Ranked in the top ten globally, Guyana’s suicide rate is said to have been consistently occupying that position, with pesticide poisoning being the method used by persons whose suicide is described as having been triggered primarily by interpersonal conflict.
These findings are according to a case study titled “Pesticides and passion: a qualitative psychological autopsy study of suicide in Guyana,” which underscored that prevention should include mental health and suicide literacy training of medical professionals.
The study was carried out by the Lancet Regional Health body of the Americas which said that the aim is to better understand the psychosocial circumstances and characteristics of suicides in Guyana.
According to the report published yesterday by the journal, Lancet, while Guyana is numbered among the top ten countries plagued by this scourge, there remains limited literature related to the context in which these suicides occur here.
As a result, it said that little is known about the circumstances, meaning, and motives of suicide in the country.
“Understanding the history and context of the people who have died by suicide is important for the advancement of suicide prevention efforts,” the research body said.
Utilizing what it described as four superordinate themes in its findings, the study said that what was illustrated were the complexities of suicide in Guyana and the importance of adopting a biopsychosocial perspective to prevention.
The four themes identified in the study were Interpersonal Conflict, Trauma, Health, and Unknown Reasons. Interpersonal conflict included the subordinate themes of domestic abuse, marital separation, and financial disputes; while health included the themes of physical as well as mental health.
The study declared that pesticide poisoning was the method used by persons whose suicide was triggered primarily by interpersonal conflict; and against this background has recommended the importation of highly toxic pesticides be restricted, and less toxic substitutes be promoted instead.
Research gap
According to the study, a recent systematic review of suicidal behaviours in Guyana (2022) revealed a significant research gap regarding those who would have taken their own lives. It noted that Parliament has enacted a Suicide Prevention Act since the systematic review.
The research said, however, that while the Act includes a provision for the establishment of a National Suicide Prevention Commission, tasked with developing the next National Suicide Prevention Plan; it is important that that new national plan be informed by local research findings so that interventions are tailored to the Guyanese context.
The implications of all the available evidence the study said, ought to now result in “pesticide reform, community engagement, and training of healthcare professionals…as key avenues for suicide prevention in Guyana.”
It said, too, that the next National Suicide Prevention Plan should incorporate a national ban on the importation of highly lethal pesticides and promotion of less toxic substitutes.
Further, the study recommends the initiation and support of community based psychosocial support groups, particularly focused on alcohol and men, which it said would supplement the scarce human mental health resources currently available in Guyana.
Furthermore, it said that mental health and suicide literacy of medical professionals should be a part of prevention in Guyana; and that future research should focus on non-fatal suicidal behaviour and means selection.
According to the case study conducted, the World Health Organization’s (WHO) Global Health Estimates indicate that the rates of suicide have been decreasing worldwide over the past two decades (2000–2019).
It said, however, that the Americas is the only region that has recorded an increase in suicides over this time and that Guyana’s estimated age standardised suicide rates have ranked in the top ten globally and the highest within the Americas region since 2000, when the WHO began reporting their estimates for member states.
The study said that the recent systematic review of suicidality in Guyana identified preliminary evidence for key risk groups; males, female youths, and people of Indo-Guyanese ethnicity.
Revealing what it said were its findings on the four themes outlined for its research, the study said that where interpersonal conflict was concerned; many of the people who died by suicide were experiencing interpersonal conflicts within family or spouse relationships.
Conflict in these primary relationships it said, appears to have caused much distress and suicide was sought before any significant attempts at mediation or problem solving. On the three subordinate themes, it said that some of the women were experiencing domestic abuse from their respective spouses when they died.
Regarding marital separation, it said that some of the deceased men had experienced estrangement from their children after a marital separation which led to heartache and suffering. Their ex-spouses had relocated overseas with promise to facilitate their husband’s emigration but had instead married other men overseas.
For these men, it appeared that they grieved most for the loss of contact with the children, rather than the break-up of the marriage, the study said; while for others, the interpersonal conflict was between adult children and parents. These conflicts according to the research, were related to money and intergenerational distribution of wealth.
Trauma
On the issue of trauma, the study said it found that for some people who died, life had been beset by much tragedy and trauma. It appeared that a long sequence of traumatic events had led them to a sense of hopelessness regarding their future.
Some men who died by suicide, the study said, had experienced significant childhood trauma and subsequently developed alcoholism in adulthood.
On its investigations regarding health, the research said that for some people who died, suicide followed a protracted period of physical ill health, including diabetes and neurological concerns. And while treatment was sought for these chronic health conditions, however, they did not experience relief from the symptoms which it said appears to have led to frustration and the development of mental health concerns.
For others, the study went on to say that where mental health is concerned, their death was precipitated by mental illness in the absence of physical illness. One person the case study pointed out, who died by suicide experienced repeated psychosis self-harm episodes, which the family attributed to evil spirits. Many families reported people who died by suicide as having significant trouble sleeping, some of whom were taking Valium. One man who was experiencing trouble sleeping had been researching depression on the internet and his phone indicated that he called the suicide helpline service three times preceding death.
It said that many people who died by suicide had a history of non-fatal suicidal behaviour.
Methods
The case series study utilised a qualitative psychological autopsy method. One to three informants per deceased person (N = 31) were interviewed regarding the lives of 20 Guyanese who died by suicide (14 M, 6 F, aged 10–74 years). Interpretative Phenome-nological Analysis was utilised for the data.
Convenience sampling, recall bias, and limited informants are limitations of this study. Future research should focus on suicidal behaviour using larger sample sizes.
This research was supported by an Australian Government Research Training Programme Scholarship through Griffith University Australia. The project was approved by the Griffith University Human Research Ethics Committee
The research body said that it was the first psychological autopsy study to be published concerning Guyana; noting that it provides insight into the psychosocial circumstances and characteristics of suicides in Guyana, which are critical for prevention.
For collecting data, the research noted that recruitment for this study was conducted by promotion through Facebook, public media campaign, distributed through NGO networks and snowballing from informant networks.
Those interested in participating it said, were invited to reach out to the lead author (CS, interviewer) via phone or direct message. Indirect snowballing involved informants being asked to provide the details of the study to others whom they know have been affected by suicide.
Snowballing it revealed was the most successful recruitment method. Additional informants for each person who died by suicide were identified using the same indirect snowballing method.
Information the research body said, was collected for 20 persons who died by suicide. These included 14 males and 6 females aged 10–74 years. Five were children (18 years). Nine of the adults were unpartnered at the time of death. Ten died by poisoning and ten by hanging.
The religious affiliations of the persons who died were: Hin-duism, Christianity, and Islam. Meanwhile, people who died by suicide were from Regions 3, 4, 5 and 6 and were of Indo-Guyanese and mixed ethnicities.
The authors of the study were listed as Charlotte Shaw, Jaimee Stuart, Troy Thomas and Kairi Kõlves.
