Features — 20 September 2013 — by Dr. Elma Whittaker-Augustine, Clinical Psychologist

Belize’s “10th September” is also the date that the world is asked to pause and focus on preventing suicide worldwide. The theme for this year is “Stigma: A Major Barrier for Suicide Prevention”.

Suicide is one of the leading causes of death worldwide. The data on the suicide rate in Belize is relatively low (13 in 2012) in comparison to other countries. However, one suicide is one too many. The more we increase our knowledge of suicide, stigma, a major barrier to suicide prevention, will hopefully gradually disappear. Our article for this month will focus on some of the causes of suicide, its impact, ways to respond and interventions.

Why do some individuals choose suicide?

It is not possible to accurately answer this question. However, some factors that contribute to this decision are feeling intense emotional pain, which is reported to be more painful than physical pain, feeling hopeless, feeling life is not worth living, feeling trapped, feeling isolated, feeling our problems are insurmountable and we have tried all options and have had enough and think that the only relief is suicide, feeling that our family and friends would be better off without us. All these feelings are also symptoms of Clinical Depression.

Other factors are feelings resulting from being hurt, a separation from a loved one, a major loss, e.g. death of husband or wife, or other upsetting life events. In some cases, when we become angry due to hurt, our anger can manifest as perverted revenge, suicide, where we hurt ourselves in an effort to hurt others.

Additional factors are Post-partum Depression which can occur after giving birth, other serious types of mental illness, the abuse of drugs or alcohol which causes us to act impulsively. Suicide also occurs among the elderly and youths. Some factors that may influence the elderly to commit suicide are medical illness, chronic pain, major changes in life, living alone. In youths, factors can be sexual, emotional and physical abuse; including bullying and family violence. Other factors are school failure, breakup of a relationship, pregnancy, identity crisis.

It is well documented that more women attempt suicide than men. However, more men commit suicide than women. This is due to the fact that men tend to use more lethal means than women and men are less likely to seek help. Also, research shows a large percentage of individuals who die from suicide suffer from mental illness.

What are some signs that a person may be having suicidal thoughts and feelings?

It is possible that at times there will be no warning signs. However, the following are common warning signs: a person making statements about wanting to die, talking about death, expressing negative view of self, expressing feelings of hopelessness, writing goodbye notes, giving away prized possessions, making a will, displaying a drastic and sudden change in behavior or mood. And if a person has a plan or has attempted suicide before, the risk for suicide is increased.

The impact of suicide on the family is usually devastating

Suicide is a sudden loss that does not make sense. Because it is not anticipated it results in a major secondary loss: it is like a double loss. There is no chance to say goodbye, there is stigma attached which results in embarrassment for the family and the family may be blamed by some in society. Suicide also raises a major question of WHY? It is difficult to understand a person’s choice of death over life. Therefore, no matter how hard we try, we will not be able to answer this question.

Loved ones will initially feel shock, disbelief, numb, helpless, confused. As the reality sinks in, hurt, anger, sadness, guilt set in and they become even more intense and painful. Anger is connected with why did he/she do this, why didn’t others help, what could we have done, why did God let this happen? Guilt comes from asking why did we not listen, or what if? Or feeling we should have been there.

Feelings may happen all at once and overwhelm for weeks or months afterwards; the pattern of grieving varies. Healing will require that we talk about it even though no one will have any answers. Talking about it does not give someone an idea to do it. If childern are present, ask about their fears, worries, misconceptions.

Ways to respond if someone is suicidal; Do’s and Don’ts for family members:

Do not agree to secrecy
Do not say go ahead and try it
Do not ignore a threat
Do not leave the person alone
Do not get into an argument
Do seek professional help immediately

Encourage the person to talk and tune in to what they are feeling, empathize and do not judge them. Scan the house and remove possible methods. Discuss coping resources and the person’s strengths. Help the person to identify at least two coping outlets

Some Interventions that can be used if someone is suicidal are the following:

Have a plan to keep the person safe until they get through the crisis; this may include hospitalization and medication. Engage in Talk Therapy to relieve the burden of despair and isolation, shift the person’s perspective to see that he/she has options, offer support in choosing hope, offer more rational ways to cope, resolve the issue/s underlying suicidal thoughts, identify meaning and purpose in life, set short and long term goals, help him/her to learn problem solving skills and learn to cope with hurt and anger. Various therapeutic approaches can be used, cognitive behavior, problem solving, interpersonal, logo and pastoral. In summary, therapy offers support to change perspective, feelings, behavior, imparts hope that the person can move beyond suicidal thoughts. With therapy, eventually the sense of hopelessness and thoughts of suicide will lift and a person can rediscover reasons for living.

It is very important for us to remember that suicidal feelings and thoughts are the result of treatable problems. However, due to stigma and discrimination, many individuals with suicidal thoughts and feelings do not seek help. It was recently, 2000, that the law in Belize which classified suicide as a crime was changed. There is much more work to be done. As a society we need to focus on providing education, awareness, services and interventions/treatment. It is hoped that one day Belize will also have a crisis intervention phone line that those at risk for suicide will be able to call.

Most importantly, we need to realize that we are all humans and can reach a point of despair. Therefore, we need to support and not judge those who express suicidal thoughts but encourage them to choose life and reassure them that with treatment they can feel better.


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