Raising awareness on suicide in Sri Lanka

According to the World Health Organisation, close to 800,000 people die by suicide each year. This amounts to one life lost to suicide every 40 seconds. The stigma surrounding mental health prevent those in need from seeking help. In 2016, suicide was the second leading cause of death among individuals within the ages of 15-to-29 years. 79% of all suicides occur in low- and middle-income countries, where resources for identification and control are relatively inadequate. Sri Lanka is one such country.

Statistics show that Sri Lanka had a suicide rate of 14.6 per 100,000 people in 2016, placing it at 31st out of 172 countries. Although suicide is highly prevalent in our country it is rarely talked about.

Historically, suicide and self-harm have always remained a public concern in Sri Lanka, with suicide rates peaking during times of the Civil war. However, it is also important to note that Sri Lanka has reduced its crude suicide rate by 70% over the last two decades. Despite the noteworthy decline in the number of deaths by suicide, there is still a high number of individuals attempting suicide, which is an indicator of the progress left to be made in terms of mental health in Sri Lanka.

Poverty is another contributor to suicide. In Sri Lanka, 4.1% of the population, around 900,000 people live below the poverty line. Moreover, individuals in low to middle income families are the most common suicide victims. Substance abuse is also a major cause of suicide, In Sri Lanka alcohol and drug abuse largely contribute to the suicide mortality rate.

The voluntary ingestion of pesticides are major cause of suicide deaths in rural areas. Pesticides were reported to have caused nearly 30% of all suicide deaths in the 1990s. Deaths due to pesticidal poisoning have been considerably minimised through regulation of the use and distribution of pesticides. It is estimated that this has saved 93,000 lives between 1995 and 2015. Similarly, if access to drug and alcohol could be reduced, overtime it would significantly deter the number of suicides attempted across the country.

The social stigma around alcoholism and drug abuse, as well as the mental conditions associated with it exacerbates the problem. According to Dr Jayamal de Silva, Psychiatrist at the Colombo South Teaching Hospital, 50% of suicides are related to alcohol abuse, with 8% being caused by mental illness or instability.

The Sri Lanka Medical Association (SLMA) published a policy document in 2019 detailing several preventive methods for suicide. The report stresses the importance of raising public awareness on detecting mental illnesses and providing support services and well-equipped healthcare facilities for substance abusers. At present, most community activities on mental health promotion and suicide prevention are conducted by the health sector in Sri Lanka, such as the Medical Officers of Health (MOH). The public should be educated on how to provide initial support to those who express suicidal thoughts and vulnerable individuals must be encouraged to seek support without the fear of discrimination.

What can we do to raise awareness on such a sensitive and heart-wrenching topic?

It is important to understand that there are many contributing factors to suicidal behavior. Not every person will show the same behavioral tendencies and not every person will ostensibly project their emotions and mental state. The mental health stigma has become a significant barrier to obtaining professional mental health services due to a lack of self-acceptance. This can make people aversive to seeking help due to the perceived social embarrassment that is associated with obtaining professional help.

This show how critical it is to educate society on mental health, that there is no embarrassment involved in seeking professional help or reaching out to a friend who might be able to help. This is particularly important because, as mentioned earlier, it is the youth that is most vulnerable to risk of suicide and are most affected by this prevailing stigma.

A holistic public health approach is important in addressing this issue at a national level. This approach should be based on,

1.Conducting school-based programs focused on promoting ‘emotion regulation’, social skills and conflict resolution. Educators should mainly focus on factors that can lead to suicide such as, anxiety disorders and clinical depression. This method is ideal in a low resource setting.

2.Workplace based programs that include free counselling sessions, which have shown to reduce stress and mental health problems of the youth workforce.

3.Conducting public awareness programs on how to respond and provide support for those expressing suicidal thoughts or attempting self-harm.

4.Mobilizing social media to effectively promote mental health awareness and encouraging the use of online mental health services.

The media has a key role to play in suicide prevention. Evidence suggests that the depiction of suicide by the media could result in an increased in the number of suicides. It is known as copycat suicide. Vulnerable individuals, particularly young or those facing issues such as indebtedness, may be negatively influenced by suicide victims portrayed by the media.

Hence, it is necessary that the government implement guidelines and regulate the portrayal of suicide in the media.

Finally, a crucial step that will pave the way for better awareness is the investment to conduct research on the causes and contributing factors that pushes a person to take such a drastic step. Among policy makers and public health officials there is a general awareness on how the suicide rate has changed with time. However, articles on suicide by Local media repeatedly seem to use information and analytics that are outdated. This arises due to an unavailability of the up-to-date data for journalist, health activists and others. It is important that such data is readily available publicly, as it allows for stakeholders that are willing to engage in raising awareness, provide facilities and conduct comprehensive studies make efficient and proactive decisions to the best of their abilities.

Many people do not know where to go when reaching out for support during a crisis. If you or a loved one are ever in need of help, please call any of the numbers below for assistance,

National institute of Mental Health: 1926

CCC foundation: 1333

Sri Lanka Sumithrayo: 011 2862 535

Sumithrayo: 011 269 6666

Sri Lanka National institute of Professional Counsellors: 0718699225 or 0772680930

References:

The Reality of Suicide in Sri Lanka: Need for Data-driven analysis:

https://groundviews.org/2017/10/06/hype-and-reality-of-suicides-in-sri-lanka-need-for-data-driven-analysis/

Suicide Prevention in Sri Lanka: Recommendations for Action:

https://slma.lk/wp-content/uploads/2020/10/Suicide-Prevention-in-Sri-Lanka-Recommendations-for-Action-final.pdf

A Closer Look at Youth Mental Health in Sri Lanka and Some Consequences:

https://www.ips.lk/talkingeconomics/2014/08/12/a-closer-look-at-youth-mental-health-in-sri-lanka-and-some-consequences/

https://slma.lk/wp-content/uploads/2020/10/Suicide-Prevention-in-Sri-Lanka-Recommendations-for-Action-final.pdf

https://economynext.com/unsuccessful-suicide-attempts-remain-high-in-sri-lanka-expert-74168/

https://www.adb.org/countries/sri-lanka/poverty#:~:text=Poverty%20Data%3A%20Sri%20Lanka,day%20in%202019%20is%200.3%25.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177120/

https://www.who.int/teams/mental-health-and-substance-use/suicide-data

https://economynext.com/sri-lanka-unemployment-hits-10-year-high-in-2020-march-quarter-72123/

https://www.colombotelegraph.com/index.php/tackling-the-burden-of-suicide-in-sri-lanka/

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30208-5/fulltext

https://groundviews.org/2017/10/06/hype-and-reality-of-suicides-in-sri-lanka-need-for-data-driven-analysis/

https://data.worldbank.org/indicator/SH.STA.SUIC.MA.P5?locations=LK

By: Rtr. Dulithi Jagoda, BSc. Economics and Finance, 2nd Year

Rtr. Alex Rajapakse, LLB.,1st Year