Suicide remains a Public Health Issue

September is “Education Month” but with the 10th of the month designated as “World Suicide Prevention Day” we should continue educating ourselves about this unfortunate phenomenon which in 2012 caused Guyana to be labelled “suicide capital of the world”. This dubious distinction was not due to the infamous Jonestown mass suicide in that consumed the lives of over 909 persons, but to numbers compiled by the World Health Organisation. While there were some questions about those numbers which did come down from the 44/100,000 the following year to be in line with previous years, a figure in the high 30s per 100,000 keeps Guyana near the top of the charts, which is totally unacceptable.
Suicide became a noticeable issue from the beginning of Indian Indentureship when the rate of suicide rose from approximately 6/100,000 in the North India districts from which they were brought, by a factor of one hundred times. While suicide is an observed phenomenon in all social groups, in Guyana Indian Guyanese remain the main victims, with their rates almost 10 times the next closest ethnic group. This was confirmed in a 1999 study by Centre for Economic and Social Research for Action (CESRA). In 2001 the Ministry of Health declared suicide as a Public Health issue and launched several initiatives within a “National Suicide Prevention Strategy” to deal with it. The then Minister of Health Leslie Ramsammy indicated that the programme would be coordinated by the Ministry of Health, would involve the Ministry of Labour, Human Services and Social Security, the Education Ministry and the Ministry of Culture, Youth and Sports.
In 2009 a very grassroot-oriented “Gateskeeper Programme” was launched to train individuals in communities to be aware of signs of suicide risks and to make interventions with the aim of directing the identified persons to professionals. He also mentioned that UG had introduced a three-year Master’s Programme in Mental Health, to produce specialists for treating mental illness, of which suicide is deemed a subset. Since then, there have been other interventions but the suicide rate rose inexorably to the 2012 high from where it has not budged significantly.
In 2012, the WHO had issued a desiderata as to what ought to be done by the authorities which bears repetition: “We need to (1) continue to research suicide and non-fatal suicidal behaviour, addressing both risk and protective factors; (2) develop and implement awareness campaigns, with the aim of increasing awareness of suicidal behaviours in the community, incorporating evidence on both risk and protective factors (3) target our efforts not only to reduce risk factors but also to strengthen protective factor, especially in childhood and adolescence; (4) train health care professionals to better understand evidence-based risk and protective factors associated with suicidal behaviour (5) combine primary, secondary and tertiary prevention (6) increase use of and adherence to treatments shown to be effective in treating diverse conditions; and to prioritise research into effectiveness of treatments aimed at reducing self-harm and suicide risk (7) increase the availability of mental health resources and to reduce barriers to accessing care (8) disseminate research evidence about suicide prevention to policy makers at international, national and local levels (9) reduce stigma and promote mental health literacy among the general population and health care professionals (10) reach people who don’t seek help, and hence don’t receive treatment when they are in need of it (11) ensure sustained funding for suicide research and prevention (12) influence governments to develop suicide prevention strategies for all countries and to support the implementation of those strategies that have been demonstrated to save lives.”
While we are battling the throes of the COVID 19 pandemic, which have stretched our human and materiel resources, we cannot afford to let up on the fight against suicide. If for nothing else than the fact that the pandemic has forced the populace into isolation which can induce depression in general, but can prove fatal to suicide-prone individuals. This year’s theme is “Creating Hope Through Action” and we must act.