Definitions

SUICID E

SUICIDE

Definitions • • • • • •

Suicide is a Mental Health Emergency Suicide is killing one’s self Infanticide is killing one’s offspring Patricide is killing one’s father Homicide is killing another human Fratricide is killing one’s sibling

Suicide (from Latin sui caedere, to kill oneself) is the act of willfully ending one's own life. Suicide is sometimes used as a noun for one who has committed or attempted the act.

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Medical views of suicide Modern medicine treats suicide as a mental health issue. Overwhelming suicidal thoughts are considered a medical emergency. Medical professionals’ advice that people who has expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially important if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Special consideration is given to trained personnel to look for suicidal signs in patients. Depressive people are considered a high-risk group for suicidal behavior. Suicide hotlines are widely available for people seeking help. However, the negative and often too clinical reception that many suicidal people receive after relating their feelings to health professionals (threats of institutionalization, simply increasing dosages of medication, the stigmatization of suicide as a topic of discussion, etc), often causes them to keep their suicidal thoughts to themselves.

TERMINOLOGIES • • •

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Suicide attempt- any act intended to end in suicide Suicidal ideation- thoughts of harming oneself Suicidal gesture- any action that appears to be a suicide attempt but that is actually contrived or manipulative and that results in only minimal harm, such as superficial cut on the wrist or small overdose of sleeping pills. Suicide threat- verbal threat to commit suicide. Completed suicide- suicide attempt resulting in death Lethality- the level of risk in suicide method chosen to cause death. Rational Suicide- self slaying base on reasoned choice and is categorized as voluntary active euthanasia. Right-to-refuse-treatment- well-informed patients with decision making capacity have an autonomous right to refuse and forego recommended treatments.

Causes • • • • • • • •

Depression and Anxiety Loss and Grief Substance Dependence, especially Alcohol and Amphetamines Other Mental Illness Gambling War, Famine, Poverty, Disaster Changes in body image

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People • • • •

More men than women succeed at suicide but more women attempt suicide Affects all age groups but is higher in the younger and older adults Affects all ethnic groups but tends to be highest in Caribbean and Africans and least in Chinese and Japanese Higher amongst Dentists, Psychiatrists, Veterinarians and Farmers

Methods Overdose Carbon Monoxide Hanging Gunshots Cutting Throat Jumping Purposeful car/train accidents

Co Morbidity • •

People often suicide when under the influence of drugs, including alcohol Amphetamines, especially Methylamphetamine, (Ice, Shabu, Crystal) are implicated in many suicides in the 18-30 age group.

Incarceration People who are jailed or detained have higher rates of suicide and suicide prevention is a major role of Primary Health Care Staff employed in Correctional and Detention Facilities.

Artists Rock stars, Poets, Actors, Painters and Writers are all known to be prone to suicide – often there is a co-morbid substance dependency. Examples are Keith Moon, Brian Jones, Janice Joplin, Jimmie Hendrix, Marilyn Monroe, Vincent Van Goth.

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Teenage Suicide – Prevention A young mind is very impressionable and therefore it is more prone to emotional upheavals than the average adult mind. In a modern day scenario, the child is burdened with the expectations of parents and society that may seem small and insignificant but certain occurrences can have a serious affect. Such occurrences that seem insignificant to the mature and adult mind can act as a trigger point and lead a child to depression. Teenage suicide is the third highest cause of death among youngsters aged between the ages 15 to 24 years. Teenagers tend to resort to easy and temporary solutions like alcohol, drugs or sex, since these are all readily available today. These are dangerous shortcuts that only amount to a temporary escape from a depressed state. However, these can aggravate suicidal tendencies. Teenage depression can be prevented. The support from close family can prove to be the best teenage depression help that you can find. Although professional teenage depression help is readily available as well as counselors at school and professional therapists can help the situation, parental support is still a must. Parents are in a position to notice the early signs of depression and therefore their support is the most important in preventing the onset of a full depressive state. With classroom numbers so high personal attention is not always possible, so you cannot depend on teachers to notice possible symptoms. Teenage depression can manifest itself in many forms. Isolation, oversleeping and despondency are the first signs that should ring warning bells. If you have a healthy relationship with your child, you will be in a much better position to counsel your child the need arises.

Gender and suicide In the Western world, males die much more often by means of suicide than do females, although females attempt suicide more often. This pattern has held for at least a century. Some medical professionals believe this stems from the fact that males are more likely to end their lives through effective violent means (guns, knives, hanging, etc.), while women primarily use less severe methods such as overdosing on medications.

National suicide rates National suicide rates differ significantly between countries and amongst ethnic groups within countries. For example, in the USA, non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or Hispanics. In the United Kingdom suicide rates

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vary significantly between different parts of the country. In Scotland, for example the suicide rate is approximately double that of England.

Murder-suicide A murder-suicide is an act in which an individual kills one or more other persons immediately before or at the same time as him or herself. The combination of murder and suicide can take various forms, including: • • • • •

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Suicide to facilitate murder, as in suicide bombing Suicide after murder to escape punishment Suicide after murder as a form of self-injury due to guilt Having a combined objective of suicide and murder Considering one's suicide as the main act, but murdering one's children first, to avoid them becoming orphans, to be together in an expected afterlife, in the context of severe depression where the person feels he is sparing his loved ones from a horrible life, or simply just to experience the act Joint suicide in the form of killing the other with consent, and then killing oneself Punishment - taking revenge on those deemed responsible and escaping the world seen as a terrible place, as in many school shootings Committing suicide using a method that results in the deaths of others such as crashing an aero plane, such a suicide was famously attempted in FedEx Flight 705 Some cases of cult suicide may also involve murder. Conversely, many spree killings have ended in suicide.

The motivation for the murder in murder-suicide can be purely criminal in nature or be perceived by the perpetrator as an act of care for loved ones in the context of severe depression. The severely depressed person may see the world as a terrible place and can feel that they are helping those they care about by removing them from it.

Suicide attack A suicide attack is when an attacker perpetrates an act of violence against others, typically to achieve a military or political goal that results in his or her own death as well. Suicide bombings are often regarded as an act of terrorism. Historical examples include the assassination of Czar Alexander II and the in part successful kamikaze attacks by Japanese air pilots during the Second World War.

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Self-injury Self injury is not a suicide attempt; however, initially self-injury was erroneously classified as a suicide attempt. There is a non-causal correlation between self-harm and suicide; both are most commonly a joint effect of depression.

Suicide locations Some landmarks have become known for high levels of suicide attempts. The four most popular locations in the world are reportedly San Francisco’s Golden Gate Bridge, Toronto's Bloor Street Viaduct (before the construction of the Luminous Veil), Japan's Aokigahara Forest and England's Beachy Head. In 2005 the Golden Gate Bridge had a count exceeding 1,200 jumpers since its construction in 1937, in 1997 the Bloor Street Viaduct had one suicide every 22 days, and in 2002 Aokigahara had a record of 78 bodies found within the forest, replacing the previous record of 73 in 1998. The suicide rate of these places is so high that numerous signs, urging potential victims of suicide to seek help, have been posted.

Multiple suicides Some suicides are done under peer pressure or as a group. Multiple suicides can take place with as few as two people, in a "suicide pact", or with a larger number of people – the mass suicide that took place in Jonestown, Guyana is an example.

Suicide and mental illness Studies show a high incidence of mental disorders in suicide victims at the time of their death with the total figure ranging from 98% to 87.3% with mood disorders and substance abuse being the two most common. A person diagnosed with schizophrenia may commit suicide for a number of reasons, including because of depression. Suicide among people suffering from bipolar disorder is often an impulse, which is due to the sufferer's extreme mood swings (one of the main symptoms of bipolar disorder), or also possibly an outcome of delusions occurring during an episode of mania or psychotic depression. Major depressive disorder is associated with a higher than average rate of suicide, especially in men.

Other reasons

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Suicide as a form of defiance and protest In the 1960s, Buddhist monks, most notably Thích Quảng Đức in South Vietnam, drew Western attention to their protests against President Ngô Đình Diệm by burning themselves to death. Also in the 1960s, Quaker Norman Morrison committed suicide by self-immolation to protest the United States involvement in the Vietnam War. In Ireland there exists a long tradition of hunger strike to the death against British rule, predominantly in Northern Ireland during the infamous 1981 hunger strikes, led by Bobby Sands, which resulted in 10 deaths. The period caused international outrage, with the Indian parliament standing for two minutes of silence and the Iranian government renaming the street in Tehran on which the British Embassy stands, as "Bobby Sands Street".

Judicial suicide In the final days of World War II, some Japanese pilots volunteered for kamikaze missions in an attempt to forestall defeat for the Empire. Near the end of WW2 the Japanese designed a small aircraft whose only purpose was kamikaze missions. In Nazi Germany, many soldiers and government officials (including Adolf Hitler) killed themselves rather than surrender to Allied forces. The Japanese also built one-man "human torpedo" suicide submarines called Kaitens.

Dutiful suicide Dutiful suicide is an act, or non-fatal attempt at the act, of fatal self-violence at one's own hands done in the belief that it will secure a greater good, rather than to escape harsh or impossible conditions. It can be voluntary, to relieve some dishonor or punishment, or imposed by threats of death or reprisals on one's family or reputation (a kind of murder by remote control). It can be culturally traditional or generally abhorred; it can be heavily ritualized as in seppuku or purely functional. Dutiful suicide can be distinguished from a kamikaze or suicide bomb attack, in which a fighter consumes his own life in delivering a weapon to the enemy. An example of dutiful suicide is a soldier in a foxhole throwing his body on a live grenade to save the lives of his comrades. Disgraced Roman aristocrats were sometimes allowed to commit suicide to spare themselves a trial and penalties against their families. An example of this was Emperor Nero who reportedly committed forced suicide following a large fire that burned through much of Rome. A more modern case is Erwin Rommel, who was found to have foreknowledge of the July 20 Plot on Hitler's life. Rommel was threatened with public trial, execution and reprisals on his family unless he killed himself, which he did.

Important facts about suicide

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Suicide is preventable, most suicidal individuals desperately want to live, they are just unable to see the alternatives to their problems. Most suicidal individuals give definite warning of their suicidal intentions but others are either unaware of the significance of these warnings or do not know how to respond to them. Talking about suicide does not cause someone to be suicidal.

Warning signs • • • • • • • •

Feeling irritable, restless, angry or sad most of the time Change in sleep pattern, self-care, and sex drive Withdrawal / isolation threatening to hurt or kill him/her self Looking for a way to kill him/her self Recent losses or major life changes Previous suicide attempts Family history of suicide Excessive alcohol or drugs

Way to be helpful to them • • • • • • • • • •

Be aware learn the warning signs Get involved, become available Show interest and support Be willing to listen Talk openly about suicide Do not leave the person alone Do not swear secrecy Remove means Get help from others Contact your nearest helpline

Why prevention is complex • • •

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Knowledge ability – familiar with suicide Availability and accessibility of means Exposure to suicide though media –modeling

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Lack of coping skills and social support isolation of family units increased pressure, demand, violence, drugs Decreased resources, emotional support

Psychological intervention • • • • • • • •

Enhancing self-esteem Coping skills training Internal attachment – making meaning External attachment - peer network Talk therapy –emotional support Problem solving, decision making Person centered approach Cognitive behavior therapy

Mass prevention strategies • • • • • • • •

Public education – awareness programmes Promote efforts to reduce access to means Identifying and educating the risk group Reducing harassment in schools, workplace and community Media education to reduce suicide contagion Educating professionals in healthcare, education and human service Increasing effectiveness of help lines Providing follow up service for suicide attempters

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