#MentalHealthDay: Know who is at risk for suicide and how to prevent it

World Suicide Prevention Day is observed on 10 September every year to raise awareness about taking action worldwide to prevent the cases of suicides. Several events and activities are organised on this day to make people understand that suicide is a major preventable cause of premature death

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Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions. For national responses to be effective, a comprehensive multisectoral suicide prevention strategy is needed.

World Suicide Prevention Day 2019 theme is ‘Working Together To Prevent Suicide’ to highlights the most essential ingredient for effective global suicide prevention

Who is at risk?

While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness.

In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behaviour.

Suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, and intersex persons (LGBTI); and prisoners. By far the strongest risk factor for suicide is a previous suicide attempt.

Methods of suicide

According to WHO, it is estimated that around 20% of global suicides are due to pesticide self-poisoning, most of which occur in rural agricultural areas in low- and middle-income countries. Other common methods of suicide are hanging and firearms.

Knowledge of the most commonly used suicide methods is important to devise prevention strategies which have shown to be effective, such as restriction of access to means of suicide.

Prevention and control

Suicides are preventable. There are a number of measures that can be taken at population, sub-population and individual levels to prevent suicide and suicide attempts. These include:

  • reducing access to the means of suicide (e.g. pesticides, firearms, certain medications);
  • introducing alcohol policies to reduce the harmful use of alcohol;
  • early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress;
  • training of non-specialized health workers in the assessment and management of suicidal behaviour;
  • follow-up care for people who attempted suicide and provision of community support.

Dr Srikant Pawar, psychiatrist at Sassoon General Hospital, Pune, said, “Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labour, agriculture, business, justice, law, defence, politics, and the media. These efforts must be comprehensive and integrated as no single approach alone can make an impact on an issue as complex as suicide.”

India today accounts for a large and growing share of suicides in the world. Today, we make up for over a third of the world’s annual female suicides and nearly a fourth of male suicides. And since 1990, this rate has been growing faster than the world’s suicide average

Dr Kalyani Parker, a psychologist from Pune, said, “Stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and are therefore not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem and the taboo in many societies to openly discuss it. Raising community awareness and breaking down the taboo is important for countries to make progress in preventing suicide.”