Public heath concern: Suicide thoughts were highest amongst 13-years old students in Malaysia even before the pandemic. – 123rf.com
SEPTEMBER 10 was World Suicide Prevention Day (WSPD). Established in 2003 by the International Association of Suicide Prevention (IASP) and World Health Organisation (WHO), the day seeks to reduce stigma and raise awareness that suicide is preventable. The current theme of “Creating Hope Through Action” from 2021-2023 reminds us that individual and collective action can generate hope for those in emotional duress – and save lives.
Lives lost too early
There is one person dying from suicide every 40 seconds in the world. 700,000 people die from suicide and many more attempt to take their own life every year. Suicide is the fourth leading cause of death for 15-19 years old, while majority of cases are in low-and-middle income countries (WHO, 2021). This is a major public health concern as more people die from suicide than armed conflict in the world.
Malaysia recorded over 1,700 suicide deaths from 2019 to mid-2021, which is an average of two deaths per day. There is an increase in suicide cases, specifically for young people.
Around 51% of suicide cases comprised children 16-18-years old (PDRM, 2021). This is not surprising as suicide thoughts were highest amongst 13-years old students even before the pandemic (National Health & Morbidity Study, 2017).
The pandemic has aggravated mental health and suicide risks across age groups. Recent media reports show men aged 19-40 years-old form the majority of suicide attempts, with an overall increase among younger and older groups. All deaths from suicide are lives lost too early.
In line with this year’s WSDP theme, what action can we take as a community to create hope and save lives? Let us explore how to overcome the major barriers – stigma, avoidance and accessibility – preventing help seeking.
Breaking the stigma
The stigma surrounding suicide and mental health in society is a major barrier against reaching out for help. Suicide remains a taboo topic, while those struggling feel cornered due to widespread myths about being “attention seeking”, “cowardly” or “selfish”. Such biases from near and loved ones for many to suffer in silence due to shame, guilt and fear, which increases suicide risks further.
Malaysia has undoubtedly come a long way to address mental health and suicide risks since the pandemic. There have been growing conversations about mental health literacy, while long overdue steps have been taken for decriminalising suicide attempts. We must build on the progress so far to continue public-private-community collaboration to make mental health more accessible for all.
Normalising conversations
Another major barrier hindering suicide prevention is avoidance on conversations about suicide by near and loved ones. Family members, friends and colleagues often find it confronting to talk about suicide with those struggling around them, which is often based on a fear the conversations may encourage suicidal behaviour. This is a myth because talking about suicide can help someone in emotional distress to cope with their underlying pain, gain different perspectives, and feel acknowledged, loved and encouraged to live.
If we want to help those wanting to end their life, there is no alternative but to normalise conversations about suicide and mental health at the individual level. We must build our own mental health literacy to help those struggling in a sensitive and informed way, including empathetic listening, sharing resources and encouraging help seeking. More conversations about suicide with close ones will enable those in pain to reach out for help earlier.
Accessing help
The lack of affordable mental health services is another major hurdle preventing help seeking for those struggling with suicidal thoughts. In many cases, professional help remains out of reach for even those who have been able to overcome the stigma and reach out for support. The mental health gap paradoxically prevents help seeking by those who need it most, including economically disadvantaged and refugee groups.
Malaysia is one of the most philanthropic nations in the world, which was evident from community responses in providing food relief and financial support for those in need during the pandemic. Mental health is also a fundamental human right that needs to be priorities in humanitarian responses after a crisis. We need to provide a variety of triaged-based interventions, including accessible early responses like Psychological First Aid (PFA) before mental health stressors escalate to suicidal tendencies.
Best practices
As we emerge from the pandemic to the “new normal”, public-private-community collaboration is imperative to expand and replicate existing initiatives to help reduce suicide risks in society. We need more research and collaboration to identify best practices and synergy between different organisations.
Some example of community initiatives include Thrive Well offering subsidised short-term mental health services for disadvantaged groups under the Jom Sembang project, the National Coalition for Mental Wellbeing running a PFA program linking flood victims with resources, including professional help; Emmanuel Community Care conducting suicide prevention training for community members; and, Humankind’s Buddy Bear providing a helpline for children to share their worries.
Way forward
We have seen widespread shock and alarm in society after recent suicide cases in shopping malls, apartment blocks and bridges. This is a wakeup call as many more cases are likely to remain unreported. We need concerted action by public-private-community groups to support those struggling with suicidal thoughts around us.
We will be “Creating Hope Through Action” if we can individually and collectively break the stigma, normalise conversation and make mental health services more accessible. These steps will help us build a kinder and more compassionate society so that those struggling around us do not need to suffer in silence anymore. All lives lost through suicide are not only lives lost too early, but preventable and avoidable.
Arman I Rashid, PhD is a mental health counsellor, trainer and researcher. He is co-founder of the Empowerment Group, a partnership between mental health practitioners in Malaysia, Australia, Singapore and Indonesia.
Those in need of help and counselling can reach out to: Mental Health Psychosocial Support Service (03-2935 9935 or 014-322 3392); Talian Kasih (15999 or WhatsApp 019-2615 999); Jakim’s Family, Social and Community Care Centre (WhatsApp 0111-9598 214); and Befrienders Kuala Lumpur (03-7627 2929) or visit www.befrienders.org.my/centre-in-malaysia for a full list of numbers and operating hours. For subsidised mental health care, contact Emmanuel Community Care (011-58614681).
