Suicide prevention: strategies that work

Over the weekend, the public was privy to a startling piece of information concerning a very sensitive topic – suicide. It was reported that over a period of two years, some 56 persons from Essequibo committed suicide. This is according to statistics from the Suddie Public Hospital statistical department in Region Two (Pomeroon-Supenaam). Sadly, immediately following the release of these statistics, another young person from that very area, barely a teenager, tragically ended her life, becoming the country’s latest suicide victim.
Further analysis of the figures emanating from Essequibo show that suicide claimed 27 lives in 2015, and 29 in 2016, with 143 attempted cases in 2015 and 130 attempted cases in 2016. Hospital records also indicated that the most prevalent method used was the consumption of poisonous substances and that most cases were as a result of domestic and/or abusive relationships. These glaring numbers, according to experts, point to the need for more mental health workshops, counselling centres and the active involvement of the Private Sector in curbing the worrying issue of suicide in this particular area.
However, as the public is well aware, the issue has affected other areas in other regions across Guyana. And while there has been support in the past from religious organisations, Government agencies and non-governmental organistions (NGO), there has been no tangible proof that these intervention methods have been successful or have made much of an impact. In fact, officials believe that even counselling has proven ineffective, to some extent, in slowing the rate of suicide. This dire situation has prompted the call for an in-depth analysis of suicide and intensified guidance, along with community and family support.
It is no secret that Guyana has an unusually high rate of suicide, in fact, according to the World Health Organisation, the country’s suicide rate stood at 44.2 deaths per 100,000 in 2014. This rate, according to the WHO, is way above the global average of 11.4 per 100,000 and the average rate in Latin America and the Caribbean of 6.1 deaths per 100,000.
In 2009, the Health Ministry in collaboration with the Pan American Health Organisation (PAHO) hosted a two-day workshop on the “Prevention and Control of Suicide Behaviour” in Georgetown. It included individuals from Trinidad, Guyana and Suriname that were working on the problem in their countries, which had similar demographics. The then Health Minister, Dr Leslie Ramsammy pointed out that even though suicide was accepted as an urgent public health issue in the mental health area, there was no significant budgetary support both domestically and from the international agencies such as PAHO. He pointed out in the past, there had been “a string of workshops” and the time had come for less talk and more action towards a solution.
After his prompting, for the first time, a programme that involved the community – the “Gatekeepers Programme” – was launched. The Gatekeepers Programme broadened the suicide prevention effort beyond the counselling centres which presumed the potential victim would reach out and seek help. Individuals in the community were to be trained by qualified Health Ministry personnel as “gatekeepers” who could recognise signs of individuals contemplating ending their lives. The “Gatekeepers” would be known in the community. As was highlighted in a previous editorial on this issue, studies have shown that once potential suicide victims have been dissuaded from the act, most of them do not attempt to repeat it. The “secret” of dealing with suicidal behaviour then, is to have the institutional capacity to counsel those that may be contemplating taking their lives. Statistics in the immediate years following the introduction of the programme suggest that they may be having a helpful effect.
Quite recently, Government received heavy criticism from several stakeholders including The Caribbean Voice which has always called for the re-implementation of the Gatekeepers Programme. The organisation in a recent statement pointed out that of the programmes introduced to deal with suicide; this initiative holds the greatest potential for reducing the incidence of suicide.
Added to this, they emphasised too that the Government needs to intensify its efforts to ensure that existing laws and regulations regarding pesticide sale, use and storage, are being enforced, and are part of a concerted pesticide suicide prevention strategy, such as the Shri Lankan Hazard Reduction Model, which has been lobbied for by The Caribbean Voice since 2015, and which is, by far, the most successful pesticide suicide reduction plan ever. The model relating to agro-chemicals has proven to be highly successful in reducing suicide in that nation. In fact, the total number of suicides in Sri Lanka fell by 50 per cent from 1996-2005 compared to 1986-1995 – a reduction of approximately 19,800 suicides, after this model was introduced. It would therefore be logical for the Government to implement a suicide reduction model which has proven to be successful, particularly in light if the fact that the vast majority of suicides in Guyana result from ingestion of agro-chemicals.