Can suicide be prevented?
Nnasaretha Kgamanyane | Friday September 26, 2014 17:02
Some time ago, I received an informative email from Sbrana Psychiatrist Hospital superintendent, Dr Mpho Thula, about World Suicide Prevention Day, which is commemorated on September 10. Before then, I had given suicide little thought. It was only when I went through the official statistics that I realised that it is an issue that needs urgent interventions. Dr Thula decried that Botswana needs a national suicide strategy that would deal with the escalating suicide crisis in the country. He noted that suicide had reached crisis proportions, to the extent that the number of people who committed suicide surpassed those who died from murder and wars combined.
The reality that suicide was more prevalent than I imagined suddenly sank in. To be honest, I have lost count of the number of people I know and have heard of who tragically ended their own lives. I could not believe how oblivious we are over suicide. It also hit me that 90 percent of these people are youth. I thought: what drives a brilliant, young and beautiful person to take their own life?
Of the suicide attempts, some may survive and live to tell the story of their gloomy experience. One of these is Thabo* (not his real name) who had the world at his feet until one day everything just came crashing down, leaving him an emotionally bruised wreck.
“Some call it waking up alive. That moment you’re aware your suicide attempt failed. It is the scariest experience ever. Horrific. You weren’t expecting to still be alive, and now you actually have to put the pieces of your broken life back together. If this has happened to you, then you would know what I mean,” Thabo* narrated, rubbing his palms together, perhaps trying to hide his shivering.
“It has been four years since my suicide attempt, and at that juncture, life seemed insignificant to me. I wish I had someone to talk to. I remember that one morning when I had made up my mind that I was going to end my life. My wife of 12 years had left me for another man. We had plans, children who were looking up to me for support. I had just lost my job. All my friends and family members had abandoned me. How funny life can be at times. Before, I was loved by everyone because I was a successful, loving and supportive neighbor, cousin, brother and husband but in my darkest hour, there was no one to hold my hand,” he said. He looks up as if trying to recollect bits and pieces of memory that could explain what really went wrong.
“I had everything a man could dream of, cars, money and loving friends but boom! One day I woke up and all this was gone. How? I still don’t know. All I know is that I started being a laughing stock in my family. My wife who I thought I could depend on and had vowed to be with me through thick and thin changed. She started coming home late at night or did not come home at all. I remember that when I married her she was a calm and loving woman. She was unemployed then. I educated her and she was working as an accountant then.”
“When things got tougher, she gave me a divorce. Her family did not want to hear anything I said. They blamed me for all the troubles in our marriage. They said I had to provide for my family not vice versa. I was puzzled.”
“My friends also abandoned me. I felt alone. Life became pointless. One day I decided to end my life. I took a rope and went to a tree not far from our house. I guess the branch was not strong enough, as it broke.”
“I ran with fright till I reached home with the rope still around my neck. I believe God rescued me. I cheated death. I am thankful to the good Samaritan who took me to church that day as if it was not with the guidance I received from the counseling team, I do not know where I would be,” he said with a glint of sadness.
With Thabo’s experience in mind, I thought; one day it might be a friend, a relative or me who contemplates suicide. Life sometimes throws us curve balls; besides, we would never know what tomorrow holds for us…
Thula said there are several factors that push an individual towards suicide. He pointed out that family problems, poverty, denial over illness such as HIV/AIDS infection and other harsh situations, could lead one to commit suicide. He also said challenges such as poverty, unemployment, loss of loved ones, arguments, a breakdown in relationships and legal or work-related problems are all acknowledged as risk factors, if they affect someone predisposed to, or vulnerable to self-harm.
“A family history of suicide is a recognised risk factor with both social and genetic correlates. Other predisposing factors include alcohol and drug abuse, a history of physical or sexual abuse in childhood, and social isolation. Psychiatric problems, such as depression and other mood disorders, schizophrenia and a general sense of hopelessness also play a central role,” Dr Thula said.
Physical illness, particular those that are painful or disabling, are also factors. Having access and means to kill oneself (most typically guns, medicines, and agricultural poisons) is a risk factor and a determinant of whether an attempt would be successful or not. “Any change in somebody’s behavior and/or emotional/mental wellbeing should be a cause for concern. Common symptoms of mental illness or mental distress include: extreme sadness, loss of interest in activities / loss of enjoyment, isolating oneself, poor sleep patterns, reduced appetite, anxiety, fatigue, lack of concentration, irritability, poor memory, poor work performance, self neglect and abuse of alcoahol or substances, as a coping mechanism,” he said.
According to Thula, some suicidal people make preparations for their death, by finalising or changing their will, distributing their property, writing suicide notes and giving instructions about what should happen following their death. He noted that loved ones usually retrospect and wonder how they missed the signs.
He said people who plan to commit suicide could also seek a weapon or item they intend to use like acquiring a gun, poison, and medications, adding that this should ring alarm bells. He added that in some instances suicidal people usually confide in someone. He explained that suicidal people usually show feelings of hopelessness and despair. “In addition to being ambivalent about life and death, they also tend to be rigid and constructed in their thinking, mood and their reasoning is dichotomized. They can however be helped when appropriately engaged,” he said.
Dr Thula added that suicide is still a taboo subject in our communities and is often shoved under the carpet out of shame. He noted that there is even a myth that enquiring about suicide would likely result in an individual carrying out the act. He emphasised that people who show emotional disturbance and are suspected to be suicidal should be counseled on their thoughts.
“When speaking to a suicidal person one has to show willingness to understand and to listen with empathy. Asking about suicide will often reduce the anxiety surrounding the feeling; the patient may feel relieved and better understood,” he said.
He also noted that it was important for the suicidal person to be assisted or encouraged to seek professional help from a Health Professional, where they get more supportive counseling or are referred to an appropriate service as per need.
“Where the danger to the person is imminent and/or there is difficulty in getting the person to go for help, assistance could be sought from the Emergency Medical Services or the Police. It is important to act with haste so that the matter resolved before the suicidal person acts impulsively,” he said.
According to Henry Maponga, a psychology and business development manager for Psychologists Botswana, suicide is usually caused by depression, psychosis, philosophical desire to die, substance abuse, distress and making major life mistakes. He adds that over 90% of people who commit suicide had suffered a mental illness at some point in their lives.
“Untreated mental illness account for the vast majority of suicide cases. Several negative life experiences like loss and illness can trigger suicidal ideation,” he said. He encouraged people to visit psychologists whenever they feel stressed or are faced with trauma.