Authorities should act before suicide becomes a pervasive health crisis, say experts

Published On: July 6, 2020 11:59 AM NPT By: Aditi Baral

The suicide rate can be decreased by making changes at individual, local and national levels

KATHMANDU, July 6: It was 1:30 on Wednesday night. The District Police Office in Dang received a phone call from an unspecified individual complaining that a girl was trying to commit suicide by coming live on Facebook. Perplexed if the complaint was a hoax or a serious one, Deputy Superintendent of Police (DSP) Sivha Bahadur Singh and few other police officers rushed to find the location. The caller had given clear details about the girl’s Facebook account and hints of her location. However, the team failed to track the spot until the next two hours.

Exactly at 3 AM in the morning, the team finally reached the girl’s residence in Tulsipur, still hoping to rescue her alive. However, on reaching the spot, they found that 23 year old Alisha had already killed herself.

When the police reached her residence, the neighbors barely had a clue about this incident as she was an evening person who rarely slept early. “We couldn’t figure out about this incident as she would always sleep late. It was only after the police officers arrived that we found out about this unpleasant incident,” said one of her neighbors to Republica’s correspondent in Dang.

According to Sita Bhandari, one of her closest neighbors, Alisha was mostly a cheerful person but in the past few weeks she looked cheerless and often mentioned that she was going to die soon. “Will you miss me after I am gone? Will you write RIP on my pictures?” Bhandari recalled Alisha asking her a few days ago. “I couldn’t ever figure out that she was trying to give hints that she would do something like this,” Bhandari said.

Alisha who stayed in the capital had gone to Dang just before the lockdown and was staying alone. Her parents and siblings are in India and they have already been informed about the incident. As mentioned by DSP Singh who is also the chief of the Area Police Office, Tulsipur, she was a two-time divorcee and had a six-year old daughter from her first marriage.

Alisha’s suicde case sounds exceptionally distressing and confounding. However, this is not a dissimilar case as the suicide rate in the country has been rising alarmingly in recent days.

Just a day before Alisha took her life, Durgesh Yadav, 24, had committed suicide inside the police custody of Lalitpur Metropolitan Police Range. Discussions over his suicide weren’t over when Alisha’s name was added to the list.

The data provided by Nepal Police shows that the suicide rate across the country has increased by a whopping 25 percent in recent months. As of Saturday (July 4), more than 1,100 people across the nation have killed themselves. The calculation sums up to more than 17 people dying due to suicide every day.

These numbers are already high but a greater fear dangles that the numbers could be higher as suicide ‘attempts’ aren’t reported and the number of attempts could be higher than the actual suicide numbers.

This figure advises us to plan crucial precautions before it’s too late as the overwhelming spike in the number of suicide cases reflects a horrifying and extremely alarming situation.

Disturbed mental health has long been discussed as the prime reason behind suicides and it is mandatory to discuss mental health to overcome this threat, say mental health experts. “About 80 percent of people who commit suicide suffer from some kind of mental health problem,” said Dr Sagun Ballav Pant, an assistant professor of psychiatry at the Tribhuvan University Teaching Hospital (TUTH).

“A suicide is the extreme form of fatal outcome of mental illness. Given that the numbers are increasing at a horrifying rate, it is very important to discuss what can be done to lessen this.” 

What can we do to reduce the high rate of suicide?

While it is mostly upon the individuals themselves to take care of their mental health, another fact cannot be ignored that an individual’s mental health status largely depends on the surroundings across them.

“It can be tricky to find if someone is going to commit suicide as very few cases of suicide are planned; most of them are impulsive and are taken on a sudden thought or feeling,” said Pant. However the actions of people and the events taking place around them can help make it easy to find out if they have suicidal tendencies.

Pant mentions that people with suicidal tendencies often show changed behaviors and try to isolate and distance themselves from other people and start maintaining a low level of communication. Similarly, they have disturbed sleep and appetite and can find difficulties in performing their daily activities. In some instances, suicidal individuals can also be seen finding ways to collect materials such as rope, poison or blades. In some cases, excessive anger can trigger these individuals.

Victims also try to seek help from people along with indirectly trying to find out about their importance in other people’s lives. In Alisha’s case, too, she was constantly giving hints to her close ones about attempting suicide. “She would often ask me if she was important in my life and if I’d miss her if she died anytime soon,” said her neighbor Bhandari.

Nevertheless, although it might seem like it’s a complex road to lower these numbers, especially when the world is facing a crisis like this, Pant mentions that this daunting situation can be altered with certain changes made at the individual, local and central levels.

“We can assist in lowering the cases of suicide as 90 percent of suicide cases are impulsive. Only 10 percent of them are preplanned,” Pant explained.

Help at the individual level

The most significant thing to do at the individual level is to reach out to people, talk to them  and ask them how they are doing. Just a simple conversation can help such people to feel good and encouraged.

Jagannath Lamichhane, a mental health expert, explains that a person’s circumstances are directly proportional to his/her mental health and it is obligatory to keep oneself surrounded in an optimistic environment. “A supportive social network or family is an important factor for suicide prevention,” he said, “Having an accepting support system helps to avoid pessimistic thoughts in people.”

Moreover, Pant states that it is important not to pass judgmental comments whenever someone is sharing the status of their mental health. “Quietly listening to others and not passing any judgmental comments can help in a significant way,” he says.   

Efforts that can be made at local level

It is said that the number of suicide cases is on the rise at present due to the global pandemic. Because of the prolonged lockdown and restrictions forced on people owing to the pandemic, the mental health status of people has been pushed to vulnerable stages. From imprisoning the fear of getting infected with coronavirus and staying confined within myriads of restrictions, limitation in social activities to facing financial problems due to job losses, people’s mental status has been crushed to frail fragments.

“The risk is elevated even in mentally healthy individuals with no record of pre-existing mental health issues. COVID-19 infected patients as well as frontline health workers are at a greater risk of mental health issues,” says Lamichhane.

According to Pant, the local units - municipalities, rural municipalities and metropolises - have the most significant role to play in order to steer clear of this crisis. “The local units should be on alert to monitor the psychological and physical activities of people. For instance, they can keep the records of people buying poisons, ropes, blades or any other means of suicide.” Cases like this should thoroughly be investigated to know about the individuals’ mental health status. With this, Pant also suggests that the local units should try to control or document the buying and use of these resources. “If we can control the means of the problem, we can eventually help in solving the problem.”                                                                                                                   

Furthermore, substantial advocacy and frequent campaigns should firmly be prioritized in order to educate the people and make them aware about mental health.

On the other hand, Lamichhane explains that the local units should also deploy mental health professionals in various wards and units to provide counseling and psychotherapy sessions to community people.

Preparations that should be made at the national level

Experts say that the central government should collaborate with the local governments to provide awareness to the people regarding suicide and mental health issues. Focusing on the recent situations and circumstances, Lamichhane states that the government should prioritize vulnerable groups like daily wage workers, people who lost their jobs or jobless people as well as other minority groups in order to tackle the current crisis. “A scheme of providing loans to people at low interest rates and lowering taxes on various possessions should be done before more people start taking their own lives due to the financial crisis,” he said.

The government should also focus on producing trained psychiatrists, psychosocial counselors, and medical psychologists to address mental health issues in the people.

Apart from that, Pant states that the central government must advocate and direct media outlets to report suicide cases under ethical guidelines. “The media can influence the behaviors of the general public. Suicide cases can turn very dangerous and lead to cases of contagion or ‘copycat’ suicide when they are reported in a wrong way.”

Studies worldwide have shown that certain types of news coverage can increase the likelihood of suicide in vulnerable individuals. According to Pant, the risk of additional suicides increases when the reported stories explicitly describe the suicide method, uses dramatic or graphic headlines and images. “The risk can intensify if it is reported repeatedly and extensively as this type of coverage sensationalizes or glamorizes death,” he says.

Taking the instance of a recent case, psychiatrist clinics across the valley had started to receive more numbers of patients complaining about having suicidal thoughts after the death of Bollywood celebrity Sushant Singh Rajput. Concerned about this issue, Dr Ritesh Thapa, director and consultant psychiatrist at Rhythm Neuropsychiatry Hospital had taken to his social media where he mentioned that his clinic witnessed double the number of patients after Rajput’s case was extensively and repeatedly reported by the media.

Moreover, Pant suggests that the central government should plan on forming a group of suicide survivors who can possibly spread awareness about the aftermath of suicide. “Only suicide attempt survivors can know better about their learning from the whole experience and edify others that suicide is not the ultimate solution to temporary problems and we can overcome most of the difficulties we face in our lives.”


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