Every 40 seconds, someone takes their own life. According to World Health Organization’s recent report, ‘Preventing Suicide: A Global Imperative,’ during the course of a year, the global number of suicides adds up to 800,000 people – more than the population of this country. As reported in this newspaper two days ago, Guyana – which recorded 277 suicides in 2012 (72 females, and 205 males) – currently has the world’s highest suicide rate. Two years ago, the rates, which may well have risen since then, were a staggering 70.8 suicides per 100,000 for men and 44.2 for women. Bad as they are, both figures represent a slight reduction on the rates recorded in 2000 – 72.2 and 48.3 – even though our current levels are approximately five times the global average (15.0 for males and 8.0 for females).
The WHO study points out that these stark figures are probably underreported, especially in countries where the stigma of suicide remains high – often for religious reasons. Among the welter of other statistics, three are particularly unsettling: globally, suicide has become the second leading cause of death for those between the ages of 15 and 29 years; three-quarters of the world’s suicides take place in “low- and middle-income countries”, and “there are indications that for each adult who died of suicide there may have been more than 20 others attempting suicide.”
In addition to the importance of accessible mental health care, the WHO warns against “inappropriate media reporting that sensationalizes suicide and increases the risk of ‘copycat’ suicides.” This point is especially relevant to Caribbean media, which often focuses on the most lurid aspects of domestic abuse, violent crime and suicide. In contrast, many developed countries deliberately under-report suicides to reduce this domino effect. The baleful influence of careless media coverage has been observed in many countries, and over several decades. In 1962, within a month of Marilyn Monroe’s death, the suicide rate in the United States spiked by 12 per cent. A similar increase was observed after the 1994 suicide of the rock star Kurt Cobain. Many fear that coverage of Robin Williams’ recent death may have a similar effect.
The WHO report identifies three key elements in any national strategy for suicide prevention: knowledge, political will, and a focus on social change. Currently, 28 countries have national suicide prevention strategies. These comprise surveillance – particularly the monitoring of online searches and discussions that indicate a likelihood of self-harm – means restriction (such as prevention barriers next to bridges), media guidelines, initiatives to reduce the stigma of depression and other mental health concerns, and public awareness campaigns. The best strategies adopt a “multisectoral” approach that involves the health and education sectors, welfare agencies, and elements of the justice system. Most importantly, perhaps, these strategies aim to affect the culture permanently, to alter attitudes to mental health and to ensure that people who need support and counselling can obtain them.
Given the urgency of the problem, we should all pay closer attention to vulnerable people in our midst. The isolation and depression many people feel prior to self-harm is easily noticed, and lessened, by attentive family members, friends and colleagues. We must also replace myths about suicide with accurate information, and try to grasp the medical and sociological complexity of the issue. In the US, for example, according to research published by the Centers for Disease Control and Prevention, suicide among white middle-aged American men has increased more than 50 per cent during the last decade. In fact, if this highly specific demographic were separated from the rest of the America, its suicide rate would exceed our own.
Mindful of the terrible impact each suicide has on the families and communities in which it occurs, we must all acknowledge that it up to us to reduce the stigma around mental illness, and to do our best, collectively, to overcome the medical, social and economic challenges that have produced our current, appalling suicide rate. Ambitious strategies, such as those required for suicide prevention, can only succeed when they are sustained by our political will and cultural support. Governments may coordinate suicide prevention programmes, but the wider responsibility falls on all of us. At the end of the day, as John Donne’s unforgettable meditation reminds us, “Any man’s death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; It tolls for thee.”
