To highlight World Suicide Prevention Day on 10 September we asked Dr Nav Uppal from IMC Jelita to explain suicide rates and what to do if you are concerned about a loved one.
Q. How common is suicide?
To give a snapshot of the situation in different countries:
UK: according to the office of National Statistics (2017) the total number of suicides across all age groups was 6,000. 253 females and 820 males between 10-29 years lost their lives to suicide in the UK. In the UK it is the single biggest killer of men under the age of 45.
US: data from the Centre of Disease Control and Prevention (CDC) shows that suicide is the leading cause of death among adolescents and young adults.
Australia: suicide is the leading cause of death among young Australians equating to around 8 suicide deaths per day.
Singapore: the suicide rate rose 10 % last year and is the leading cause of death for those aged 10-29 yrs. According to the Samaritans of Singapore 397 lives were lost to suicide in 2018 (nineteen boys aged 10 – 19 committed suicide last year, the highest since records began in 1991).
These figures are shocking and support the need to open up about mental health and provide easy to access supportive services with well trained professionals.
Q. What are the factors that make people at risk of attempting suicide?
Many people who have suicidal thoughts experience them when they are not in their usual frame of mind. This can be due to an illness, such as depression, or because of stressful events going on in their lives. These feeling are often temporary, or treatable.
There are numerous established risk factors for suicidal ideation including:
- Being male – three times as many men die from suicide than women.
- Age – the highest risk in in people 40-54.
- Having a Mental Health Disorder – 9 in 10 people who die from suicide have a mental health problem of some kind. Illnesses that increase the risk are: Depression (for people with depression suicide is a serious complication with a risk of about 3 % over the next 10 years), Bipolar, Schizophrenia, Emotional unstable personality disorder (borderline personality disorder), Alcohol or drug dependence.
- Having a painful physical illness – e.g. Arthritis or cancer
- Being unemployed, homelessness or living alone
- Difficult life events – such as the death of a loved one, redundancy, relationship break-ups.
- Bullying – whether this be in person or online.
Q. If someone reading this is concerned about a partner / teenager – when should they seek external support? And who should the parent go to for support?
Suicidal thoughts are usually related to thinking that no one cares, feelings of worthlessness or uselessness. There may be associated imagery of picturing the act or after death state. The combination of these feelings can be extremely distressing. Children and young adults and their families need good information and supportive relationships with the right healthcare professionals. Seeing your GP would be a good place to start. They would be able to offer support and point you in right direction for other wee trained health professionals including
Counsellors, Psychologists, School services, Psychiatrists or in clinic support with the GP. Noticing these signs can offer potential opportunities to intervene and save lives. While self-harm is not directly related to suicide there is research that individuals who self-harm are more at risk of attempting or completing suicide.
Q. What is the ‘treatment’ for those who have attempted suicide?
If you are having thoughts about suicide, you may feel alone or have the belief than nobody can help you, or that nobody cares. This is not true. Your coping mechanisms are usually overwhelmed by psychological pain – sadness, anger, stress, loneliness. Often the causes of these feelings are something that can be treated, or a feeling that can change in time. You don’t have to feel controlled by them. That is why friends, family, health professionals and governments want to do everything they can to help people cope with suicidal thoughts. People with suicidal thoughts often think that everyone else is better off without them. In fact, suicide leaves devastation and guilt for others left behind. Relatives and friends are left wondering what more they could have done to help and wishing the person who killed themselves had confided their feelings. Everyone’s situation is different, but people may be able to help just by listening. Often just sharing how you feel and being able to express yourself helps. Remember you may not be in a normal frame of mind so feelings may be confusing and talking them through with somebody else may help see things differently.
- Close friends, your partner and family members
- GP- seeing your GP would be a good place to start when trying to deal with your feelings. They will be able to check whether you have any signs of depression or any other mental health disorders. Remember these can often be successfully treated. For example, if you have depression, a course of antidepressant, or a dose adjustment in your usual medication may totally change the way you feel. Having established the reasons for your feelings, your GP may want to refer you for support or specialist help. e.g. a Counsellor, Psychologist or a Psychiatrist.
- A Counsellor, Psychologist, Psychotherapist – some people are helped by different types of talking therapies. These include counselling and Cognitive behavioral therapy (CBT). CBT aims to train your brain to look at things differently and react to stressful situations in other ways.
- Consider keeping a diary – Try to look for positive things to make you feel better. List the good things in your life, memories, future goals that give meaning to life. By doing so you may find that the feelings of hopelessness that often plague people with suicidal thoughts begin to lift. Try to eat well and exercise regularly, as this boosts your ‘happy hormones’
Q. Are there support networks in Singapore?
In times of severe distress where you need to speak with someone immediately, there are suicide hotlines available. The calls are free and often 24 hrs and are manned by volunteers or professionals who are trained to deal with suicide crisis. Look through the information on self- help websites:
Not all people with suicidal thoughts have a mental health condition. However, a large proportion of people who attempt suicide have a mental health condition. The promising news is that mental health conditions are highly treatable; with the help of you GP/ Psychiatrist/ Psychologist or Counselor. You may be given medication and / or offered psychotherapy for treatment which are proven effective for treating mental health issues.