Suicide prevention: How recognising the warning signs can save lives

Guwahati, Sept 10: Imagine, we are trying to understand whether the number of Elephants in Kaziranga is growing or reducing. We can take help from some observers, do some calculations, and may have 'one' answer for it. But imagine we are trying to understand why the numbers of Elephants in Kaziranga are reducing, we will surely not have one answer for it! The reason why the number is reducing may include elephants leaving their territory at their will, elephants being chased away by other animals there, human-elephant conflict, the climate becoming unfavourable for them in Kaziranga and like that there can be infinite explanations.

Similarly, if you are looking for a 'yes or no' answer to whether many young people die by suicide, the answer is 'yes'. Undeniably, a surprising number of young people are indeed ending their lives by suicide. But when the question is why they are doing so, there is never one single answer for it. The answers to 'why' may start from rather simple responses like having mental illness to a range of inter-related and more complicated issues like violence, homophobia, bullying, ragging, terrorism, political violence, state of unemployment in country and so on. So, the backdrop of suicide is complex and multifaceted. We will only get in an incomplete picture if we try to explain a phenomenon like suicide with one or two causes. To make sense of suicide, we need to broaden the horizon of understanding. We need to borrow lenses from psychologists, sociologists, economists, historians, activists, literalists, statisticians, & other disciplines. A sole psychological explanation of suicide would not only be insufficient but 'unjust'.

When we know that the phenomenon is so complicated, naturally the question arises 'Can we really do anything about it then?'. Answer is 'yes'. We can take some actions to lessen the pain and despair. Suicide often looks like a window to the distressed person to step away from unbearable pain and despair. So, we can do something at our individual level or as a community to reduce the pain and despair for the other person. In fact, the World Health Organisation (WHO) has laid out a triennial (2021-2023) theme of 'Creating hope through action' for World Suicide Prevention Day to build awareness among masses about aspects of suicide, a global public health crisis.

Not knowing 'when to help' and 'whom to help' are often one of the roadblocks in reaching out. National Institute of Mental Health (NIMH, USA) has indicated some warning signs of suicide in guiding us whom to help. It includes,

● Wish to die

● Excessive guilt

● Feeling of being a burden to others

● Feelings of hopelessness, emptiness, not finding meaning to continue with life

● Increased sadness, visible anxiety features, signs of behavioural restlessness, anger

● Change in usual behaviour pattern such as, isolating from friends, sending goodbyes, searching for ways to die, self-destructive behaviour, change in sleeping & appetite patterns

Once we know someone is in pain, it may lead to states of ambivalence within us about what to do, what not to do, what to say, what not to say or whom to reach out? It surely is an uncharted territory to venture in; especially when it involves dealing with the apprehension of losing a loved one. Frankly, there is no prescribed elixir to initiate this 'difficult conversation'; what matters here most is the intention of listening, asking sensitively & holding the space with care and compassion. Here are some ideas of certain thing we can do at our individual level:

● Checking up frequently with the person with gentleness

● Creating a safe space where the person feels understood, valued, supported, and validated

● Listening to their stories with curiosity

● Asking the individual, simple questions like, 'How do you want me to help you?'

● Getting acquainted about local or available resources of professional help

There are certain things we should avoid doing:

● Not trivialising/ comparing their experiences with us or anyone else

● Resisting from giving quick suggestions and solution

● Not enforcing support by pushing someone to disclose their experience or into professional help

● Not falling into trap of believing in discourses like 'who think about ending their life are weak or failure'

Apart from the actions at individual level, schools, colleges, universities, workplaces, or communities can also take up actions to prevent the pain and despair. They can create spaces for discussions and gatherings to facilitate peer relations, awareness programmes, enhancing resilience, group cohesiveness & building a network of safe spaces. Such activities may foster an environment of empathy, compassion & connectedness.

The role of psychologists and other mental health professionals begin when a person reaches the hospital; but the role of parents, friends, teachers, community members, colleagues and others start much early. As a community we need to go beyond the single stories of suicide and suicide prevention. We should prevent the pain and despair that pushes one to suicide rather than preventing suicide. Now is the time when we take a pause, reflect, realign ourselves and take a pledge to keep ourselves open to hear stories of persons in pain. It is not going to be easy for us to listen without judgements, just like it is difficult to share such stories of pain. Every individual who thought of ending their life has at least one story to share. Are we ready to listen?

About the authors

Pramita Sengupta is a PhD Scholar in Clinical Psychology and a researcher in the area of depression. She is also a Clinical Psychologist working with adults & adolescents. Her psychotherapy practice is largely informed by Compassion Focused Therapy & eclectic approach.

Tama Dey is a PhD Scholar in Clinical Psychology and a qualitative researcher in the area of youth suicide. She is also a psychotherapist working with children and adults primarily taking a Narrative Therapeutic Approach.