Towards better suicide prevention support for women

Economic hardship, unequal care responsibilities, immense stress, and job insecurity during the Covid-19 crisis are factors that can contribute to feelings of depression. Women are particularly vulnerable to these changes as they face social structures that work against them, which are further exacerbated by an unprecedented pandemic.

The increase of suicide cases, particularly among women, as seen in police data is one indicator of this problem.

Recent data on suicide cases has varied significantly from previous years – statistics show a definite rise in the number of suicides, and a higher rate of women who died of suicide. Police data from 2019 to May 2021 show more than 1,700 cases of reported suicide of which1,427 cases involved women while 281 cases involved men.

Although there has been little research done to explain these numbers that go against global trends, the Women’s Aid Organisation (WAO) acknowledges that there have been added pressures faced by women during the movement control order.

“It is increasingly difficult for Malaysians to maintain stable employment to support themselves and their families in these incredibly trying and stressful times. Unfortunately, vulnerable groups such as women with dependants or in low-income households remain some of the most affected by the pandemic,” says WAO Advocacy Officer Kiran Kaur.

More care work, high unemployment

One contributing factor is the “double burden” faced by women who juggle both care work and job insecurity.

“Before the pandemic, women in Malaysia took on three times more unpaid care work at home compared with men. This rate has only increased as women’s employment fell by five times the rate of men’s employment year on year in the second quarter of 2020,” says Kiran, citing data from an Institute Of Strategic & International Studies (Isis) report released earlier this year.

Kiran explains that due to deep-rooted gender norms in our community, the unpaid care burden has a gendered impact that disproportionately affects women.

As a result, many women are pressured to give up their careers and assume a full-time caretaker role. Single mothers often resort to asking for fewer hours at work to be able to care for dependants, although this severely impacts their ability to earn a liveable wage.

All of the above not only results in increased mental health pressure but places extreme financial stress on women, says Kiran, pointing to the recent White Flag movement as a reflection of the dire situation on the ground.

According to the Isis report on the unequal impacts of the Covid-19 crisis on Malaysian workers, not only have women in Malaysia experienced a far greater fall in employment compared with men, but women’s employment has also been much slower to recover. The study’s author, Calvin Cheng, also found that young workers have suffered large employment losses, with younger women the hardest hit and far more likely to have exited the workforce during the pandemic.

Unsafe at home

Due to MCO restrictions, more women in abusive households found themselves trapped at home with perpetrators of domestic violence.

“Being subject to heightened and continuous abuse not only compromises their safety but deteriorates their physical and mental health significantly,” says Kiran.

“Cumulatively, these factors contribute to an increase in psychological symptoms of stress, anxiety and depression. This may help explain the reported increase in suicide cases among women – the psychological effects of the pandemic clearly have a varying impact on the basis of gender,” she says.

Awareness and accessibility

To address this pressing issue, the government must improve mental health awareness and accessibility to services, says Kiran.

Information on recognising symptoms of mental illnesses and avenues for assistance needs to be widely disseminated among the public, especially during a national crisis like the pandemic.

She also calls for the setting-up of a separate public helpline specifically for mental health support which can complement pre-existing helplines like Talian Kasih, which primarily focuses on assisting victims of domestic and child abuse.

Boosting mental health response and initiatives to change societal attitudes is not only essential to improving women’s mental health but is also needed to improve the mental health of all genders, says Kiran, who explains that men are also impacted by depression, anxiety and stress in addition to the social stigma that prevents them from getting much needed assistance.

Revive the NSRM

Observing an increase of suicide risk among both men and women since the start of the pandemic, Mental Illness Awareness & Support Association (Miasa) president Anita Abu Bakar does not feel that suicide rates among women are much higher than men as there is no hard data to support this at the moment, and that numbers may be skewed by underreporting (see “Many suicide cases go unreported” above).

While raw data provided by the police can be used as an indicator, it may not accurately reflect the situation on the ground, says Anita. Nevertheless, she acknowledges that women face added pressure during lockdowns and have higher risk factors as they traditionally carry more responsibility at home in addition to work.

For a better understanding of suicide patterns and to implement suitable and comprehensive policies to address the issue, Malaysia must revive its National Suicide Registry (NSRM) which ceased collecting data in 2009, says Anita, echoing calls by other NGOs including the Human Rights Commission of Malaysia (Suhakam).

She adds that the process to restart the NSRM is currently underway and it will hopefully begin recording again soon.

Targeted strategies

The first step Malaysia must take is to decriminalise attempted suicide. Efforts have been made towards this end but progress has been slow since the Attorney General’s Chambers said it would review Section 309 of the Penal Code in December last year.

We also need to implement better suicide prevention strategies, says Anita, but the challenge the country faces is a lack of resources and funding.

“There needs to be more targeted support groups that address specific conditions for women, something we don’t have in Malaysia at the moment as current support groups are very broad-based,” she says, giving examples of targeted groups to support at-risk women such as women with postpartum depression, eating disorders and women who have experienced sexual abuse and domestic violence.

“Post-vention” treatment, or providing support for bereaved friends and family of suicide victims, is also needed as they too are a highly vulnerable group.

Fortunately, Anita says that members of the public are becoming aware of the importance of mental wellbeing and are becoming more proactive about caring, providing empathy and sharing mental health support networks among themselves.

“The rakyat are helping one another. At the very top, the government needs to prioritise because there is a parallel pandemic happening: A Covid-19 pandemic and a mental health pandemic.

“And in the end, this mental health pandemic will outlive Covid-19 if we don’t do something now,” she says.

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