For five years Trevette (not her real name) struggled with thoughts of suicide, while locked away in her bedroom for most of the afternoons and nights of her teenage life.
“There was no one I could turn to… Every night I would try to overdose on alcohol and painkillers or whatever tablets were at hand. I thought if only they knew how much I was hurting they would love me more. But I continued to be the bane of their existence,” Trevette said, recalling the years she battled with her fear of failure and an insatiable urge to be perfect.
According to the World Health Organisation (WHO) Report “Preventing suicide: a global imperative,” over 800,000 persons die from suicide globally each year – one death in every 40 seconds. Some of the warnings signs suicidal persons express are communicated thoughts of suicide, increased use of alcohol or drugs, withdrawal and recklessness. The study showed that suicide occurs during moments of depression, financial problems, relationship break-ups and chronic illness and isolation.
Twenty-year-old Trevette said she lived in a household where everything had to be perfect. With both parents having white collar jobs and her siblings studying overseas, Trevette felt like the delinquent who was failing at school. “I felt like I couldn’t amount to anything in their eyes. Everything I did was never good enough… I was the wild child who did everything wrong and soon I started feeling like a burden,” she said.
At 18, she ran away from home, hoping to make something of herself and eventually please her family. “I remember getting my first real job. I called my dad and told him, hoping that he would be proud of me but he beat down instead. I was told that I would never get a good paying job with my grades…I was never encouraged. And the more I thought about it I blamed myself because I made things worse when I ran away.”
Even though she worked hard at being “perfect,” she said she never felt accepted by her parents, siblings and friends. And soon, the anger seeped in and she hated everyone, including herself. “I was angry with everyone. I felt like they loved my other siblings more. I felt like they never cared enough to see that I was hurting and alone. Most of my afternoons were spent in my room… I used to cut my legs just to ease to the pain. Then the thoughts of killing myself would come back and I would tell myself that if I did it, it would fix everything. Everyone would be happy and I wouldn’t have to be like this anymore.”
Religious beliefs
However, Trevette was one of those persons who sought help. She spoke to a pastor’s wife about her feelings and the urge she was struggling with. “I started dealing with it, when I started talking about it. I spoke to my pastor’s wife and she told me that God is there for me and that I didn’t need to be perfect…that I don’t have to get the best job or the highest grades to be accepted,” she said.
“She said perfect is God’s job. But the thing I kept remembering about her is that she had this calm assurance that things will work out for me,” she recollected, saying that it was then she started to accept who she was.
Trevette stopped attempting suicide when she held on to a religious belief system. According to WHO, strong personal relationships, religious and spiritual beliefs, and lifestyle practice of positive coping strategies are protective factors that guard against suicide. It stated that while many involvements are geared towards the reduction of risk factors in suicide prevention, it is equally important to strengthen factors that have been shown to increase resilience against suicide.
However, WHO said when considering religious or spiritual beliefs as protection against suicide, it is important to be cautious, stating that many religious and cultural beliefs and behaviours may have also contributed toward suicide stigma. It stated that some moral stances on suicide can discourage help-seeking behaviours but the protective significance of religion and spirituality may arise from providing contact to a socially cohesive and supportive community with a shared set of values.
The risk of suicidal behaviour is increased when people suffer from relationship conflict, loss or discord and as such the maintenance of healthy relationships can fight against suicide.
“If someone in that place, I would say find a friend…someone you could talk with. It is important to surround yourself with positive people. Most of the time people talk about suicide as though it is some nasty secret that’s not supposed to be shared, but if we don’t talk we won’t get help,” Trevette stated, encouraging people who are struggling with suicidal thoughts “not to count your mistakes or the bad that has happened because one day it will all blow over.
“We can’t control what happens to us in life but we can control how we respond. We need to know that there is always a tomorrow…and that tomorrow might be the turnaround…”
What needs to be done?
Suicide is the second leading cause of death among 15–29-year-olds. Seventy-five per cent of global suicides occur in low and middle-income countries, with suicide rates high amongst vulnerable groups, experiencing discrimination— such as refugees and migrants; indigenous peoples; lesbian, gay, bisexual, transgender, and prisoners.
Guyana was estimated as having the highest suicide rate in world in 2012 with an overall rate of 44.2 cases per 100,000 individuals. Guyana’s ranking comes even though there was an 8.5% decline in the country’s suicide rate between 2000 and 2012, suggesting that local efforts to combat suicide have simply not kept up with that of other countries.
Managing Director of the Guyana Foundation Anthony Autar said in an interview with Stabroek News, that there is a need for suicide to be tackled through a multi-sectoral approach. He said suicide was not only a Ministry of Health or a non-governmental organisation issue, but should also concern the ministries of Education, Labour and Legal Affairs, the media and politicians. He said it was imperative that the assessment and management of mental disorders, especially depression, be improved, and also that Guyana develop a suicide hotline so that people who are battling with suicidal behaviours can have someone to talk to. He said the country is already struggling with far too few psychologists and mental health counsellors and a suicide hotline could be a mechanism that would turn people from suicide. He said it was something the government needed to urgently address since a hotline could prevent individuals from following through with suicide.
He said Guyana’s ranking on suicide was troubling. “The way we view the situation is human resources are the most valuable in this country and every act of suicide is an irreplaceable loss that we can never get back and we hope that all stakeholders would wake up and see this. Suicide prevention requires coordinated collaboration among multiple sectors…”
He said there is a lot of noise being made about issues “…but we don’t hear anything about suicide. There is not a lot of effort placed into preventing suicide,” Autar said, noting that there was a lot of talk about suicide walks and strategies being developed but “we are not seeing anything done urgently.”
Autar, nonetheless, commended the Ministry of Agriculture for implementing activities to reduce the availability of pesticides. However, he made another call to have the mental health law revised. He said suicide being outlawed has attracted stigma and has caused people who have attempted suicide to be fearful of speaking out because they are afraid of being charged.
“People knows that it is criminal and if they try to kill themselves and it doesn’t work then they could end up facing charges…if they think it is a criminal act after they attempted it they wouldn’t to seek help and this is what drives the stigma, the silence and the shame…it should be taken off the books,” he said.
He said the Guyana Foundation was working to create awareness on the risk factors of suicide and also to fight against the stigma attached to it. “We realized that we couldn’t jump into this issue just like that without understanding the underlying factors that are driving people to commit suicide. So we wanted to find out the socio-economic factors driving people to commit suicide,’ he said, adding that they were seeking to bring awareness to media about reporting suicide.
“The media should also know its role in reporting suicide. They can help to prevent copycat cases or they can encourage it by giving too many details,” he explained.
Attempted suicide
The WHO said that for every suicide there are many more people who attempted it every year. “By far the strongest risk factor for suicide is a previous suicide attempt,” the WHO study said.
Autar said Guyana has a lot of unreported cases of suicide and attempted suicide because families are ashamed of it and would choose to remain silent. He said, anecdotally, Black Bush Polder, Region Six, has the highest rate of suicide and suicide attempts. “People are very concerned about stigma…while people who attempt suicide sometimes can use it as a cry for help, there are other ways that they can reach out to people,’ he said, urging people who have suicidal thoughts not to make their cry for help a suicide attempt because “they never know how much is too much,”
WHO said it is a myth that someone who is suicidal is determined to die, stating that on the contrary suicidal people often are uncertain about living or dying. It stated that the suicidal acts are sometimes impulsive. However, a prior suicide attempt is also the single most important predictor of death by suicide in the general population.
“Individuals who have made prior suicide attempts are at much higher risk of dying by suicide than individuals who have not made prior suicide attempts. Identifying these high-risk individuals and providing them with follow-up care and support should be a key component of all comprehensive suicide prevention strategies,” WHO study said.
Seventeen year-old Khavita Rambajue was one individual who said she would do it again if she survived. Rambajue of Suddie, Essequibo Coast died on December 5, 2013 at a hospital after ingesting poison.
Rambajue, a former student of the Anna Regina Secondary School, reportedly drank the substance on November 25 and had been a patient at the Suddie Public Hospital. Her father, Ramsahoye Rambajue, a prosecutor at the Georgetown Magistrates’ Courts, told this newspaper that his daughter was at home alone when she ingested the substance. “When I came home from Anna Regina, the house was locked up so I called for her since she was upstairs and then she told me that she wasn’t feeling well. She also said that she had drunk something.”
The policeman said the doctors told him that it was “luck and chance” that she would survive more than three days. He said during those few days he never brought up the topic but was told that she said if she survived she would do it again.
“I never brought it up because I was seeing she was getting better. I remember she would message me every night from the hospital and tell me what to bring for the next day,” he recalled.
However, he said on the third night no text message came. “I felt she was leaving me and it was true because when I got there at the hospital the doctors told me she passed away.”
Rambajue said every time he opens a newspaper and reads about someone committing suicide it brings back the pain he felt when the doctors had to pump the poison out of his daughter’s system.
“I still miss her and I try my utmost best to cope with the situation but sometimes the memories come back and all I see is her face,” he lamented.
He stated that his daughter became depressed after she was unable to get into the University of Guyana and her mother told her that she could not live in Georgetown. “She went too late to carry in her documents,” he said. ‘She wanted to be a doctor.”
Khavita Rambajue would have turned 18 a week ago.
“When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace,” said Clinical psychologist Kay Redfield Jamison in her book Night Falls Fast: Understanding Suicide. Jamison said there was a need to understand suicide in order to dispel the shame and silence, and to recognise persons at risk.
“Suicide is not a blot on anyone’s name; it is a tragedy,” she wrote. Jamison is a part of the expert team of the Johns Hopkins medical institution.
