Destigmatizing Suicide

Last September 10, we celebrated the World Suicide Prevention Day, and the World Health Organization (WHO) gave us a disturbing fact on the rate of suicide: a staggering figure of around 600 cases a day. This has been reported by The Philippine Star last September 11, 2012.

WHO and the International Association for Suicide Prevention (IASP) reported that suicide claims approximately one million lives a year, that is more than the lives lost due to homicide and wars combined. This means a life is lost due to suicide every 40 seconds.

Suicide attempts are even higher. WHO further revealed that “Suicide attempts and suicidal ideation are far more common; for example, the number of suicide attempts may be up to 20 times the number of deaths by suicide.  It is estimated that about 5% of persons attempt suicide at least once in their life and that the lifetime prevalence of suicidal ideation in the general population is between 10 and 14%.”

Seemingly, not all of us react to this fact in the same way that we do for other causes of death like those related to health, accidents, calamities, murders and yes, war.  Many would still believe that these are isolated cases until we take a deeper look without fear and reflect without judgment on what this statistics means.

Personal Decision vs. Social Pressure

At quick glance, one can say that suicide is personal because indeed what could be more personal than deciding to kill one’s self.  Suicide ideation or thoughts, and plans of it, dwell in the mind of the person, unrevealed in as much as these were not acted upon. And many times for completed cases, we stopped there making the victim fully responsible for his or her action and passing on a judgment or two about how weak or mentally unstable the individual was for resorting to suicide.

But, an earlier sociologist, Emile Durkheim made a study of suicide in 19^th century France to illustrate how such a personal decision can actually have a social dimension, which should be equally considered.  From the Editor’s Introduction to his book, “Suicide: A Study on Sociology,” it was stated “Since, according to Durkheim, suicide cannot be explained by its individual forms, and since the suicide-rate is for him a distinct phenomenon in its own right, he proceeds to relate currents of suicides to social concomitants.” And, “But where the rate increases rapidly, it is symptomatic of the breakdown of the collective conscience, and of a basic flaw in the social fabric.” This thought challenged and continue to challenge the view that suicide is simply a personal decision whilst it reveals the kind of society we have.  Can we take responsibility for the rising number of suicides?

Why people commit suicide?

From a psychological point of view, recent studies on suicide would tell us that the leading causes of suicide are related to mental health such as depression. Other examples of possible triggers for suicide are “real or imagined losses, like the breakup of a romantic relationship, moving, loss (especially if by suicide) of a friend, loss of freedom, or loss of other privileges,” according to Roxanne Dryden-Edwards, MD, at MedicineNet.com.

Further research disclosed that there are five common factors that lead to a suicide: (1) presence of life stressors, (2) impulsive behavior, (3) inability of a person to tolerate failure or negative feelings, (4) psychosis, and (5) hopelessness brought about by depression.  According to IASP, having one or more of these conditions can make a person vulnerable or at risk to suicide.

On the other hand, sociological imagination would invite us to go beyond the individual reasons for suicide but examine how society is contributing to the decision of an individual to commit the act.  Here we look at how society encourages the individual’s integration to make him or her feel that sense of belonging,  be it in the church, family or any group which the individual comes in contact with.  This is why the term used is “suicide victim” which implies that the person is just a victim of something, of others, even a victim of him/her self.

The question should be “What pushes a person to commit suicide?” instead of “Why did the person commit suicide?”  The difference is that the first question invites us to understand the circumstances leading to the act, while the latter focuses on the individual.  Or maybe both questions should be explored if we are to understand better the cases of suicide.

Suicide as a gender issue

Based on the IASP report, on the average, there are three males for every female suicide cases which means fewer women resort to suicide than men. Thus, a closer look would tell us that suicide is also a gender issue.

As women are socialized to express emotions and relate with others, especially with fellow women, a stronger social network has made them cope with various problems.  On the contrary, men are taught not to display emotions and thus lead them to more destructive courses of action such as alcoholism and substance abuse.

But, the rate of suicide attempts, according to IASP, is 2-3 times higher in women than in men, though the gender gap has lessened in recent years. This is also another area that needs to be further studied through gender lens.

The Stigma

To this day, a stigma is still attached to suicide as this remains a taboo in our society. When we examine our reaction to suicide cases, we still feel a certain level of discomfort, if not outright repulsion, from the deep feeling that something is very wrong with the person who committed suicide.

Contributing to this would be the stand of the church, especially the Catholic Church, before not to give “ecclesiastical funeral rites” to suicide victims and considered it a scandal. But, this is no longer true today as the Catholic Church changed its stance.

Unfortunately, the stigma suffered by those left behind by the suicide victim takes a very long time to heal, even transcending generations. In the case of the Philippines, the Department of Health said in Sun Star report last September 10 that we have 2 cases per 100,000 which is considered low as compared to other countries, but it also mentioned the difficulty in getting accurate data on suicide because of the stigma attached to it.

What can be done

Methinks that in order to address the alarming rate of suicide, first of all we must recognize that this is something you and I have to feel strongly about, in that compelling sense that this is a social ill we need to respond to. Only then can we be able to take concrete steps towards suicide prevention.  IASP experts said that, “Suicide is a multi-determined phenomenon that occurs against a background of complex interacting biological, social, psychological, and environmental risk and protective factors. Despite the complexity of this phenomenon, suicide can be prevented.”

We can pay closer attention to and be extra sensitive to people we care for, our families and loved ones, colleagues and friends, and recognize possible symptoms like changes in behavior, loss of interest about life in general, depression, and others.  We must develop a non-judgmental attitude towards people with problems and thus providing a supportive and open atmosphere for the person to take refuge in.  Even to ourselves, we must extend the same gentleness and non-judgmental attitude.

Collectively, we have to continue our efforts at addressing various societal problems, including gender issues and marginalization of people who are the least, the lost, the last, and the lonely.  Institutions working on mental health concerns have to be substantially supported by the government.  Strengthening of the family relationships can also be a direct intervention towards this.

Little by little, let us remove the stigma that goes with suicide cases and find the courage to discuss it more openly and make people more aware about this.  Most importantly, let us reflect on how we deal with people, especially those closest to us, so that consciously we can be a positive instrument in preventing suicides.