September may be a month for mooncakes and strolling the parks with lanterns, but what needs illuminating is suicide awareness. Acknowledging the menace of suicide, many countries have also made September the suicide awareness month. This started because of World Suicide Prevention Day, which is observed on 10 September every year, since 2003.
Suicide is when a person harms him/herself with the purpose of ending life, and die as a result. There were a total of 452 suicides reported in Singapore in 2020, the highest figure since 2012. Evidently, Covid-19 has weighed down heavily on mental health, and some have undertaken drastic measures to stop their torment.
Amongst the 452, 154 of them were seniors, which marked a 26 per cent increase from the year before. The percentage of suicides for other age groups also rose, such as youth aged from 10 to 29 and middle-aged adults between 30 and 59 years old, by 7 per cent.
Suicide is a major public health concern and when someone dies by suicide, the lasting effects are felt by family and friends. It may be a result of long-term planning or impulsive behaviour, and if the ideation comes to fruition, there’s no turning back.
It has also been recognised that it is not just a personal issue, but can be reflective of community and societal problems. In the Singaporean Indian community alone, a total of 352 lives were lost between 2015 to 2020. Statistics begets analysts and governments to question structures and look at suicide from a sociological perspective.
Who’s at risk?
Whatever the impetus to this horrific action might be, anyone may turn to suicide, at anytime and anywhere. “There is a multitude of reasons why people attempt suicide. The person is usually in severe physical or emotional pain.
Some examples include being abused, diagnosed with a critical illness or loss of a loved one,” comments Chriselda Rose Pereira, a counsellor practicing at A Space Between.
An non-exhaustive list of factors that increase the risk of suicide includes:
- Depression and other mental health disorders
- Having attempted suicide before
- Alcohol and drug use
- Family history of a mental health disorder
- Family history of an alcohol or drug use disorder
- Family history of suicide
- Family violence, including physical and sexual abuse
- Being in or having recently gotten out of prison or jail
- Being exposed to others’ suicidal behaviour, such as a family member, peer, or celebrity
- Medical illness, including chronic pain
- Stressful life event, such as a job loss, financial problems, loss of a loved one, a breakup of a relationship, etc.
- Being between the ages of 15 and 24 years or over age 60
- Bullying or trauma
- Experiencing legal problems or debt
- Exposure to graphic or sensationalised accounts of suicide
- Historical trauma, such as the destruction of communities and cultures
- Stress due to discrimination and prejudice
- Not being able to access care for mental health issues
- Feeling of seclusion or loneliness
- identifying as LGBTQIA+ with no family or home support
Are there warning signs?
Prior to suicide, there will first be suicidal thoughts and behaviours. Suicidal behaviours refer to talk or actions related to ending one’s life, while thoughts instigate such behaviours.
These may be noticeable or not, but if you or someone is exhibiting either suicidal thoughts or behaviour, it is a psychiatric emergency and you should seek immediate assistance from a healthcare provider.
“Suicide is often a cry for help rather than call for attention. They are in real or perceived pain and are unaware of how to help themselves,” says Chriselda. “Every threat should be taken seriously. A serious threat is someone who has a concrete plan and finds the future bleak.”
Talking, writing or thinking about death and threats about killing oneself should not be taken lightly. Some indirect tell-tale signs can include social withdrawal from friends, family and the community, dramatic mood swings, increased alcohol and drug abuse, aggressive behaviours.
Warning signs that someone may be at immediate risk for attempting suicide include:
- Talking about wanting to die or wanting to kill themselves
- Talking about feeling empty or hopeless or having no reason to live
- Talking about feeling trapped or feeling that there are no solutions
- Feeling unbearable emotional or physical pain
- Talking about being a burden to others
- Withdrawing from family and friends
- Giving away important possessions
- Saying goodbye to friends and family
- Putting affairs in order, such as making a will
- Taking great risks that could lead to death, such as driving extremely fast
- Talking or thinking about death often
Other serious warning signs that someone may be at risk for attempting suicide include:
- Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
- Making a plan or looking for ways to kill themselves, such as searching for lethal methods online or stockpiling pills
- Talking about feeling great guilt or shame
- Using alcohol or drugs more often
- Acting anxious or agitated
- Changing eating or sleeping habits
- Showing rage or talking about seeking revenge
When danger is imminent
If the threat of suicide encroaches, to yourself or someone you know, seek help immediately. Samaritans of Singapore is available 24/7 and they can be reached by dialing 1-767. If there is still time, you can speak to the person in a non-judgmental and non-confrontational way. Address the problem directly by asking, ‘Are you thinking about suicide?’ Don’t leave them alone.
Chriselda advises, “Start by asking questions and allow self-expression of suicidal thoughts or feelings. It often reduces the risk. Make a safety plan: contact a family member, friend or a professional.”
“Use positive reinforcement while acknowledging their current emotions. Say things like ‘You feel hopeless right now, we will get you the help that you need. You are not alone’.”
If you are the one who feel helpless, always reach out for help. While in the suicidal state of mind, avoid drugs and alcohol.
Preventing suicidal thoughts
Many have had such thoughts and no one should be ashamed of it. However, it is important to take action to help prevent these thoughts from recurring.
Talk to someone
Professional help, such as private counselling, will assist you in coping with thoughts and eliminating suicide as an option to managing stressful life events. “Counseling is both a science and an art, but that’s really true when it comes to [preventing] suicide,” says Julia Whisenhunt, a licensed professional counsellor.
“Recognising suicidal ideation in clients and meeting their unique needs comes not only from being trained and up to date on suicide prevention and response, but also from a measure of professional intuition.”
Take medications as directed
If you are currently seeking treatment for your mental health, you should never change your dosage or stop taking medications unless your healthcare provider tells you to do so. Suicide ideation may recur and you may experience withdrawal symptoms if you suddenly stop your course of medication.
Don’t miss your therapy sessions or doctor’s appointments
Sticking to your treatment schedule and plan is a good way to keep the suicidal thoughts and behaviour at bay.
Watch out for warning signs
Learn about your triggers with your therapist, and take steps ahead of time to avoid these pitfalls. When you feel that you are spiraling into negativity, seek help early and speak to someone, preferably your counsellor.
Eliminate access to lethal methods of suicide
Get rid of anything dangerous – knives, blades and do not stock up on medication that you might abuse.
Suicide is not the way out
Many a times, a person who is distressed will not be able to see beyond the fog and darkness. However, lives are precious and we should do our best to prevent lives being lost in this way. Suicide awareness and prevention efforts should not be limited to just a month, but should be in perpetuum. Whether it is for yourself or your loved one, there is a road out of the abyss.
Chriselda Rose Pereira works with diverse profiles across ages, races, socioeconomic groups including LGBTQ+. A CBT trained Master of Counselling, she specialises in grief and loss, self-harm and suicidal feelings, autism spectrum disorder and pediatrics, just to name a few.
Known as Nate, I am someone who cannot quit wielding the pen or punching the QWERTY, no matter where life brings me. Writing has always been the most effective conduit for channeling my wanted or unwanted opinions since I was an undergraduate at NUS. Naturally, I used this skill as a means of sustenance after working as a writer and editor for many years until I decided to start a business in music. That did not put a halt to my marriage with the vernacular.
In October 2016, I graduated with my Masters in Visual and Media Anthropology, which is the study of cultures through films and photography, at Freie Universität Berlin. This transitory period of residing in two cities has pushed the boundaries of my creativity and my battles with word count have not ceased.
Now a new mode of writing, the academic one, has been added to my existing smorgasbord of corporate and lifestyle collaterals, articles, advertisements, annual reports and books. At the moment, my learning curve is an uphill journey as I attempt to grasp the camera for stills and motion clips, while I juggle that with developing my love affair with my other mode of expression – electronic music.