If you’re having suicidal thoughts or know anyone who is showing suicidal tendencies, who would you call? A confidential hotline maybe? Well, as it stands, there are currently no hotlines in Trinidad and Tobago that offer 24-hour counseling for those considering suicide. T&T Guardian tried contacting Lifeline but calls went unanswered. It was learnt that in 2010, Lifeline— which has been in existence since 1978—had to cut counseling services after 4 pm due to a shortfall in funding. Lifeline’s limited service appears more troubling after Health Ministry figures show there has been a significant increase in the number of reported suicides with an average of 1,000 admissions annually related to self-harm or suicide at each Regional Health Authority (RHA). These figures were released on World Suicide Prevention Day on Monday. Health minister Dr Fuad Khan told the T&T Guardian he was not was not aware of Lifeline’s predicament. He said he could only offer assistance if the Ministry was approached for funding as Lifeline is a private organisation.
Mental health a problem in T&T
The World Health Organisation (WHO) has listed suicide as a major cause of premature death. According to their data, almost 3,000 people commit suicide daily, making it the third leading cause of death among those aged 15 to 44 years in some countries. Among 15 to 19-year-olds, suicide is the second leading cause of death worldwide after accidents. The latest Central Statistical Office data on suicide is from 2007 and showed that 111 men and 20 women died from self poisoning and hanging. Mental disease leading to deviant and suicidal behaviour is definitely a problem in Trinidad and Tobago says Secretary of the Association of Psychiatrists, Dr Varma Deyalsingh. He said WHO’s statistics and confirmation from the Health ministry that suicide it is on the rise in this country, is something to be worried about. Deyalsingh said there are many underlying factors that force teenagers to become suicidal or commit suicide, because the teenage years are filled with turmoil. “They go through social and personal changes. It is a time when they begin to make decisions about the future, their hormones are changing… they are looking for answers to their many questions, they are sometimes fearful to ask,” he explained. He said they often have to deal with situations that they cannot change such as the divorce of parents, domestic violence in the home, substance abuse by adults in the home, peer-pressure, relationship break-ups, poor grades, bullying or even sexual abuse. Deyalsingh said all those problems can force a teen into a place where they feel powerless. These influences can cause them to externalise their level of frustration and anger by lashing out at others and becoming violent or it can cause the opposite—hurting themselves. He said studies have also shown that if that child has had a close relative who also committed suicide during turmoil in their life, they are more likely to do the same as they automatically believe suicide is the only way out of a negative situation.
What to look for
Deyalsingh said the first thing family and friends should pay attention to is significant changes in the potential suicide victim’s behaviour. “You can look for general loss of interest for pleasure, change in appetite (eating less or more), withdrawal or over-hyped behaviour, becoming suddenly cheerful after a period of depression, someone who is usually loud becomes an introvert and vice versa. Their sleep patterns may change, they may begin vocalising negative statements such as “life is not worth living” or it was nice knowing you.” He said another warning sign might be their sudden urge to give away things they valued or held dear. He said young people who talk about suicide have a greater risk of attempting it in the future if they haven’t already. Suicide in adults, he said, stems mainly from socio-economic problems, infidelity and depression brought on by perceived failures and rejection or illnesses. He added that the elderly may consider suicide if they are terminally ill, feel they have become a burden to their family or are not able to withstand pain and the constant need for medication. Deyalsingh advises that if someone shows suicidal tendencies, get them help from a psychiatrist, counsellor or psychologist immediately.
System in place
Dealing with a suicidal person is very stressful for family and friends, as most people are not equipped to deal with those scenarios. Suicide victims have to be constantly monitored, and this can become nervewracking for the caregiver. “Any object in the home can be used to hurt themselves, so family members have to constantly hide things and actually put themselves the victim’s frame of mind to keep abreast of what they might do,” said Deyalsingh. He said hospitals may not be the correct place in which to treat suicudal people as psychiatric wards at hospitals are not generally set in a peaceful atmosphere, and this may actually cause more problems. “Remember the mind is where you are attacking. Whatever the cause, the end decision is made up in the mind, therefore the mind is what needs to become well.” Follow-up care is also paramount as a potential suicide victim could relapse if they go back to the situation which created the dilemma in the first place. “Social problems still exist and if the patient’s problem stemmed from a social issue, say financial problems, then I think the Ministry of the People and Social Development and even charitable organisations can step in to ensure that the person is looked after until they are back on their feet. Some may think it not the best idea, but we must start somewhere.
Education is important
The Health minister said his ministry is currently undertaking a study into the various aspects of suicide prevention that should be completed by the end of September. “Education on this topic is what is mostly important. We are working on developing programmes that will provide the public with information on suicide and suicide prevention. It will be taking a much deeper look into the root causes of suicide and what can be done to prevent it,” he said. “The ministry has been putting a lot of emphasis on mental health and well-being. We are becoming more vigilant about this. “People become suicidal for various reasons, finding the root cause is important in order to apply appropriate treatment to that patient,” he said.
ABOUT WORLD SUICIDE PREVENTION DAY
The Day is celebrated on September 10 annually. It seeks to promote worldwide commitment and action to prevent suicides. WHO and other partners including the International Association for
Suicide Prevention, advocate for the prevention of suicidal behaviour, provision of adequate treatment and follow-up care for people who attempted suicide, as well as responsible reporting of suicides in the media. At the global level, WHO says awareness needs to be raised that suicide is a major preventable cause of premature death. It also stresses that Governments need to develop policy frameworks for national suicide prevention strategies. While at the local level, policy statements and research outcomes need to be translated into prevention programmes and activities in communities across the globe.