Kelvin Teo
Abused, depressed, suicidal by Steve H
According to a Straits Times article, Singapore’s suicide rate in 2009 was 9.35 per 100,000, an increase from 8.76 per 100,000 in 2008. A Hong Kong study of youth suicide attempts established the role of family relationships, life stressors, psychological issues and suicide idealation in mediating suicide amongst youths.
Just recently, it was reported that Cambridge student George Starling committed suicide after experiencing double tragedies of the death of his mother in her sleep, and good friend, Singaporean Tan Mingwei in an accident. On superficial analysis, Starling could have been subjected to life stressors in the form of mother’s and good friend’s deaths and this pre-mediated his subsequent suicide.
Hence, a suicide prevention strategy would entail identifying risk factors in a population of Singaporeans who are susceptible to attempting suicide, and the administration of early intervention such as antidepressant drugs or/and other forms of behavioural therapy.
Among the vulnerable group are those whom have good friends who have completed suicide, especially amongst adolescents. The age of adolescence is the time of immersion into social networks and peer groups, both of which have an influence on the individual. In a study of suicide and friendships by Bearman and Moody, it was found that having a friend who had committed suicide increases the likelihood of suicide idealation and action for both sexes.
What this study means is that the friends of the deceased individuals who have committed suicide are likely to contemplate suicide and follow through with the action. And this makes the identification and intervention in this susceptible group all the more important.
Philip Hazell, a child psychiatrist and Conjoint Professor of Child and adolescent psychiatry at the Universities of Sydney and Newcastle conducted an intervention study on three schools in whom a student of each has committed suicide. Feeling irritable, sleeplessness and loss of concentrations are amongst the responses of students identified as those who have known the victim. There was a possibility that some of the students in this group could have been feeling depressed or suicidal.
Initially, upon learning the news of the deaths, each school mounted a response by identifying distressed students, informing their parents and sending them home. What transpired in the subsequent months was a persistent increase in students with distress and suicide idealation.
Hence, what has to be done in order to prevent further suicides is a concerted effort involving teachers, school councillors and psychiatric experts. The classroom teacher plays an especially important role since the latter is in the loop of the events in the class such as relationships amongst classmates. In the event of a student committing suicide, the teacher has to be on high alert and keep a vigilant eye on the victim’s classmates. In the aforementioned study, the psychiatric expert together with the school principal, teachers and councillors participated in a session directed at those students who were affected by the suicide of their peer.
Much of this discussion has been directed at the impact of suicides within a school setting, but a more worrying finding is that a history of completed suicide within the family puts the current surviving members at risk of suicide. Qin and colleagues conducted a study within a European population in which they analyzed 4262 individuals who committed suicide. Their work was subsequently published in the premier medical journal The Lancet.
The results of the study suggested that a history of completed suicide within the family should be established as an independent risk factor for suicide on top of those mentioned earlier. Hence, social workers, family doctors or even neighbours who are close to such a family should be on the lookout for distress or/and suicidal agendas within such a family so that interventions can be timely in order to prevent further suicides.
It is unfortunate that an individual chooses to end his or her life but the story does not end there. He or she may well be the first domino to fall, and if nothing is done, the rest of the dominos could possibly fall too. Hence, the purpose of a timely intervention is to provide support to the other ‘dominos’ to prevent them from falling.
References
- Bearman P & Moody J. Suicide and Friendships Among American Adolescents. Am J Public Health. 2004 January; 94(1): 89–95.
- Hazell P. Postvention after teenage suicide: an Australian experience. J Adolesc. 1991 Dec;14(4):335-42
- Qin P, Agerbo E, Mortensen PB. Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case-control study based on longitudinal registers. Lancet. 2002 Oct 12;360(9340):1126-30.
We know from Durkheim that suicide is only the symptom of much deeper social ills, like the feeling of alienation from the things that matter. We probably should have a hard look at those instead of just treating the symptom.
Suicide is like self service Advance Medical Directive.
Which one is more popular in Singapore ?