Dear Editor,
The Caribbean Voice wonders why Ms Annie Baliram (‘A significant decline in the suicide rate is not possible’ SN, August 21) is casting doubt on the 2015 suicide rate for Guyana, which shows a reduction from 44.2 to 30.6 per 1000,000, and not all or any other previous rates. After all it is the same global organization, WHO, that has been putting out these rates annually using the same yardsticks, processes and methodologies et al. According to Ms Baliram, “a significant reduction in suicide can come about only by addressing the abnormally high levels of stress arising out of the social, economic and political conditions. Stress mechanistically drives suicide directly or indirectly.”
This limited characterization by Ms Baliram runs counter to the complete picture which, in the context of Guyana, indicates the following: With a proneness to copycat, a practice referred to as the Werther Effect, suicide ideation is the result of depression and/or anxiety triggered by helplessness, hopelessness, powerlessness and loneliness. These triggers are catalyzed by low levels of self-acceptance and/or feelings of inadequacy/low self esteem, as a result of abusive and dysfunctional relationships; lack of empathetic communication, teenage affairs and pregnancy; rape and incest; an inability to deal with problems (lack of coping skills) and/or unbearable pain – physical or emotional – poverty, unemployment and substance abuse (and to a significantly lesser degree psychosis such as bipolar disorder and some other mental illnesses).
Ms Baliram also stated, “a robust reduction in the suicide rate can come about only by eliminating the primary triggers of suicide, together with making available meaningful therapeutic interventions (counselling, community support, reducing access to pesticides, etc).” Actually, if the triggers are eliminated then so is suicide, an ideal to which all prevention organizations and activists aspire.
Meanwhile, if Ms Baliram had taken the time to get the facts, rather than merely speculate, she would have learnt about the work done by NGOs like The Caribbean Voice (in August alone, three mental health outreaches and three workshops in three different regions, costing over $150,000; two feature articles and six letters in the local media based on researched data; suicide prevention messages daily on radio and TV in all three counties; extensive ‒ tens of thousands of views and thousands of interactions ‒ social media information dissemination and advocacy; twelve counselling cases handled; and a number of meetings to explore collaboration and plan upcoming activism), Monique’s Helping Hands, Guyana Foundation, the Mibicuri Community Developers, the Counselling Centre at Corriverton established by ex-magistrate, Krisndat Persaud, the St Francis Community Developers, Prevention of Teen Suicide (POTS), Help & Shelter, Red Thread, Crossroads Counselling & Mental Health Services and a host of others who give their time, efforts, skills and resources, many on a voluntary and all on an ongoing basis, to address all the triggers, their causes and results, suicide ideation and suicide.
The work of these suicide prevention entities is holistic, comprising counselling and follow-up, training of first responders and gatekeepers (to foster community support through proactive interventions and follow-up), information dissemination and awareness building (including safe use and storage of pesticides), advocacy and lobbying (that led to the establishment of the suicide helpline and that is focusing on a range of other measures, including counsellors in schools), a lot of it through stakeholders’ collaboration. In effect, interventions are neither a “band aid” approach nor are they “marginal” and certainly do not result in merely “transient gains”.
As well, tens of thousands of counselling sessions have been done over the years with no suicide relapse recorded, although there has been some resistance to counselling because of the stigma and misconceptions attached. Furthermore, some NGOs and various government ministries and agencies also focus directly on skills building such as self-esteem, coping strategies, job training, relationship needs, or indirectly by collaboration with entities that offer such skills building – various ministries, the police force, the First Lady’s office, businesses and other stakeholders.
While we agree that a lot more needs to be done, we are confident that, in total, the impact of the work of these NGOs and activists, combined with the incremental work done by government, especially the Ministry of Indigenous Affairs in the hinterland areas and the Ministry of Health through the mhGAP training and other measures, would certainly justify the suicide rate reduction from 44.2 to 30.6 per 100,000. Besides, both a content analysis of the media and empirical and anecdotal data garnered by The Caribbean Voice and other stakeholders do actually support this level of reduction.
The Caribbean Voice does agree with Ms Baliram that genetics has a role in suicide. However, that is still to be clearly defined. Besides, there are differences regarding this in the scientific world with some dubbing it a controversial issue, stating that because of the complexity of suicide, more studies, data and replication are needed.
In effect, the tests to identify potential risks in order to develop treatment modalities are still a long way off, and thus cannot impact suicide prevention anywhere in the world any time soon.
Meanwhile we are happy that Ms Baliram has taken such a keen interest in suicide prevention in Guyana. Now The Caribbean Voice invites her to walk with us on this journey to save lives and empower people so her passion can take concrete manifestation and so that she would become aware of the reality on the ground and not ignore, disregard and/or negate the tremendous work of suicide prevention organizations and activists, which will not only continue but expand in time.
Yours faithfully,
Annan Boodram
The Caribbean Voice
