Unsuccessful suicide attempts remain high in Sri Lanka

Though death by suicide has decreased in Sri Lanka, the number of attempts remain high, making the island nation worse than some Gulf and South American countries in terms of suicide attempts, an expert said.

Colombo South Teaching Hospital Child Adolescent Psychiatrist Dr Jayamal de Silva said despite Sri Lanka not doing so well regionally where suicide is concerned, the country has fared better than some developed nations like Australia, Japan, UK, Switzerland and Sweden.

However, he said: “We are doing worse than the Arabian countries and some South American countries, and we’re currently in the same category as some of the second world nations [like China].”

The psychiatrist, who is also a senior lecturer at the Sri Jayawardenapura University, shared these insights at an event organised by the Sumithrayo Foundation recently to mark world suicide day that fell on September 10.

A World Health Organisation (WHO) report says nearly 800 000 people die due to suicide every year, which is one person every 40 seconds. Sri Lanka’s Institute of Policy Studies (IPS) said in its blog quoting the World Bank that the suicide mortality rate (per 100,000 population) in Sri Lanka was reported at 14.6 per cent in 2016. In 1995, Sri Lanka topped the suicide mortality rate with 47 per 100,000 inhabitants. However, de Silva believes the situation changed for the better over time.

This drop in the suicide mortality rate, according to de Silva, can be explained by a ban on pesticides two decades ago.

In a report published in 2019 by WHO titled PREVENTING SUICIDE, it was noted that countries which banned pesticides were able to minimise suicide deaths.

“Sri Lanka and other countries indicate that many suicide deaths can be prevented by bans on specific pesticides. In Sri Lanka, for instance, bans are thought to have led to 93 000 fewer suicide deaths between 1995 and 2015.

“The culture has shifted from buying pesticides to paracetamol. As a result ‘successful’ suicides have come down in the present,” de Silva said.

The pesticide ban and improvement of factors such as access to good healthcare and reforms to protocol have allowed the country to revise the numbers, he said, adding that there was however an increased incidence of overdosing (by, for example, ingesting paracetamol).

“Due to numerous reasons, suicide numbers have gone down in Sri Lanka significantly. Where it was around 45/100,000 before, it is now closer to 14/100,000,” said de Silva.

“We have specific reasons for this, such as developing roads to hospitals and changes in the treatments administered to patients who survived a suicide attempt. Normally when a patient is admitted, we try to pump out all the poison as soon as possible. Now we try to keep the patient’s heart working, after which we proceed to other steps,” he added.

Though the drop in rates is encouraging, the expert went on to say, the number of suicides in the country is not zero. “The number of deliberate cases is actually on the rise, and it is several points higher than completed suicides,” he said.

The most common methods used now, de Silva said quoting a study by Dr Ranil Abeysinghein 2007 of psychological autopsies suicide victims, said pesticides have come down to 30 percent, while suicide by hanging has dropepd by 50 percent. “The latter is high because the government cannot restrict access to rope the way they did with pesticides,” he said.

Accordion to de Silva, reasons for suicide in Sri Lanka are 20 percent marital disharmony, 8 percent mental illness, 12 percent chronic disease, and 50 percent related to alcohol. “If we take the bottom line most male suicides were carried out after consuming alcohol,” he said.

De Silva called for a new strategy to help prevent suicide.

“Today’s generation has access to a lot content related to suicide on YouTube. If you look at the most popular Sinhala songs, it’s all about drugs, suicide and violence. So, the time has come to rethink the tactics we’ve been using, successfully or otherwise,” he said.

Educators mustn’t talk about suicide directly but they should talk more about the factors which causes it such as anxiety and depression symptoms rather than opening the door to an option called ‘suicide’, he added.

“Even after teaching students life skills for the last two decades mostly from grades 7 to 9, we still saw young adults between the ages of 15-25 commit suicide.”

The reason for this, according to de Silva, is a lack of child psychology experts in Sri Lanka.

“We are in a suicide culture. That is why the suicide rate is high. We have to change this culture. Otherwise we cannot do anything to stop it,” he said. (ECONOMYNEXT)

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