention and intervention programs.

There are reliable indicators that a suicide attempt leaves suicide persons and families at loggerheads, with strong evidence of dyadic tensions, which may lead to an escalation of distress among suicidal persons. This presents opportunities to compare the views of attempt survivors directly with their families on the reasons for the act.

Suicide mortality rate is the number of suicide deaths in a year per 100,000 population.

• Ghana suicide rate for 2016 was 5.40, a 1.89% increase from 2015.
• Ghana suicide rate for 2015 was 5.30, a 12.77% increase from 2010.
• Ghana suicide rate for 2010 was 4.70, a 9.3% increase from 2005.
• Ghana suicide rate for 2005 was 4.30, a 7.5% increase from 2000.

Suicide is a serious public and mental health challenge. Ranked as the second leading cause of death in 15- to 29-year-olds, globally, suicide claims over 800,000 lives each year, with a suicide-related death occurring every 40s somewhere around the world, and many more people attempting suicide (World Health Organization [WHO], 2014).

As reported generally across the African continent and most low- and middle-income countries (LAMICs), there are no official statistics on the epidemiology and burden of suicide in Ghana. However, recent anecdotal statistical evidence shows that about 1,556 people (i.e., roughly five people in a day) die by suicide yearly in Ghana (Citifm Online, 2012). Although these statistics and estimates may appear staggering (and arguably crude), they are undoubtedly a fair reflection of the reality and burden of the phenomenon of suicide in Ghana.

World Health Organization (WHO 2014) encourages member countries across the world to place high premium on suicide prevention irrespective of a country’s current position in terms of suicide rate or suicide prevention activities; and in Africa, there is an urgent need to prioritize suicide prevention. Thus, the clarion call to suicide prevention is now a global imperative targeted at reducing the rate of suicide in countries by 10% by the year 2020.

The recommendations to achieve this target according to the World Health Organization include (but not exclusively limited to) programs such as timely and effective evidence-based interventions, treatment and support, and decriminalization of suicide attempts. A suicide attempt here refers to engagement in a potentially self-destructive behavior which does not result in death but in which there is at least some intent to die.

• How can suicide be prevented?
• What ways can be taken to reduce suicide within our society?

As already said, Suicide Victims have several reasons as to why they attempt suicide. Suicide victims are blinded to the point that they feel they have no other options than to end their lives. In order to end the unbearable pain, they tend to attempt or even commit suicide. Suicidal thoughts being dangerous has preventive measure that will reduce suicide mortality rate globally:

• Creating awareness on suicide and its effects. People getting to know the effects on suicide especially on their families and friends will help them kick the suicidal thoughts out of their heads.
• Offer help and support to vulnerable suicide persons: you can support a person with suicidal thoughts by giving them the needed support such as giving them a listening ear, some words of encouragements, showing love and making them feel accepted.
• Respond quickly in a crisis: messages sent from suicide victims must be treated as emergencies. Friends and families of persons who have suicidal thoughts to treat their messages as emergencies and attend to them as quickly as possible. Some suicide victims might not speak up but will show signs and symptoms, this is where those close to the victims of suicide must pay close attention to them in order to help them.
• Another way to prevent suicide is to bring an end to stigmatization. As with mental illness, one of the biggest barriers to preventing suicide is stigma, which prevents many people from seeking help. Stigmatization plays a major role in suicide cases all around the globe. The victims see themselves as outcasts and have a great feeling of disapproval from the people in the society because of they are being stigmatized.

Psychotherapy: This treatment is for individuals with mental disorder. Seeking early treatment for persons with mental disorders can help in suicide prevention. The suicide victims must speak up about what is bothering them and not bottle up things in them.

• Other tips to do when concerned about a friend or loved one is to keep them safe by reducing their access to lethal means, try to be there for and with them whenever they need help or support.

Also, help them connect with ongoing support via available support groups and stay connected with these individuals to know how they are faring.

Suicides and suicide attempts have ripple effects that impact Individuals, family and friends, colleagues, communities and society as a whole. However, suicide is preventable and this prevention can be achieved at the individual, community and national levels. Many are the warning signs we see which are communicated to us one way or the other. We can only help fight this if we pay particular attention to the things people say or do. We need to be there for each other in all situations to create a stress-free atmosphere for survival.

People should not feel rejected or stigmatized in times of crisis, rather, with the right support system, we can create a serene environment for human existence. A healthy mind lives in a healthy body just as a healthy body lives in a healthy nation. This interconnectivity should give us the sense to wake up and help fight against suicide. Suicide is not the answer to eradicating problems, it rather worsens the situation. Let us come together and fight for a common course. Say no to SUICIDE.

>>>The writer is the Executive Director, Kandifo Institute. He can be reached on [email protected]