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September 20, 2019

Every 40 seconds, someone somewhere loses life to suicide


September 20, 2019

Mental health experts said Thursday that after every 40 second, someone died due to suicide and many more attempted suicide in the world.

They said suicide was a serious public health problem and for its prevention there was a need for collaborative efforts by psychiatrists, psychologists, social workers, law enforcement agencies, educators, families, communities and faith healers.

They were speaking at a seminar organised by Karwan-e-Hayat, Institute for Mental Health Care (KeH), to observe World Suicide Prevention Day (WSPD) in collaboration with World Health Organization (WHO), the statement released on Thursday said.

The event attracted prominent psychiatrists of the country, including Professor Iqbal Afridi, Prof Munir Hamirani, Prof Naim Siddiqui, Prof Sohail Ahmed, Prof Iqtidar Taufique, Prof Zafar Hayder and Prof Raza-Ur Rahman, who highlighted that in Pakistan the figures related to suicide were notoriously vague. Certain practising doctors are reporting that there is a sporadic increase in the number of such cases.

The event was presided over by Senator Karim Ahmed Khawaja, chairman of the Sindh Mental Health Authority, said the Sindh government was already working on the legislation process related to suicide. He said they were in the process to involve district health officers along with police for collecting and sharing data on suicides in their respective districts.

Prof Dr S Zafar Haider said that about one million people reportedly die by suicide each year in the developing world, while 10 times more than that number attempt suicide, and these cases are probably under-reported. He said that there is a wide variation of suicide rates. The most alarming fact is that suicide sentiments have increased in younger males in developed countries.

Professor Haider added that diathesis-stress model is a useful frame work to conceptualise suicidal behaviours. Psychological studies demonstrate that 80-90 percent of people who commit suicide have a diagnosable mental disorder, and a population attribute risk analysis highlights the importance of mental disorder.

Dr Raza Ur Rahman said that suicides may have many complex socio-cultural factors but 90 percent are associated with mental disorders. Therefore, he said, we have to create such an environment where mental health can be discussed. Most importantly, common people should have easy access to mental health services.

He said that due to fear of harassment, social stigmas, confidentiality in such sensitive cases and complicated legal procedures, such cases go unnoticed. He said suicide is a serious public health problem, and we all need to work together and collaborate with each other.

Prof Dr Raza said understanding risk factors can help dispel the myths that suicide is a random act, or results from stress alone. The impact of some risk factors can be reduced by intervention & clinical care for mental, physical and substance abuse disorders.

Prof Dr Iqbal Afridi said that although medication and psychotherapy are necessary for mentally ill-patients with suicidal behaviour, folk wisdom can play a vital role. “We listen to many songs which are pro-suicide; we should discourage such songs, because a person facing a depression-like situation and listening to such songs may become emotional and reach a high level of anxiety.”

“Let us promote Kachehries, social gatherings, motivational proverbs and anti-suicide poetry for motivating suicidal to enjoy life,” he said.

“We all have experienced through social, print and electronic media that students are sufferings from mental disorder and depression. We must integrate our program with educational institutes for educating and involving students in mental health promotion and suicide prevention for maximising impact through peer to peer learning.

“There is a dire need for campaigns aim to improve mental health education in the general population. We may run programs focusing on increasing the ability to recognise risk, improving understanding of suicide causes and risk factors.” The involvement and role of academia and psychiatrists, awareness raising and interaction by public-private partnership were critical for addressing the issue, he said.

According to the Human Rights Commission Pakistan (HRCP) report of 2018, nearly 1,338 people died by suicide in Pakistan due to depression, 786 of them were male while 552 were female.

Statistics and the HRCP 2018 report show that political instability, lack of peace and lack of basic necessities of life are among the main causes for a person to attempt suicide. Other reasons for suicide include unemployment, health issues, poverty, homelessness, family disputes, depression and a range of social pressures.

Depression is a major risk factor for suicide as one out of 16 people with depression commit suicide, and two-thirds of people who commit suicide are depressed, and the victims are mostly adolescents. The presence of anxiety hopelessness and use of alcohol further increase the risk of suicide.

Most suicidal people do not want death; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever. The Recently Mental Health Act (MHA) of 2013 has documented suicide as an illness and a cry for help rather than a crime but this disparity in MHA & PPC has to be removed. Despite its importance, no official data on suicide is available and it is neither included in the national annual mortality statistics of Pakistan.