By Paonam Thoibi
On account of similar questions which concern suicide attempts and deaths pouring in, I am reproducing a Q&A which was carried on 13th Sept, 2014 with some more inputs.
Q: Dear Madam, even though I don`™t know the correct numbers and figures, I think the rate of suicide is ever increasing. We do not really have suicide hotlines or suicide first aid centres. I want to know how having a hotline service or suicide counseling centres would help in this menace. Kindly share us some of the causes of people committing suicide so that we may be aware of it may prevent it in our best possible way. -Student, K.V Langjing
Ans: Your question is a very thoughtful one and revolves around an issue which challenges all of us mental health professionals. Suicide as we all know is a self- inflicted death in which one makes an intentional, direct, and conscious effort to end one`s life. People commit or attempts suicide for many reasons, most of which no one knows. Mostly these are people in crisis `“that is, under great stress, unable to cope, feeling threatened or hurt, and interpreting their situations as unchangeable.
Also, families of people who die by suicide report that they have some kind of psychiatric conditions, most commonly depression or bipolar disorder. Depression and the depressive phase of bipolar disorder may cause symptoms such as intense sadness, hopelessness, lethargy, loss of appetite, disruption of sleep, decreased ability to perform usual tasks, loss of interest in once-pleasurable activities etc.
The other major risk factors include substance use and abuse. A previous suicide attempt is another major risk factor and a number of people who successfully commits suicide have made a previous attempt. The loss of meaningful relationships and issues related to sexual identity or sexual orientation can also be reasons which can get people trapped in the depression which can lead to suicides. It is said that people who are suicidal somehow are telling people and reaching out in a way they that they are looking for some relief. Most of the time before the attempt they are said to be telling their close friends how they want to end their life and even how they have planned it. Therefore it is believed that people who are suicidal want the pain to end but not their life itself.
It is on this logic that suicide centres and hotlines for suicide prevention are enforced. In such centers, mental health professionals can try to help people work through that intense psychological pain and find a way out. They can try to help suicidal people perceive things more accurately, make better decisions, act more constructively, and overcome their crisis. Once a person with suicide risk is identified, intervention can start at the centre by a visit or quickly through a phone call which can skillfully be developed into a proper psychotherapeutic meeting very soon. The mental health professionals can take the opportunity to gather more information about actual risk, such as determining whether the client has an actual plan and the means to carry out the plan. The professional can challenge the irrational belief if the client`™s life will be better if he/she commits the suicide. Also, crises can occur at any time, therefore the centers should ideally have a 24-hour-a-day telephone service (“hot lines”) and also welcome clients to walk in without prior appointments.
In our place without such a centre, we can still make use of the health care facilities like RIMS, JNIMS etc and reach out to the mental health professionals there.
Also we should be aware that after a suicide attempt, the victims` primary need is medical care. Some are left with severe injuries, brain damage, or other medical problems. Once the physical damage is reversed, or at least stabilized, a process of psychotherapy may begin. The goal of therapy is to help the client achieve a non-suicidal state of mind and develop more constructive ways of handling stress and solving problems.
There are many different medications and therapies implemented for the successful treatment of depression. Not all medications work the same for all people, so it may take some time for some people and the doctor will develop a treatment plan that`s right for a particular person and stick with it and inform the doctor about any doubts.
All said and done, a good communication system in the family and the environment which has a foundation in good education and proper social and moral support can prevent many suicide deaths.
Once a while, if anyone begins to think about suicide, it`s important to recognize these thoughts which should be addressed. Talk to somebody. It is advised not to let embarrassment stand in the way of vital communication with the physician, family, or friends. When people don`t understand the facts about suicide and depressive illnesses, they may respond in ways that can cut off communication and worsen the person`™s feeling. That`s why it`s important to find someone trust worthy with whom one can be honest and open. It can be the family members too. Also we have mental health professionals at health care centres and network of friends who knows them. Spending time with family and friends who can give unconditional support and remind life is important, avoiding drugs to control impulses and being sensitive to one`™s own feelings and thoughts are important to manage feelings of low and thoughts about dying.
Lastly, if someone is threatening to commit suicide, if you strongly believe someone is close to a suicidal act, take the person seriously. Stay calm, but don`t underact. Listen attentively. Maintain eye contact. Use body language such as moving close to the person or holding his or her hand, if appropriate. Acknowledge the person`s feelings. Be understanding`” not judgmental or argumentative. Make sure there are no potentially dangerous materials around. Be swift to try to reach out to professionals who can help. Involve other people and don`t try to handle the crisis alone. If possible, don`t leave the person alone until you`re sure he or she is in the hands of competent professionals. If you have to leave, make sure another friend or family member can stay with the person until professional help is available.
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