The Preliminary Report of the Suicide Prevention Symposium

The Preliminary Report of the Suicide Prevention Symposium Abstract This is the preliminary report of the Suicide Prevention Symposium which I was asked to compose by the Ministry of Health. Here, in this report, I would like to present a detailed report of the participants which should be selected for the Suicide Prevention Symposium and I would like to explain clearly why they should be selected. In the same way, personally, my contribution to the symposium as a psychologist also will be explained. Further, any other methods and actions that can be taken to prevent suicide will be discussed. Introduction Suicide which means (Latin suicidium, from sui caedere, "to kill oneself") the act of intentionally causing one's own death is a serious social problem that both developed and developing countries face (www.psychiatrictimes.com). Suicide is often committed out of despair, the cause of which can be attributed to a mental disorder such as bipolar disorder, schizophrenia, depression and also alcoholism or drug abuse. In the same way, stress social factors such as financial difficulties or troubles with interpersonal relationships often play a significant role in suicide. Environmental risks like, presence of a firearm in the home and situational crises like a traumatic death of a loved one, physical or sexual abuse, family violence etc. may be the causes for suicide. Suicide is a big social problem in all European, Western and Asian countries. In Sri Lanka also, there are considerable deaths are caused by suicide per year. New official data shows that Sri Lanka still has one of the highest suicide rates in the world, with almost 4,000 people killing themselves per year or about 11 per day (www. wikipedia.com.). In Sri Lanka, most of the suicide victims belong to 20-25 age group and most of the victims that commit suicide males (www. wikipedia.com.). Suicide Prevention If prediction of suicide is difficult, no doubt that prevention is even more problematic and difficult. Preventing suicide is very difficult because people who are depressed and contemplating suicide do not realize that their thinking is restricted and irrational and they are in need of assistance. But, we as psychologically healthy human beings, it is our duty and responsibility to help to save a valuable life and it is the duty and responsibility of the Ministry of Health also. In considering the strategies for suicide prevention, there are two perspectives: a community model and a medical model (www.psychology.about.com). A community model is thought to be related mainly to the first half of the suicidal process and a medical model to the latter half. It is an ideal that both community and medical approaches are put into practice simultaneously. Participants That Should Be Selected For the Suicide Prevention Symposium A Clinical Psychiatrist who has at least five years experience Clinical psychiatry plays a greatly important role in preventing suicide. In the world, about 90% of suicides occur in persons with a clinically diagnosable psychiatric disorder (Barlow & Durand, 2005). In Sri Lanka also, the situation is same. Mood disorders, personality disorders, anxiety disorders, schizophrenia and also alcohol and substance abuse are frequently associated with suicidal behavior. The standardized mortality risk ratio is higher for patients with major mood disorders than for the general population. For patients with unipolar major depressive disorder, standardized mortality ratios show a 20-fold increase over the general population of patients with bipolar disorder or depression who have ever been hospitalized (www.psychology.about.com.). In the same way, according to the Leonardo Tondo and Ross J. Baldessarini, 28 studies involving 823 suicides among 21500 patients with BPD found a weighted mean annual incidence of suicide of 390 per 100,000. That rate is 26 times higher than in the international general population, which is approximately 15 per 100,000 (www.psychology.about.com.) It is also found that approximately 20% of seriously injured suicide attempters were diagnosed as adjustment disorder in Japan, which means that even the mildly depressed can commit suicide (www.psychologyabout.com). So, when considering above facts it is clear that most of the people who have committed suicide were with a mental disorder or in a mentally unstable situation when they committed suicide. The best person to work with a patient who has a mental disorder is a clinical psychiatrist. A clinical psychiatrist is a medical doctor who has undergone specialized training in mental health and he or she is well aware of medicine that should be given to mentally ill people, behavior of mentally ill mainly, psychotic patients’ and has a clear knowledge about how the brain of a psychotic patient works as he or she is well educated about brain imaging studies such as computed tomography (CT/CAT Scan), magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning. During his or her career the clinical psychiatrist may have faced some incidents regarding suicide. Though the clinical psychiatrist has a better understanding about both medical aspect and the mental aspect, he or she can mainly point out the biological part of the psychotic patients. For example, in those who have attempted suicide, it has been found that they have lower serotonin levels and individuals who have completed suicide have the lowest levels (Carson, Butcher and Mineka, 2000). In the same way, genetic inheritance accounts for roughly 30–50% of the variance in suicide risk between individuals. Having a parent who has committed suicide is a strong predictor of suicide attempts. Further, the brain functioning of psychotropic patients are different from normal people. For example, schizophrenia affects the balance in neurotransmitter concentration of dopamine, glutamate and serotonin systems (Barlow, 1998; Barlow et al., 1996). As the clinical psychiatrist has a clear knowledge about these things, he or she can explain how the people who have suicidal ideas behave when they are lack of those neurotransmitters. Using multimedia and other instruments, he or she can explain the various pictures of psychotic patients who display various behaviors. Then, the audience can get a better picture how mental disorders link to suicide. Similarly, with his or her experience, a clinical psychiatrist know what should be done and what should not be done with a patient that who has attempted suicide and who has suicidal thoughts. The clinical psychiatrist can explain and describe with examples the behavioral characteristics and verbal communication patterns and words that a person displays and say before committing suicide (Suicide ambivalence). In the same way, a clinical psychiatrist can inform the immediate methods that should be taken if someone displays such characteristics. So, a clinical psychiatrist can cover a very big part of the suicide prevention symposium. Social Psychologist who has worked in the field at least 5 years Suicide rates appear to vary considerably from one society to another (Carson, Butcher and Mineka, 2000). Socio-economic factors such as unemployment, poverty, homelessness, debt, some social and cultural issues and discrimination may trigger suicidal thoughts. In the same way, traumatic situations like flood, death of a beloved one also can cause suicide. Poverty may not be a direct cause, but impoverished individuals are at major risk group for depression, itself a risk factor for suicide. According to the French sociologist Emile Duyrkheim, the greatest deterrent to committing suicide in times of personal stress is a sense of involvement and identity with other people. For example, there is a well known association between unemployment and suicide which may primarily be related to the effects that unemployment has on mental health (Hawton,1992; Maris,1997). Similarly, suicide rates have been found to be higher than average among people who are “downwardly mobile? And among groups undergoing severe social pressure. The lack of education, helping hand, divorce or going abroad of parents, quick temper are few causes for suicide. A social psychologist can give practical answers for above mentioned problems. As the social and cultural situations are different from place to place, the same solution can’t be applied to different places. As the social psychologist is well aware of those social and cultural situations, he or she can give and explain solutions accordingly. For example, though guns are used to suicide in America, In Sri Lanka, most people use poison to suicide. The social psychologist is well aware of these things. Similarly, a social psychologist has solutions for the problems like unemployment, poverty, homelessness, and discrimination can overcome. He or she can explain how to overcome those social and cultural situations. In the same way, in Sri Lanka, some old and helpless people commit suicide because they do not know any answer other than suicide. So, the social psychologist may have the details about the places where helpless and old people are looked after. So, the audience can direct those people to due places. Some people in the rural areas like Anuradhapura and Polonnaruwa commit suicide mostly because of debt or breaking of love affairs. A social psychologist can explain how to face those situations. In the same way, a social psychologist is a researcher also. As he or she has detailed reports of various provinces in Sri Lanka about suicide, he or she can have a best understanding of what methods are practical to each area. Thus, his or her knowledge will be very helpful. In the same way, in a traumatic situation, the social support is very important. The social psychologist can explain how to give the social support with his or her experiences and knowledge. So, in this symposium, as the social psychologist can act the both roles of a sociologist and a psychologist, his or her knowledge is very important and valuable. Suicide Counselor who has at least five years experience Suicide counselor is a person who is working with people who have attempted suicide or who have suicide thoughts. During his or her career, he may have faced with different clients who have various ideas and opinions regarding suicide. He or she may know various ways of committing suicide from his or her experience. A very good skill and quality of a counselor is active listening. In the counseling sessions with a client who has attempted suicide or a client who has suicidal thoughts, a suicide counselor deeply listens to the client and analyses the problem even more than one hour. So, he or she is well aware of various mental aspects of a person who has suicidal thoughts. He or she can give possible solutions to the problems regarding suicide. As he or she has many experiences and deeper knowledge his or her knowledge will be very important and relevant to the audience. A Religious Leader Religion impacts suicide. One's degree of religiosity can potentially serve as a protective factor against suicidal behavior. To accurately assess risk of suicide, it is imperative to understand the role of religion in suicidality. Mainly, religious taboos concerning suicide and the attitudes of a society toward death are apparently important determinant of suicide rates. Most of the people in Sri Lanka belong to a religion. Sri Lankan people, mainly Buddhists respect religious leaders and they listen what religious leaders say. So, for this symposium, the contribution of a religious leader is very important. Anyway, we want to prevent suicide in Sri Lanka. So, we should consider each and every resource that can be useful. Here, mainly I suggest that three religious leaders should be called concerning the three main regions Buddhism, Christianity and Islam. Mainly in Sri Lanka, most of the people are Buddhists. So, a Buddhist monk should be summoned. In the same way, as there are Christians and Muslims a Christian father and an Islamic priest should be called. They can explain suicide from their religious angle. Buddhist people are afraid of doing sins because they think that if they do sins they will go to the hell. Suicide is a sin. If someone commits suicide in anger, he may be reborn in a sorrowful realm due to negative final thoughts. According to the Roman Catholic Church also, death by suicide is considered a grave or serious sin. The chief Roman Catholic Christian argument is that one's life is the property of God and a gift to the world and to destroy that life is to wrongly assert dominion over what is God's and is a tragic loss of hope. Islam, like other Abrahamic religions, views suicide as one of the greatest sins and utterly detrimental to one's spiritual journey. As, the religious leaders can point out these facts from the religious aspect it will be very useful and fruitful. If calling three religious leaders are difficult, one religious leader who has a good knowledge about other religions also will be alright. Medical practitioner who has at least five years experience Medical practitioner is someone who practices medicine. The help of a medical practitioner is mainly important after the suicide attempt. There are things that should be physically done and that should be not done after a suicide attempt. The medical practitioner has various experiences regarding such incidents of suicide attempts. If the person is not dead, the medical practitioner can explain what methods the people should take on such occasions mainly concerning the physical side of the body like if it is good to give water, soapy water and salt etc. to drink. In the same way, he or she can explain mistakes people do with an attempted suicide person and how people have died because of those mistakes. So, here, the contribution of a medical practitioner is also very important. A Family Member or a Friend whose very closet one has been suicide Though it is very difficult to talk about the painful experience of suicide of closet one, for this symposium, the words of such a family member or a friend is very important. All the participants above mentioned without the religious leaders are professionals in the field. This family member is out of such fields and his or her words will form an attitude change in the audience. Here, I have chosen this person because that person can explain and describe as he or she has experiences regarding suicide. Family members are the most closet ones of the suicide persons. Sometimes, one word of a family member may have caused suicide. So, family members have experiences concerning this matter. The family member can explain what the suicide person did before committing suicide. It is true that psychiatrists and psychologist also can explain those things. But, I am sure, a family member’s words will be very helpful for this symposium. His or her emotional words may significantly change the minds of the listeners. Family members may have experiences what should be talked and what should be not talked with such people. He or she can explain how to look after a person who is about to suicide. So, their experiences will be very important. My personnel contribution to the symposium as a Psychologist As a psychologist, I personally have a very big role to do in this symposium. I, as a psychologist have a clear understanding about the topic “suicide” in Sri Lanka. As the social psychologist also can talk about the mental aspect of the persons who committed suicide and who have suicidal thoughts and preventions, personally, I have to look at the other ways of prevention suicide. But, I can explain how the basic psychological therapies can be used to solve the people’s problems. Further, I can give an overall picture of the suicide prevention. I can explain how to ensure the health and well-being of all people: individuals, families, groups, and society as a whole. In the same way, I can explain the methods and actions that should be taken to prevent suicide in Sri Lanka. Mainly, my point is to give the idea that living is very important than suicide. I can explain how to look at problems with a profound and developed psychological mind. In Sri Lanka, there is a negative attitude about counseling. I can explain the audience necessity of taking counseling if there arises a problem. People are encouraged to take counseling if they have problems. In the same way, as a psychologist it is my duty and responsibility to take the suicide prevention message to the society and make an awareness in the society regarding this topic. For that we can use media. The TV channels, FM Radio channels and each and every newspaper companies should be invited to cover the symposium and we should give them a clear understanding and importance of their role to prevent suicide. They should be informed to continue the message without stopping about suicide and they should be informed how the advertisements and reports regarding suicide prevention should be presented in a proper attractive and a psychological way. In the same way, we can use social media, such as this Facebook, MySpace, Twitter etc. to send the message to the society. Each and every listener is encouraged to use those social media to take this message. In the same way, I invite the members of Ministry of Social affairs to participate the symposium. Then they can get an idea about suicide in the country and they are encouraged to practically apply solutions to the existing social problems what the participants explain. In the same way, all the major organizations and NGOs in the country are invited to symposium and they are motivated to conduct counseling centers and in their workplaces to prevent suicide. Their contribution to prevent suicide is explained. In the same way, I inform the Ministry of Health, the shortcomings and the aspects that should be developed of the counseling centers of government hospitals. The religious leaders are also invited to participate the symposium and they are explained how to solve people’s problems from a psychological base. They are informed to carry this message to village leaders and other villagers also. According to the research studies suicide is the 3rd leading cause of death for youth ages 10-24 (www.pschatristtimes.com). This age group includes school children and university students too. So, a school teacher and a university lecturer are informed to participate the symposium as audience representing their school and university. They can take the message to the schools and universities. The Ministry of Education and the Ministry of Higher Education is informed to start counseling centers in schools and universities. Some students commit suicide when they fail exams. The solutions for those problems are discussed in this symposium and teachers and lectures are informed to teach using psychological theories. Further, government and private companies are encouraged to starts counseling centers in their workplaces. All the government and private organizations, NGOs, schools, universities Ministries etc. are encouraged to work collectively to prevent suicide. In the same way, it will be very useful if the posters about suicide prevention are distributed to government and private hospitals and offices, religious places etc. The poster can be distributed among the audience and they can be informed to distribute them among others and to use government and private transport services to display this message. If these methods and actions are taken, we can reduce or stop suicide in Sri Lanka. The above mentioned facts clearly explain how the participants for the symposium should be selected and my personnel contribution as a psychologist for the symposium. Conclusion The prevention of suicide is a very problematic and difficult process. However, for a symposium regarding suicide prevention a clinical psychiatrist, a social psychologist, a medical practitioner, a suicide counselor, a religious leader and a family member whose very closet one has been suicide are very important as their knowledge and experiences are very helpful for the prevention of suicide. As the audience: school teachers, university lectures, religious leaders, government and non government organizations etc. should be summoned. In the same way, the suicide prevention message can be taken through media and social media, posters and various other ways. When all these units in the society work collectively the suicide can be prevented in Sri Lanka. . References Barlow, D. H., & Durand,V. M, (2005). Abnormal psychology (4th ed). USA: Thomson Wadsworth. Carson, R. C., Butcher, J. N., Mineka, S., (2000), Abnormal psychology and modern life (11th ed.) Delhi: Pearson Education. Comer, R. J., (1995). Abnormal psychology (2nd ed.). USA: W. H. 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