Suicide in Sri Lanka | Daily News

Suicide in Sri Lanka

Myths and Misconceptions

It’s a widely-held belief that Sri Lanka has one of the highest rates of suicide in the world: the World Health Organization (WHO) actually ranks Sri Lanka’s suicide rate as the highest.

But researchers who study suicide say there’s a big catch: the data is wrong.

“It’s disregarding that there’s actually been a drop in Sri Lanka’s suicide rates and that’s a problem,” said Dr. Dee Knipe, a professor at the University of Bristol, speaking in Colombo last week.

To standardize and compare data from around the world, the WHO uses mortality data and puts it into a model. But Sri Lanka last submitted data to the WHO in 2006. The organization’s current numbers are projections based on that past submission.

More local data tells a different story. Numbers compiled annually by the Sri Lanka Police’s Division of Statistics show that the suicide rate has actually fallen by 70 percent since the mid-1990s.

That would put Sri Lanka’s suicide rate closer to the 22nd highest in the world, rather than the first.

Instead of a global tragedy, Dr. Knipe believes Sri Lanka should be held up as an example of suicide prevention.

“I don’t understand, we should be shouting about this,” she said. The story of how those rates fell–and what she estimates amounts to 93,000 lives saved–is one of diligent public policy. But there’s much more work to be done.

Pesticide bans


Dr. Dee Knipe

Sri Lanka’s suicide deaths stood at an all-time high in 1995, according to police records, with a rate of 57 per 100,000 people.

They started rising in the 1960s and 1970s and academics and health advocates at the time pointed to the introduction of highly hazardous pesticides as the culprit.

That’s because attempting suicide by pesticide poisoning, which was very available in largely agricultural Sri Lanka, was more likely to result in fatality.

“What we know is that people who experience a certain level of distress might engage of impulsive acts of self-harm with low suicidal intent,” Knipe said, “They would use the thing that’s most readily available–and often that’s self-poisoning.”

The Registrar of Pesticides initially banned the toxic chemicals parathion and methyl parathion in 1984. The move quickly slowed the exponential growth of suicide deaths, police records show.

That initial ban was followed by bans of five more highly toxic pesticides in 1995 and another in 1998. Three more pesticides, dimethoate, fenthion, and paraquat, were banned between 2008 and 2011.

“Sri Lanka’s pesticide regulations appear to have contributed to one of the greatest decreases in suicide rate ever seen,” Knipe said. “We are a leading example of how a public policy can really have an impact on saving lives”

Knipe warns, though, that the work is far from over.

“We haven’t really dealt with the causes (of suicide), the distress and underlying issues,” she said, “But basically, more people are at least surviving their attempts.”

Seeking help

People going through psychological distress often feel completely alone. But mental health advocates urge people to pick up the phone and ask for help. One of the most visible help-lines in Sri Lanka is Sumithrayo. The organization was founded over 40 years ago and offers free over the phone, face-to-face, and online counselling.

A Sumithrayo spokesperson said that their office usually receives 20 to 25 requests for help a day. Help line volunteers remain anonymous, which they say lowers the mental barrier to calling for help, and protects client confidentiality.

“Our main objective is suicide prevention, but we also look at alleviating any other kind of pain they’re going through,” the spokeswoman said. “It’s a process of unburdening, helping them to cope with those feelings…after they’re comfortable we talk about what they can do to help themselves and empower them to cope with their situations.”

“Talking helps,” she said, “To reach out, and to talk about it before they act on their feelings.”

But rather than only helping individuals struggling with suicidal thoughts, psychologists say they are also fighting another battle: against the culture at large.

“People think that talking about suicide is attention-seeking, but suicide is most often a cry for help,” said Nivendra Uduman, a private practice counseling psychologist who has also worked with King’s College London Resource Centre for Trauma, Displacement and Mental Health in Colombo.

Uduman said the stigma around suicide in Sri Lanka keeps many from talking about the pain they’re going through, as they feel shame or fear they won’t be taken seriously.

“Suicide can be very impulsive, it can be used as a way of communicating something to another person that they find difficult to communicate,” he said.

Apart from his work as a therapist, Uduman also leads trainings for the general public to identify risk factors and warning signs of suicide.

Mental illnesses

Some people turn to suicide because they are struggling with mental illness, he said. Symptoms of depression and warning signs of suicide can include “changes in sleep or appetite, lack of interest in daily activities, fluctuations in mood, substance abuse, talking about killing themselves and giving away possessions,” Uduman said.

“But attempting suicide is not always a sign of mental illness, that’s a misconception,” he said. “Most people in their lifetime may have thought about suicide–that doesn’t mean they have a mental illness.”

Big life changes–like an ended relationship, or debt–can lead people to impulsive, suicidal behaviour. Uduman hopes people can start speaking about suicide more openly, without judgment, with their friends and family.

“Research has shown that talking about suicide will give people the environment and permission to start talking about how they feel,” he said.

Uduman warned that Sri Lanka needs to bolster its mental health system to meet the need. “Services are mostly available in Colombo, and outside Colombo it’s much harder to find help,” he said.

Most general hospitals around the island have mental health units, but proper staffing remains a problem. Sri Lanka only has between 30 and 40 registered psychologists, according to Dr. Shamala Kumar, the current head of the Sri Lanka Psychology Association.

There needs to be more psychological support to help people struggling with suicidal thoughts, Uduman said. Until then, people should actively pursue the available treatment.

Because making that call, asking a person how they are feeling, and connecting them to professional help can mean the difference between life and death.

“Most people don’t want to die,” he said, “They just don’t want to live the life they have.”

This article discusses the topic of suicide. If you feel you are in crisis, or you believe somebody you know may be contemplating suicide, please talk to

Sumithrayo (011 269 6666) or the CCC Line (1333).


Suicide rate graph


 

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