Stop the rhetoric, time for action – Dr Frank Anthony

Suicide Prevention Day

Every year on September 10, World Suicide Prevention Day, there is an opportunity to raise awareness and reflect on what has been accomplished in the prevention of suicides in Guyana. As such, Government has embraced a National Suicide Prevention Action Plan and established a Georgetown-based mental health unit to implement the plan.
However, People’s Progressive Party point person on health, Dr Frank Anthony, emphasised that notwithstanding this, 170 persons died by suicide in 2016, which is the third leading cause of death in persons ages 20 to 24, and the fourth leading cause of death in the 10 to 19 and 25 to 44 age groups. In 2016, like previous years, the vast majority of suicides occurred among persons of East Indian descent (accounting for 77.6 per cent of all cases), while smaller proportions were among persons of African, mixed and Amerindian descent.
Further, an analysis of the geographical distribution revealed that unlike previous years where Region Two (Pomeroon-Supenaam) was disproportionately affected, in 2016, Region Four (Demerara-Mahaica) accounted for almost one-third of cases (28.8 per cent) while Regions Two, Three (Essequibo Islands-West Demerara), Five (Mahaica-Berbice) and Six (East Berbice-Corentyne) accounted for significant proportions of suicide cases.
According to Dr Anthony, these statistics paint a clear picture for need in policy development and public health action to target the particularly vulnerable East Indian population in the respective regions.
The Member of Parliament pointed out that Government’s response has been lacking in the most affected and susceptible regions; inferring misalignment between what Government is doing and what is needed.
One suggested area of intervention was the repeal or amendment of obsolete laws which criminalise attempted suicide (as set out in Section 96 of the Criminal Offences Act 8:01 and Summary Jurisdiction Offences Act Cap 8:02 Section 203) under the view that it is an “outdated approach”.
“Many persons who attempt suicide typically have symptoms of psychiatric illness or distress, indicating that the person needs medical assistance. If our laws were to be followed then those who need medical help would needlessly end up in jail. During a parliamentary debate on suicide, Public Security Minister Khemraj Ramjattan promised that he would bring the necessary amendments to repeal these obsolete sections of the law, suffice to say that nothing has happen,” Dr Anthony lamented.
Moreover, the National Suicide Prevention Action Plan indicated that 63.7 per cent of suicide cases were caused by the ingestion of a pesticide or herbicide.
In addition, Dr Anthony pointed out that countries with high numbers of self-poisonings have implemented a menu of measures referred to as the Hazard Reduction Model which is emerging as one of the best practices around the world – a model which he suggests that Guyana should adopt instead of reinventing the wheel. For instance, Sri Lanka’s model, which include Legislative restriction on Highly Hazardous Pesticides (HHP) have caused a 50 per cent reduction of suicide cases in the country from 1996-2005.
Further questioning the effectiveness of the Customs Act Cap 82:01 Section 216 (a-e), dealing with the penalty for evading customs laws regarding imported or exported goods, Anthony believes that there should be discussions in this regard, while proposing that perhaps it is time for an expert panel to review the list of HHP, to ensure that it is meeting the new public health objectives of preventing suicides.
Another important intervention was highlighted as the improvement of health services in that there is need to train and equip health facilities to ensure competence in dealing with self-poisoning.
In the same breath, Dr Anthony believes that there is need to provide ongoing professional support to health personnel across Guyana to help in the management of poisoning, while suggesting that Government should move expeditiously to establish a national poison control centre which operates 24/7, to house a database with the name of all toxic chemicals, substances and medication and the recommended treatment protocols to be followed in the event that a person has been poisoned.
“As we mark another World Suicide Prevention Day, the occasion must not be used for empty rhetoric but to carefully scrutinised Government’s policy to see whether it is achieving the objectives, whether it is reaching those most susceptible to suicide, whether it has a footprint in the hot spot regions, whether the public health system has the capacity to treat cases of self-poisoning, whether it has repealed the attempted suicide law and amend other appropriate legislation, whether it has implemented a national hazard reduction model and whether it has established a national poison control centre,” he noted.
These, he added, are the yardsticks by which society should judge the Government’s prevention efforts. “Unfortunately, the Government has fallen woefully short in its effort. Let us hope that moving forward we will have less rhetoric and more tangible actions to prevent suicides”.