Suicide Prevention: Alive?
On September 10, the world once again observed “World Suicide Prevention Day”. This year the theme was, “Suicide Prevention across the Globe: Strengthening Protective Factors and Instilling Hope”. If the Ministry of Health (MoH) had any program locally to use the occasion to highlight the havoc wrought by suicide in our society, it escaped us. In Black Bush Polder, Berbice, a US Peace Corps Volunteer performed a wonderful act when he released the results of a survey on suicide he has conducted in that community. Black Bush Polder has long held the title of ‘suicide of Guyana.”
Guyana has become infamous globally for the Jonestown mass suicide of 1978 when 909 persons took their lives. Many Guyanese brush off this tragedy by pointing out that it was not a ‘Guyanese thing”. But most Guyanese are unaware that Guyana, with barely three-quarters of a million in population, ranks number three in the list of highest suicide rates in the entire world. With our number of suicides averaging around 189 annually, every five years more Guyanese commit suicide than in the Jonestown horror. According to figures released by the MoH, there were 946 suicides reported in Guyana in the five years between 2003 and 2007. Now, we cannot say suicide is not a “Guyanese thing.”
Early in the last decade, this newspaper began highlighting the scourge of suicide in our country. In 2001, after private groups had highlighted the extent of the problem, the MoH acknowledged that suicide was a public health issue and that a national response was demanded. Minister Ramsammy launched into a flurry of activities and established a National Committee for the Prevention of Suicidal Behaviour (NCPSC).
The Committee started some centres in Berbice, but gradually seemed to have petered out. After a great deal of handwringing, by 2007, the Ministry launched a new body, the National Committee for Suicide Prevention (NCSP). The NCSP’s objectives were to: reduce premature deaths due to suicide; lower the rate of suicidal behaviour; decrease the harmful aftermath and stigma associated with suicidal behaviour and the traumatic effect of suicide on family and friends, and promote awareness that suicide is preventable and train more persons in recognising mental health problems.
Since then, the Ministry of Health has conducted several studies of its own, all of which have confirmed the findings of the pioneering study. In 2009, the Minister candidly asserted that the government, the region and PAHO had not deployed the requisite budgetary allocation to deal with suicide, even as they all acknowledged the gravity of the problem locally. In 2011, a decade after the identification of suicide as a public health problem, the Minister announced on World Suicide Prevention day that for the first time in thirty years, the rate of suicide had dipped: from 189 to 160 from the previous year.
This was obviously the result of the subsequent flurry of activities involving national and international actors to first get a handle of the phenomena and simultaneously to make targeted interventions. There were reports of training sessions in suicide prevention that involved the International Association of Suicide Prevention, Pan American Health Organization (PAHO) and Dalhousie University Department of Psychiatry to get both health care professionals and communities on board.
Simultaneously with the intervention aspects of the pilot program, a detailed history of suicide victims (“psychological autopsy”) was to be compiled to discover specific causative factors in the Guyanese milieu. A “Gate-Keeper Program” (of influential persons in the community that may intervene to prevent suicide) was kicked off. Since pesticides (especially gramoxone) are one of the most popular means to commit suicide, the Ministry claimed to have also initiated a program to institute a more secure method of storing the poisonous substance.
Last year we pointed out that most of the programmes initiated by the MoH seemed to be languishing on the vine or had withered completely. After the elections, this trend appears to have intensified, even as the scourge of suicide seems to have spiked once again.