When death gets appealing to a person when in pain, there is a way to help…

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TW : In the last week, I was referred a young teenage who was expressing suicide symptoms.  Her reason was that she had trusted a lot of people and now they were not there for her.  Just yesterday, I was requested if I can see a young adult who had slit her wrist.  At times, they are considered to be transient or just an attention drawing one-off situations.  A close look at the youngsters’ life story unfolds that her thought process may be after a difficult event and may not be a one-off situation.  The immediate reasons that are closely connected with the wish may be many and may include family issues, concerns with friends, adjustment issues at college or work, financial issues, stressed and so on.  The fact is that this is not the only one factor that plays.  Very often, it is thought that it is not a concern of the children, but we are seeing that the age of attempting a suicidal event is gradually lowering.

All of us are, in a way, gatekeepers who support people around us and prevent them from taking any drastic step in their lives.  We need to learn about suicide so that we will be better able to help them.  We at PEARLSS 4 Development and also at Learning Space are running a campaign on prevention of suicide.

Very often when you catch a conversation around suicide with your acquaintances, you often hear commonly held viewpoints.  Some of them include statements such as, if you want to die by suicide, you will and no one can stop you from doing it.  They try to stop you from talking about it as they think that the youngsters will get ideas on suicide.  There is also a belief that it is only the person who has mental illnesses, someone who wants attention or is mentally disturbed will try such risky behaviour.  But the reality is that one does not need to be mentally ill to die by suicide.  At least 50% of the causes are not mental illnesses.

Death by suicide is the fourth largest cause of death.  For every death by suicide, there are 20 more attempts.  The warning signs of suicide include, talking about wanting to die, guilt or shame around some part of their life, feeling that one is a burden on others, researching on how to end one’s life.  Many others may show reckless behaviour with may be moderate to severe.  One of the important signs are hopeless and agitation.  They may give a closure to life’s happenings such as donating and giving out what they have or wishing a goodbye to close members.  Many people may think of ending their life because of the pain they are undergoing and may not find a way to end the pain.  Some of the risk factors of suicide are- previous attempts to end life, loss of a loved one, previous sensationalization or glorification of death, cultural and religious beliefs, access to lethal methods, marginalization and oppression, interpersonal problems with loved ones, lack of access to services, substance abuse, familial history of mental illnesses and so on.

The question is what is meant by a suicide intent.  This is basically understanding the intentionality of the person’s death wish.  The intent may be deep, moderately intense or not really well founded.  This needs to be evaluated by a professional and hence, even suicide helplines tell its volunteers to refer the person who comes on their helpline to a therapist once the initial support is provided. 

The most important and first step is to develop a connect and relationship with the person who expresses the desire to end her or his life.  Our language and the way we build the relationship is important as that is the crux to provide and extend the support.  Holding on to the person until the person has found a professional service and continuing to provide the service even after the person is in care is extremely important.  The next step is to acknowledge the person’s pain and make her or him feel validated in the experience.  This may be a small step to build confidence in self and other and get in a feeling that someone understands them. The third step is to refer to a service.  Remember we are not aware of the dynamics that play in the person’s life and one needs to reach out to a professional who can do a diagnostic formulation and provide the needed care and treatment.  Once the person is back into to the community, the gatekeeper will continue to provide ongoing support and engage with the person to develop a new meaning and connections to life purpose.  

Dr. Anita victorina Rego

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