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Tuesday January 18, 2022

Demystifying suicide

October 03, 2021

It is said that “the person who commits suicide, dies once. Those left behind die a thousand deaths, trying to relive those terrible moments and understand the reason why?” During our initial years in the police service, we learnt that suicide was the only crime that, even if unsuccessful, was still punishable under Section 325 of the Pakistan Penal Code (PPC). Interestingly, this law exists only in the penal code as I have hardly seen any conviction on the offence.

The paradox of suicide is that the person taking their own life sees it as the only option for salvation. A successful attempt leaves their family in perpetual agony. If unsuccessful, there is a stigma of shame. Considered illegal by law or condemnable by providence, the fact remains that the rate of suicide is growing all over the world, including in Pakistan.

In some cultures, it is viewed as an honorable way to depart from certain humiliating situations. Opinions have been shaped by existential themes such as religion, honour, and the meaning of life. Theists traditionally believed in the sanctity of life and condemned suicide. Samurais in Japan saw seppuku (suicide) as a form of protest or an act done to make up for failures. Until the 17th century in India, the tradition of sati required a widow to burn herself alive on her spouse’s cremation pyre, either willingly or under pressure.

The theme for World Suicide Prevention Day, observed last month on September 10, was ‘creating hope through action’ to support those who overcame suicidal tendencies and those who have been bereaved by suicide. Unfortunately, every 40 seconds, someone takes his/her life, and every year, almost 800,000 people die by suicide, with over 75 percent of these cases happening in low- and middle-income countries. Alarmingly, according to the World Health Organization (WHO), suicide is the second leading cause of death in young people around the world.

Lesotho has the highest suicide mortality rate (per 100,000 population) at 72.4 percent, and Antigua and Barbuda have the lowest rates at 0.4 percent. India, with a rate of 12.70 percent, stands at the 38th place; several European and South Asian countries are among top positions. Pakistan, with a rate of 8.90 percent, is at the 74th position. It should be noted that here suicide remains an underresearched subject and is not even part of the national vital registration system.

Lately, suicide and attempted suicide – which were previously illegal and are no longer so, especially in the West – are being treated as mental illnesses. Suicide is also accepted in societies where life is viewed as a sole individual domain. In such societies, euthanasia, abortions and other such practices are lawful. However, in some countries, including Pakistan, such practices are not widely accepted as a majority of people see life, and rightly so, as a Divine blessing.

In the post-9/11 era, suicide attacks/bombings were used as a means to overpower aggressors and opponents. This was done by manipulating people’s minds through vicious narratives. Suicide bombing is regarded as an extreme violent crime, while martyrdom is exemplified by self-sacrifice in the service of others in emergencies or for a national cause.

Conventionally, suicide attempts have taken place at many well-known sites like the Eiffel Tower in Paris, the West Gate Bridge in Melbourne, the Empire State Building in New York, and, in our part, the Native Jetty (naty-jetty) bridge in Karachi.

For us, suicide is as alarming as elsewhere. But due to cultural and prevailing beliefs, deaths by suicide are normally seen as God’s will and shown as accidental deaths. The police do try to take cognizance on suspicion when suicides happen, or any attempt is made on some provocation, persuasion, or ulterior motives; it is brushed under the carpet for fear of prosecution – and more so of social taboos.

Although prevention and uncovering murder and death is the police’s foremost priority, unlike in murder cases where complainants pursue a case, in attempted suicide or suicide cases, the bereaved family ensures that investigations don’t go ahead. Most families don’t allow for postmortem procedures as there are fears that local clerics may refuse to carry out a person’s last rituals if it is found out that s/he took their own life.

Suicidal thoughts are complex, and no single approach works for everyone. But research reveals that anxiety and depression triggered by stressful life events are the principal contributing factors. In Pakistan, the most prevalent mental illnesses are depression and schizophrenia. The current pandemic has also led to an increase in feelings of isolation and vulnerability. The worldwide adoption of suicide pervention models like the ‘zero suicide model’, ‘the AIM model’ (the assess, intervene and monitor for suicide prevention), and others have paid dividends or provided a platform for some relief.

We must laud our government’s recently initiated local mental health and psychosocial support strategic plans. But with just 11 mental hospitals, 624 community-based psychiatric inpatient units, 800 general hospital psychiatric inpatient units and 5,781 resident care facilities, the response to this illness is still a baby step.

Supplementing government policies, principal frontliners in cities and villages – local councillors – healthcare setups and educational institutions is an essential step that can be taken to help people overcome socio-economic crises. These steps, along with an active role of the civil society, can do wonders when it comes to suicide prevention by creating hope through action and by caring and supporting through available therapy. It is also important for everyone to understand that the social stigma of mental illness is a major barrier to people who need psychological help.

Fortunately, there are models that can help prevent this ultimate destructive human action. However, the success of these models depends on the workings of the relevant departments and societal attitude towards those who have suicidal tendencies. We ought to feel the pain of these people. Our loved ones can also go through the same situation as this challenging materialistic world is full of triggers.

It is said that we need one pebble of change to create ripples that spread out. Steps taken by us to prevent suicide can have the ripple effect and help us encourage people to help themselves. We can all do something to live in a world where suicide is recognised, and we can all do something to help prevent it.

The writer, a security expert, holds a PhD in Politics & International Relations, and is presently serving as IGP NHMP. Email: skimam98@hotmail.com

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