Wednesday July 18, 2018

Amante: A suicide every 40 seconds

WHAT could have driven a 17-year-old girl to leap from a seventh-floor window, when help waited just outside her door? We will never know for sure, but it’s a question we need to think about.

Each suicide is specific. But if a community diligently collects as much information as it can, enough insights can be drawn to inform policies that may prevent suicide.

It was the lack of organized information that prompted the World Health Organization (WHO) in 2014 to publish its first report on suicide as a public health issue. In “Preventing Suicide: A Global Imperative,” the WHO pointed out that a suicide takes place as often as every 40 seconds. Among people 15 to 29 years old, the WHO data from 2012 showed that suicide was the second leading cause of death.

Southeast Asia seemed particularly vulnerable, the report showed. In 2012, there were an estimated 804,000 suicides worldwide. (That figure is believed to be under-reported, because many countries lack a system for documenting suicides.) Translated into age-standardized suicide rates, that meant there were 11.4 suicides for every 100,000 persons in 2012.

In Southeast Asia, the number of suicides for that year was pegged at 314,000. This meant an age-standardized suicide rate of 14 for every 100,000 women and 22 for every 100,000 men. Both numbers were higher than the global rate of eight for every 100,000 women and 15 for every 100,000 men.

This shatters our expectation that Southeast Asians, with our extended families providing a dependable support system, would be less vulnerable to suicide than other, presumably less-connected cultures. It also affirms the WHO’s caution: there isn’t enough data in most countries on how often suicide happens, which demographic groups are most vulnerable, and what methods are most often used. These gaps in understanding exist because suicide remains a taboo subject.

Suicide can be prevented. But we will need to learn to talk about it. If the social media conversation that grew out of that 17-year-old girl’s death is any indication, we have a lot to understand. Most of the comments focused on whom to blame, although there were a handful who suggested ways to help those who have considered taking their lives. Parents, be gentle with your children, some suggested. Remember that all problems are fleeting, said others. Ask for help.

In 2012, when the figures for the WHO’s first suicide prevention report were drawn, there were 2,558 suicides documented in the Philippines. That meant a suicide rate of 2.9 for every 100,000 persons, much lower than the global rate of 11.4. But compared with the figures from 2000, the Philippines’ record for 2012 reflected an increase of 13.5 percent.

Suicide can be prevented, yes, but such efforts will take time. In Japan, suicide became an urgent public health issue after 1998, when the number of suicides rose by nearly 8,500 in the midst of the Asian financial crisis. Children who had lost their parents to suicide began a public discussion in 2000 on suicide prevention. Japan’s Basic Act for Suicide Prevention became a law in 2006. But it wasn’t until 2012 when the number of suicides in Japan fell to below 30,000 for the first time since 1998.

The WHO has identified several strategies to prevent suicide at the national, group, and individual levels. These include limiting access to the means for suicide (such as restricting access to pesticides and firearms); creating dependable helplines, especially for vulnerable groups like those affected by conflict or disaster, or those families who have lost someone to suicide; and providing follow-up support for those who have just been treated after a suicide attempt.

All these kinds of strategies, the WHO report said, will benefit from protective factors “such as strong personal relationships, a personal belief system, and positive coping strategies.” At an individual level, we can offer to listen and find professional help for those among our loved ones who have recently lost a job, who suffer from chronic pain and illness, who abuse alcohol and other substances, or who have admitted feeling a persistent sense of hopelessness. Suicide can be prevented, but we must begin by making it safe for people to talk about it.

(On Twitter: @isoldeamante)