Published On: July 5, 2020 12:20 PM NPT By: SHREE RAM SUBEDI
17 people commit suicide every day in Nepal; over 5,000 per year
KATHMANDU, July 5: A 31-years-old man from Rolpa committed suicide during his home quarantine on Wednesday. A native of Ramdev Rural municipality-5, Avan Sarki, had returned home from Dubai on June 24 and was at home quarantine, alone at a home of his relative as India returned workers refused to allow him to stay with them at a quarantine center run by the local government. He was tested RTD negative while returning home.
On June 8, another youth and a local hospital janitor Siddarth Auji of Accham burned himself to death after he lost his job. The 25-year-old man self-immolated after spraying petrol over his body in front of the emergency ward at Bayalpata Hospital, Achham. He died in a hospital in Kohalpur while undergoing treatment. He was one of the 32 laid off staff from the Hospital.
These two cases are just the tip of the iceberg. Almost three and a half months of the coronavirus pandemic, the country is on the verge of another health crisis, with daily doses of death, isolation, and fear generating widespread psychological trauma. Data suggests that depression and anxiety are already roiling the nation as coronavirus is making inroads to the deeper parts of Nepal, covering all 77 districts. Of the total seven deaths in quarantine so far, four were suicide cases.
According to the official record of Nepal Police, a total of 1,105 people have committed suicide in 100 days, since March 24. The highest number of suicide cases was recorded in Pradesh 5 with 242 cases followed by Pradesh 1 with 186, Pradesh 3 with 162, and Pradesh 2 with 152. Sudur Pashim Pradesh recorded 115 deaths while Karnali saw 58 deaths. Likewise, Gandaki saw 121 and Kathmandu Valley saw 69 suicide cases during the period. A majority of these suicide happened through hanging, followed by inhaling poison and other methods including fire, jumping, and weapons, among others. Official data shows that above 5,500 Nepalis kill themselves evey-year, making Nepal a country with one of the highest suicide rates in the world.
"Nearly 16 people used to die every day from suicide in Nepal, and the lockdown has increased the rate to above 17," Bharat Gautam, a clinical psychologist at Transcultural Psychosocial Organization said. Terming suicide as "severe mental behavior", Gautam fears that the COVID-19 crisis could further agreevate mental health crisis to an unprecedented scale. Recent studies have shown, Gautam adds, 20 percent of the Nepalis are affected with psychosocial issues including anxiety, fear, and depression and they could lead to suicide if not addressed on time.
A pilot National Mental Health Survey(2018), commissioned by the Nepal Health Research Council, showed that suicidality among adolescents was 8.7 percent and 10.9 percent among adults. The same survey showed that the prevalence of any form of mental disorders was 12.9 percent.
Experts and officials concede that Nepal utterly lacks trained psychiatrists, clinical psychologists, and psychosocial counselors to address the mental health issues. Concentrated mainly in urban areas, there are only 180 psychiatrists, 35 clinical psychologists, and 1,000 psychosocial counselors in Nepal.
Why do people go to such extremes?
People commit suicide for various reasons, mainly driven by socioeconomic and psychological factors. Emile Durkheim, a French sociologist, in his 1897 book "Suicide" presents a sociological study of suicide. He says that suicide can have origins in social causes rather than just being due to individual temperament. Many other scholars, including Sigmund Freud, Roy Baumeister, suicidologist Edwin Shneidman, Thomas Joiner, Aaron Beck, Marsha Linehan provided additional inputs to the psychological theories of suicide. However, it is important to note that no single theory can explain the complexities of suicide or suicidal behavior, regardless of whether the theory is rooted in sociology, psychology, or even medicine.
"COVID-19 crisis has increased the risk factors for suicide," adds Chaitanya Mishra, a professor of Sociology at Tribhuvan Univerty. "People have lost jobs and income, they are socially isolated, while others who require treatment and counseling are devoid of the service."
What do religious leaders say ?
Chairperson of Rastriya Dharma Sava and professor Madhab Bhattarai terms suicide as a grave sin."It is against religion to commit suicide," he argued, "Those who committed suicide would not improve his/her reincarnation." He even goes to the extent of saying that it is not required even to participate in the funeral rites of someone who committed suicide.
"Suicide is against the rule of nature," argued Rajendra man Bajracharya, Chairman, Vajrayana Mahasangha, and a faith-healer. He argues that any troubles are resolvable. "Any challenge in life should be accepted and fought back," Bajracharya, who has treated over 300 patients during lockdown, said.
What can be done?
In his seminal book, Durkheim concluded that the more socially integrated and connected a person is, the less likely he or she is to commit suicide. As social integration decreases, people are more likely to commit suicide. Durkheim reasoned that social integration, in particular, is a factor. The more socially integrated a person is—that is, the more he or she is connected to society, possessing a feeling of general belonging and a sense that life makes sense within the social context—the less likely he or she is to commit suicide. As social integration decreases, people are more likely to commit suicide.
"Connectedness is the answer," argued Mishra, professor of Sociology at Tribhuvan University. “Family and friends have a great role. Fear of God can help. People should be socially connected by profession and religion. People should share their feelings with others. This can help prevent suicidal tendencies."
Dr Kamal Gautam, a consultant psychiatrist, recommends grassroots level health care providers to be adequately and continuously trained on social risk assessment and recognition, identifying risk groups prone to suicide behavior, and increased community awareness. Since mental health issues relate to social, political, and economic lives of the people, experts highlight the concerted effort to tackle the issue.
"Multisectoral coordination is needed to tackle the mental health crisis," Gautam said.
“Mental health issue is growing by the day and there is an urgent need to formulate a national strategy and action plan to address the mental health and suicide related issues together,” says Dr. Sagun Ballav Pant, assistance professor at TUTH, who is also a consultant to TUTH helpline on suicide.
"Also, there is an urgent need for centralized mental heatlh and suicide prevention crisis helpline, which are currently run by academic and non governmental institions,” suggests Dr Pant.
If you have suicidal thoughts, contact one of these centers for help:
TUTH, Maharajgunj Suicide Hotline: 9840021600
Patan Hospital has a 24-hour crisis helpline: 9813476123
Transcultural Psychosocial Organization-Nepal Crisis Hotline: 16600102005
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