2019 Sep 10
While awareness on suicide prevention is important to address all year-round, we explore its common misconceptions, risk factors and warning signs in lieu of September being World Suicide Prevention Month.
Suicide, for most, is an unnerving topic. One that, in Sri Lankan society and many others, remain highly stigmatized and seldom spoken of. But in order to address an issue, it has to be acknowledged- in the hope that creating awareness, in turn, will help us look out for friends and family and ensure that everyone, including ourselves, have access to resources dedicated to suicide prevention.
The latest report by the World Population Review gives the current suicide rate in Sri Lanka for 2018 as 14.6 per 100,000 population. This ranks Sri Lanka 29th among 157 countries. This statistic, however, excludes the number of attempted and/or considered suicides which range in intent and severity.
Debunking the myths
Distinguishing between common myths and facts can help immensely in creating a safe space for healthy conversations on suicide prevention and mental health in general. It also shows the importance of reaching out, seeking treatment and taking good care of our overall mental health. So, what are the common misconceptions surrounding suicide?
“Most suicides happen suddenly. It takes place without warning.”
This is not necessarily true. Suicide can be both planned and impulsive. Most people exhibit warning signs before they attempt suicide but we fail to recognize them because either we miss them, or we dismiss them as attention seeking or just ‘ him being funny’ and we avoid it because it is uncomfortable for us to talk about it. A great deal of lives are lost every day because we miss the signs.
“People who decide to take their life are selfish.”
The common idea surrounding this myth is that the individual ‘takes the easy way out.’ This highly misconstrued idea cannot be more far from the truth. People who attempt suicide do so because they want to end their pain or because they do not want to live the life they have anymore. It is not because they necessarily want to die.
“Talking about it can encourage a person to become suicidal.”
Research has shown that there is no harm in asking someone about suicidal thoughts in a gentle and sensitive manner. The more we ask, the more space we open up for conversation.
“Being suicidal is a sign that a person has a mental disorder.”
Suicidal ideation and mental disorders are not always connected. Being suicidal comes from a deep state of unhappiness and hopelessness. Those diagnosed with mental health disorders do not always have suicidal thoughts and vice versa.
What are the risk factors?
While there is no single reason that may increase the likelihood of suicide, it is important to be aware of the many stressors and risk factors that can make someone you know more vulnerable. Some of them are:
- Depression; a top mental health risk factor.
- Childhood abuse or trauma
- Previous suicide attempts
- Experience of a loss (a relationship, job, etc.)
- High risk occupations (farmers, medical professionals, military personnel, due to easy access to means).
- Access to lethal weapons (having access to firearms or other dangerous equipment that has not been stored in a safe place can reduce the time spent between thinking of suicide and doing it.)
- Impulsiveness/ poor coping skills
- Loneliness and isolation
- Chronic pain
- Financial problems
- Alcohol and substance misuse
- Difficulties with gender and sexual identity
- Acute emotional distress
- Family history of suicide
- “Contagion effect” – a person is more likely to decide to end their life after recently learning about someone else who did it.
How do I know that someone may be suicidal?
Being aware of warning signs can be potentially life-saving. Verbal markers are one way of identifying signs of suicidal ideation. They may sound something similar to the following:
- “I feel like you and everyone would be so much better off without me.”
- “I wish I was never born”
- “I feel like I have no purpose”
- “I feel numb”
Verbal markers can be either active (“I want to kill myself”) or passive (“I wouldn’t mind if I got hit by a bus…”) and it is important to look out for both types. Passive statements should be taken equally seriously.
How can someone’s behaviour indicate that they may be suicidal?
- Sudden isolation from others
- Researching methods to end one’s life on the internet
- Increased agitation and mood swings
- Reckless behaviour
- Giving away what they own and writing last wills
- Calling loved one’s/friends to say ‘good-bye’
- Difficulties with sleep and appetite
- Talking and writing about suicide
- Loss of interest in daily and pleasurable activities
- Loss of energy
- Sudden positive mood after a period of being low
- Purchase of materials intended for an suicide attempt
Additionally, if you or a loved one begins to feel irritable, hopeless, angry and anxious in addition to losing interest in activities that previously brought joy, these may also be other signs to be mindful of.
What can I do to help?
- Take all talk of suicide seriously.
2. Engage the person in a serious conversation –
i. Connect in a personal way
ii. Ask if they are experiencing a crisis in their lives
iii. Are they feeling hopeless?
iv. Have they withdrawn from daily activities?
i.e. Hey, I’ve noticed in the past few days that you seem rather low. I am concerned, and I am wondering if everything is okay…”
- Ask about suicide using a caring approach
i.e. “I can see that you are going through a difficult time right now. Some people in your situation might feel like life is not worth living anymore. Have you felt this way?”
“Are you having thoughts about suicide?”
“Do you have thoughts about ending your life?”
- Explore risk by asking if they have a plan to attempt suicide and whether they have attempted suicide in the past.
- Engage the person in a plan for safety
i. Do not leave the person alone
ii. Provide accessible contact information of crisis services
iii. Try to ensure that they do not use drugs or alcohol
iv. Be prepared to listen non-judgmentally
v. Do not promise confidentiality
Encourage the person to seek professional help as soon as possible.
Sri Lanka has a network of mental health advocates that are always ready to help you or a loved one when they need it. Don’t hesitate to contact any of the following:
- The Ohana Project – firstname.lastname@example.org
- CCCline – 1333 (24 hours)
- NIMH toll free hotline – 1926 (24 hours)
- Shanthi maargam – 0717639898
- Sumithrayo – 011 2696666 (9am to 8pm)
It is also important to keep in contact with the person who helped even after they recover from suicidal ideations. Make sure you follow up and let them know that they have you. This can help them to stay connected and feel loved and cared for.
Today, there are many resources and ongoing research on the many ways of preventing suicide. Recognizing the signs and spreading awareness can help save a life- literally.
A few wise words from the great statesman and orator Winston Churchill seems apt in concluding;
“Never never never give up.”
Happy reaching out!
*This article was written with help from The Ohana Project; a community of mental health professionals who aims to ‘leave no one behind.’