Suicides remain under-reported in Pakistan due to social stigma

Rawalpindi : The Institute of Psychiatry and WHO Collaborating Centre for Research at Benazir Bhutto Hospital, Rawalpindi Medical University held a symposium in connection with World Suicide Prevention Day to raise awareness on the topic of suicide, and renew the commitment to reduce the rate of these preventable deaths.

The symposium held to commemorate World Suicide Prevention Day, which is observed every year on September 10 was aimed at providing an insight into the current state of affairs regarding suicide so that its gravity could be better appreciated, as well as to highlight the current work being done at the Institute and the future endeavours and further possibilities, in order to build up the armamentarium to counteract the rising suicidal rates.

Head of the Department at the Institute of Psychiatry Dr. Asad Tamizuddin Nizami began the symposium by welcoming all the attendants and introducing the guest speakers from the University of York, UK, who are also involved in a research collaboration with the Institute of Psychiatry titled IMPACT: Improving mental and physical health together; Dr. Najma Siddiqi, working as Associate Professor in Psychiatry and Jerome Wright, a Senior Lecturer in the Department of Health Sciences, University of York and Hull York Medical School, UK. Dr. Asad also introduced the co-speaker for the session, Dr. Bushra Razzaque, Senior Registrar at the Institute of Psychiatry, as well as his other faculty members to the audience, and gave a brief overview of the topics to be covered.

Dr. Nizami conducted the first session titled ‘Suicide – Global and Regional Perspectives’ involving the participants while presenting the facts and figures related to suicide, with special emphasis on the situation in Pakistan. He reported that although the current global suicide rate – one million people annually, is horrendously high already, in view of the current rising trend, the ratio is expected to increase to 1.53 million people annually by 2020. Stated differently, suicide will be responsible for one death every 20 seconds, as opposed to one in every 40 seconds presently, he said.

He said suicide is a major public health issue, being the 10th leading cause of death in all ages. However, these cases are under-reported in Pakistan not only due to the social stigma but also the legal implications.

He then provided a review of the Pakistani studies done on this subject and expressed concern over the fact that national data on suicide are lacking. He explained that studies suggest that most people contemplating suicide do in fact contact mental health professionals months to days before commission, but are not managed effectively. Therefore, despite the lack of resources and great patient-load, there is a need to keep an eye open for potential cases and to prioritize their management, he said.

Dr. Najma Siddiqi spoke on the topic of “The Mortality Gap in Mental Illness”. This is the difference in the life expectancy of people with and without mental illnesses. The mortality gap, she went on to say, is 20 years in high-income countries, and as high as 30 years in low-income countries. This high mortality rate among the mentally ill is accounted for mostly by poor physical health, whereas suicide contributes to around 15% of the deaths, she said. The total life-expectancy of patients along with their quality of life can be improved, she said.

Jerome Wright spoke on “Integrating Mental Health into Work of Non-Specialist Health Workers: The Case for Mental Disorders and Suicide Prevention”. After giving a glimpse into the problems currently challenging the health sector with respect to the mentally ill – low availability of resources versus the ever-growing mental health burden, he explained that the solution lies in involving non-mental health specialists to work at the community level to bring about a positive impact in the overall mental, and by extension, physical health of the population.

He gave examples of such activities already in place not only in Pakistan but also around the rest of the world, including the mhGAP program initiated by the WHO. Concluding his talk, he impressed upon the need to work together globally to implement such plans more effectively.

The final session was conducted by Dr. Bushra Razzaque, who, speaking on the topic of “Suicide Research Updates from the Institute of Psychiatry” delved into the details of the past as well as current research programs relating to suicide and deliberate self-harm at the Institute.