Provident, Inc.

SUICIDE IS PREVENTABLE

Causes of suicide: During the last three decades we have learned a great deal about the causes of this complex behavior. Suicide has biological, cultural, social and psychological risk factors. People from socially and economically disadvantaged backgrounds are at increased risk of suicidal behaviour. Childhood adversity and trauma, and various life stresses as an adult influence risks of suicidal behaviour. Serious mental illnesses, most commonly depression, substance abuse, anxiety disorders and schizophrenia, are associated with increased risk of suicide. Diminished social interaction increases suicide risk, particularly among adults and older adults.

Suicide can be prevented. Despite its often complex origins, suicide can be prevented. Communities and societies that are well integrated and cohesive have fewer suicides. Restricting access to methods of suicide (such as firearms or pesticides) reduces suicides. Careful media reporting of suicide prevents further suicides. Educating communities and health and social services professionals to better identify people at risk of suicide, encourage them to seek help, and providing them with adequate, sustained and professional care can reduce suicides amongst people with mental illness. Providing adequate support for people who are bereaved by suicide can reduce their risk of suicide.

SUICIDE PREVENTION IN DIFFERENT CULTURES - EXAMPLES OF ACTIVITIES

Efforts to decriminalize suicide: In some cultures (for example, Lebanon and Pakistan) suicide is still a criminal activity. This status determines the way suicide is responded to. It stigmatizes the families of those who die by suicide, inhibits suicide attempters from seeking appropriate help and hinders efforts to establish suicide prevention programs. As a fundamental step in suicide prevention, efforts have been made in India to decriminalize suicide and the International Association for Suicide Prevention is collaborating with the World Health Organization to support and facilitate these efforts.

Reduction of pesticide suicide in Asia. Culture influences the methods people use for suicide. Most suicides in the world occur in Asia, which is estimated to account for up to 60% of all suicides. In many Asian countries (including China, India, Sri Lanka, Malaysia) a large proportion of suicides result from poisoning by swallowing agricultural pesticides. Suicide by this method is particularly common in females in rural areas. Given the large contribution to world suicide rates, reducing pesticide suicides could make a significant impact on global suicide rates. Current efforts to reduce pesticide suicide focus on removing the most toxic pesticides from sale, restricting access to pesticides by the use of locked storage boxes, improving access to emergency treatment and health care, educating about help-seeking and providing crisis support for rural women in stressful situations.

Minimizing media reports of suicide methods. Culture shapes the way suicide is reported by the media. In Hong Kong, media reports of a novel method of suicide, charcoal burning, contributed to the rapid adoption of this method by people who did not previously make suicide attempts. Concerted efforts by suicide prevention experts in Hong Kong focussed on persuading the media to adopt a more cautious and muted approach to reporting suicides by charcoal burning. At the same time, novel efforts were made to restrict access to charcoal by reducing access within supermarkets, and to train community accommodation owners to recognize people who might be at risk of suicide and were possibly seeking a room in which to use charcoal burning to kill themselves. Implementation of these initiatives resulted in a significant reduction in suicides by charcoal burning.

Support for Immigrants. Increasing globalization, ease of international travel, and refugees and asylum seekers from war and disaster have swelled the number of immigrants worldwide. People who are alienated from their country and culture of origin are vulnerable to various stresses, mental health problems, loneliness and suicidal behaviour. Suicide prevention strategies, tailored to the specific needs of migrant groups, exist in many countries. These programs typically focus on understanding the specific cultural and religious attitudes to mental health and suicide of the migrant group, reasons for migration, and family and social structures. Interventions include educational and social programs designed to identify stresses, teach coping skills, promote use of preventative health practices, improve access to health services and encourage socialising. Suicide prevention programs for migrants may require involvement, championship or leadership from religious or community leaders to be successful.