Suicide is a major public health concern in Fiji and most individuals make impulsive decisions to attempt suicide rather than planning it out extensively, says mental health specialist Prem Singh.
Ms Singh, who is also the regional clinical supervisor at Empower Pacific, says suicide does not discriminate and people of all genders, ages and ethnicities can be at risk.
She says suicidal behaviour is complex and there is no single cause, but a few risk factors can lead one to contemplate suicide.
Risk factors
- Mental health conditions: Multiple factors may influence a person’s decision to commit suicide but the most common contributing factor is severe depression. Depression can cause an individual to feel great emotional pain, self-doubt, alienation, helplessness and hopelessness, driving them towards committing suicide as they are unable to find solutions to manage their situations and/or emotions. Other mental health conditions may include schizophrenia, bipolar disorder, borderline personality disorder where self-harm and suicidal ideation behaviours are quite common.
- Post-traumatic stress: Individuals who have a history of trauma because of childhood sexual abuse, rape/sexual assault, physical abuse, bullying, etc are at greater risk of suicide.
- Substance use: Alcohol and other drugs can also be a contributing factor for people to experience suicidal ideations making them more impulsive and likely to act on their urges. In addition, substance abuse can also lead to financial problems and interpersonal issues adding to the risk.
- Fear of loss: A person may decide to take their own life when facing a loss or fearing that they may lose something or someone valuable to them. These situations can include bullying (including cyber bullying), shaming, financial issues, end of close friendship or romantic relationship, job loss, academic failure, loss of social status, rejection and humiliation due to sexual orientation, alienation, etc.
- Feeling like a burden to others: An individual with chronic illness or terminal illness or those who belong to the vulnerable groups such as the elderly can feel like a burden to others. In fact, many people think that their loved ones would be better off without them. Their helplessness and hopelessness, teamed with depression and loneliness, at times drive them to commit suicide.
- Accidental suicide: Some situations that seem like suicide may be accidental deaths such as unintentional overdoses, deliberate self-harm (chemical ingestions), autoerotic asphyxiation, etc.
- A cry for help: Sometimes people who attempt suicide do not want to die. They simply do not know how to ask for help. Suicide attempts are not a cry for attention but a cry for help. They do this to show the world how much they are hurting and, unfortunately, these cries for help turn fatal as they end up misjudging the lethality of their chosen methods. People who make failed attempts or have histories of multiple suicide attempts are also at a much higher risk of re-attempting, and their next attempts are much more likely to be lethal.
“Most people who have the above risk factors will not attempt suicide, and it is very difficult to identify who will act on their suicidal thoughts. Although, it is important to be mindful of the risk factors for suicide. A person who is showing warning signs of suicide may be at higher risk of committing suicide and will require immediate attention,” said Ms Singh.
Ms Singh said individuals aged 12–36 years had reported negative impacts on their mental health and wellbeing such as difficulty in sleeping, lack of appetite, suicidal ideations, increase in deliberate self-harm behaviours, attempted
suicide, negative thinking and an increase in alcohol/cigarette/kava/ marijuana consumption because of worry and stress resulting from isolation, job loss, academic-related issues, relationship and family issues during the COVID-19 pandemic.
She said Empower Pacific’s 24-hour toll-free counselling helpline received about 20 to 30 calls per day where callers were accessing their services for mental health and psychosocial support as well as accessing information about COVID-19 safety guidelines.
She said effective suicide prevention was comprehensive and it required a combination of efforts to address various aspects of the issue at hand and Empower Pacific aimed to incorporate the following strategies in their mental health promotion related programs and activities:
1. Identify and assist persons at risk: Many individuals in distress do not seek help on their own. Identifying people at risk of suicide helps us reach those individuals who are vulnerable and link them to appropriate care and support. We incorporate suicide screening and teaching about suicide warning signs in our health and community- based programs.
2. Increase help-seeking behaviour: we encourage people to recognise when they need support and assist them to find it. Our outreach programs aim at lowering the barriers to obtaining help; reducing stigma associated with suicide; making services more convenient (toll-free counselling helpline #5626) and culturally sensitive; raising awareness on mental health, promoting mental health wellbeing and enhancing individual resilience.
3. Ensure access to effective mental health suicide care and treatment: Making sure that individuals have timely access to evidence-based interventions and coordinated systems of care (access to referral pathways, safety planning, effective case management, collaboration with relevant stakeholders (to reduce financial, cultural and logistical barriers to care).
4. Provide for immediate and long-term postvention: A postvention plan is put in place to assist our organisation to respond compassionately to a suicide death. We provide immediate and long-term support for individuals, families and communities bereaved by suicide.
5. Reduce access to means of suicide: One of our interventions to prevent individuals from accessing lethal means is facilitation of family conference sessions. We aim to educate the families in crisis about safely storing medications and other lethal means away from the reach of the vulnerable person and monitoring them thus reducing the risk of reattempts.
6. Enhance life skills and resilience: Our counselling and psychoeducational programs aim to enhance a person’s critical thinking, stress management and coping skills so they are prepared to cope with daily life stressors and adapt to changes – this is a protective factor against suicide.
7. Promote social connectedness and support: Empower Pacific aims to promote supportive relationships and community connectedness by reducing isolation, promoting a sense of belonging and fostering emotionally supportive interpersonal relationships amongst the vulnerable groups.
Empower Pacific is a non-governmental organisation registered under the Charitable Trusts Act of Fiji.
The core business of the organisation is to provide therapeutic counselling and social work support services through the use of evidence-based practices to ensure that services delivered in Fiji and the Pacific are on par with global standards.
- This article is a joint initiative of Empower Pacific and team Taura Tale of the Leadership Fiji program 2021 to spread awareness on suicide prevention.
