A preliminary report of the Suicide Prevention Symposium

A 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 have presented a detailed report of the participants which should be selected for our symposium and I have clearly explained why they should be selected. In the same way, personally, my contribution to the symposium as a psychologist of the Ministry of Health is also explained. Introduction Suicide which means (Latin suicidium, from sui caedere, "to kill oneself") the act of intentionally causing one's own death is a serious problem that both developed and developing countries face. Suicide is often committed out of despair, the cause of which can be attributed to a mental disorder such as bipolar disorder, schizophrenia, depression, 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. Suicide is a developing social problem in all European, Western and Asian countries. In Sri Lanka, there are considerable deaths are caused by suicide per year. New official data shows that Sri Lanka still has one of highest suicide rates in the world, with almost 4,000 people killing themselves per year or about 11 per day. Suicide Prevention If prediction of suicide is difficult, no doubt that prevention is even more problematic. 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 of the Ministry of Health also. When considering the prevention of suicide, emphasis is placed on i. Maintaining contact with a person over a short period of time-usually one to six contacts. ii. Helping the person realize that acute distress is impairing his or her ability to assess the situation accurately and to asses to choose among possible alternatives. iii. Helping the person see that other ways of dealing with the problem are available and preferable to suicide. iv. Taking a highly directive and supportive role. v. Helping the person that the present distress and emotional turmoil will not be endless. Above mentioned facts should be thoroughly considered when considering prevention of suicide. In the same way, it is very important to distinguish between the individuals who have demonstrated relatively stable adjustment but have been overwhelmed by some acute stress as about 35-to 40 percent people coming to the attention of hospitals and suicide prevention centers. Similarly, attention should be given to individuals who have been tenuously adjusted for some time and in whom the current suicidal crisis represents an intensification of ongoing problems -about 60 to 65 percent of suicidal cases. In considering the strategies for suicide prevention, there are two perspectives: a community model and a medical model. 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. Thus, we should select the participants for the symposium considering mainly above mentioned facts. 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. 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. 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. They found that the risk of suicide among nearly 3000 outpatients with BPD type I or II was several-fold higher than in patients with UP-MDD. 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. So, when considering above facts it is clear that most of the people who have committed suicide were with a mental disorder or mentally unstable 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. So, a clinical psychiatrist can mainly point out the biological part of the psychotic patient. 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. 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. As the clinical psychiatrist has a clear knowledge about these, he or she can explain how the suicide patients behave when they are lack of those neurotransmitters. Then the audience can clearly understand if any person they know display such characteristics. 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. 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, some cultural issues and discrimination may trigger suicidal thoughts. Poverty may not be a direct cause, but impoverished individuals are a 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 of going abroad of parents, quick temper are few causes for suicide. 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 situations, he or she can explain solutions accordingly. Similarly, a social psychologist has solutions for the problems like unemployment, poverty, homelessness, and discrimination can overcome. In the same way, if there are children or elderly people who have no any support the social psychologist can give the details about the place where such people are looked after. So, the audience can direct helpless people to due places. Suicide Counselor 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, opinions, and various ways of committing suicide. 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 go into the problem and analyses it. So, a suicide counselor’s contribution is also very important here. As he or she has many experiences and deeper knowledge his or her knowledge will be very important and relevant to the audience. Medical practitioner This person is mainly important after the suicide attempt is prohibited. There are things that should be done after an suicide attempt both physically and mentally. This medical practitioner has various experiences regarding the incidents of suicide. If the patient is dead but still if she or he is in the process of suicide, the medical practitioner can explain what methods the adudice shoul take on such occasions mainly concerning the physical side of the body.Like if it is good to give water etc. So, here the contribution of a medical practitioner is very important. 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 suiciderates. 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. 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 points out these facts from the religious point it will be very useful and fruitful. A family member or a friend whose very close one has been suicide. Though it is very difficult to talk about the painful experience of suicide of close one, for this symposium, the words of such a person is very important. All the participants above mentioned without the religious leader are professionals in the field. This one is out of such fields and his or her words will form attitude change in the audience. Here, I have chosen this person because that person can explain and describe he or she may have experiences regarding suicide. Family members are the most closet ones of the suicide person. Sometimes, one word of a family member may have caused a suicide. So, family members have experiences. They may have realized 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. As a psychologist I personally have a very big role to do in this symposium. Actually as a psychologist I have open If we want to prevent the suicide, the message should go to the society. 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 and how the advertisements and details regarding suicide prevention should be presented in a proper and attractive way. In the same way, we can use social media, such as this Facebook, MySpace, Twitter etc. to send the message to the society. In the same way, I invite the members of Ministry of Social affairs to participate the symposium. Then they can get a idea about suicide. Later I can discuss this problem with them and come to solutions to reduce problems from the social aspect. In the same way, all the voluntary organizations in the country are invited and they are motivated to conduct counseling ceners to prevent suicide. As the M According to the research studies suicide is the 3rd leading cause of death for youth ages 10-24. This age group includes school children and university students. So, a school teacher and a university lecturer should be informed to participate the symposium as audience representing their school and university. They can take the message to the schools and universities. In the same way, As a psychologist my contribution If we want to prevent suicide, the message should be given to the society. The media can be