Text by Henrylito D. Tacio
Photos courtesy of WHO
New research published by the UN health agency revealed that suicide remains one of the leading causes of death worldwide – taking more lives each year than HIV (human immunodeficiency virus), malaria, breast cancer, war, and homicide.
Based on its estimates that more than 700,000 people, or one in 100, died by suicide in 2019, the World Health Organization (WHO) is releasing new guidance to help countries reduce that rate by a third no later than 2030.
“We cannot – and must not – ignore suicide,” said WHO chief Tedros Adhanom Ghebreyesus.
In the Philippines, more and more people are committing suicide.
In 2020, 4,420 people took their lives intentionally; in comparison, 2,810 deaths were recorded in 2019. The death toll made suicide the 25th leading cause in 2020, which was 31st place in 2019.
But some experts believe the figures are just the tip of the iceberg.
“Certainly, the actual rate in the Philippines is probably higher, with many doctors agreeing not to report deaths as suicides because of the stigma. But even if we could get the true figure, it would probably still be relatively low,” Dr. Michael Tan wrote in his weekly column.
Dr. Dinah Nadera, a psychologist at the University of the Philippines’ Open University, told the Philippine Daily Inquirer that based on research made on 300 cases from hospitals and police reports in 2008 and 2009, suicides happened between 8:01 in the morning and noon on weekdays, “when other people were not around in their homes.”
Least suicides occurred between 12:01 and 4 a.m., the study found.
“There is no clear and concrete answer as to what pushes people to end their lives,” stated the Makati Medical Center (MakatiMed). “However, it may stem from various reasons and factors, such as post-traumatic stress, financial distress, mental health problems like depression, and substance abuse or addiction.”
According to MakatiMed, people who commit suicide often experience despair and suffering. “When it becomes unbearable, ending their lives seems the only option left to relieve them of their pain. It’s less about wanting to die and more about wanting to put an end to their suffering,” it said.
There are those who believe that people who die by suicide refused to seek help. That’s a myth. “A lot of individuals who contemplate and die by suicide get help before attempting the act,” MakatiMed says. In fact, studies of suicide victims showed that “over half of them sought medical assistance within six months before taking their lives.”
Another myth is that people who commit suicide are cowards and weak-willed. On the contrary, they are courageous and strong. “They are fighters who fought their own battles for months or years,” MakatiMed says. “Sadly, they can only fight for so long, especially when they are on their last string of hope.”
The choice of method often is influenced by cultural factors and availability and may or may not reflect the seriousness of intent.
“Some methods (for example, jumping from a tall building) make survival virtually impossible, whereas other methods (for example, overdosing on drugs) make rescue possible,” says The Merck Manual of Medical Information. “However, even if a person uses a method that proves not to be fatal, the intent may have been just as serious as that of a person whose method was fatal.”
Drug overdose and self-poisoning are two of the most common methods used in suicide attempts. Violent methods, such as gunshots and hanging, are uncommon among attempted suicides because they usually result in death.
Of completed suicides, a gunshot is a method most frequently used by males. Females are more likely to use non-violent methods, such as poisoning, drug overdose, or drowning.
In the Philippines, a study showed that the methods of committing suicide included shooting oneself, 40%; hanging, 30%; poisoning, 16.7%; and jumping from high places, 13.3%. In 73% of the reported cases, suicide was committed in their own homes.
“Suicide remains as one of the most pressing issues in the world,” the Department of Health (DOH) contends.
As such, it is tapping the media to help curtail suicide incidents in the country. In fact, it has issued Administrative Order No. 2022-0004 recently stipulating guidelines for the ethical and responsible reporting of suicide in the news and broadcast media as part of its efforts on suicide prevention.
“Media, as a powerful took means to transmit information and influence its audience, is seen as an effective tool by the WHO to responsibly report suicide, as current evidence shows there is an association between suicide content in the media and the risk of death by suicide,” the DOH said in a statement.
“It is important that those at risk are not exposed to articles or movies that encourage or give instructions on suicide,” DOH’s Dr. Maria Rosario Singh-Vergeire reiterated.
That seems to jibe with the WHO’s guidance. It highlights that in the social media age, media reports can prompt copycat suicides, especially when surrounding a celebrity. It calls for suicide coverage to be counteracted with articles highlighting successful recovery from mental health challenges or suicidal thoughts. It also recommends working with social media companies to increase awareness and remove harmful content.
WHO’s guidance to suicide prevention zeros in on four strategies: limiting access to the means of suicide; educating the media on responsible suicide reporting; fostering socio-emotional life skills in adolescents; and early identification, assessment, management, and follow-up of those with suicidal thoughts and behaviour.
Meanwhile, Dr. Dinah Pacquing-Nadera, in a paper, “Suicide in the Philippines: A Second Look at Rates and Ratios,” identified three major barriers to the development and implementation of national suicide prevention plan.
The three barriers are 1) lack of factual data to cite the magnitude of the problem; hence, lack of evidence to support need and fund for program; 2) competing interests within the health system where budget is limited; and 3) strong Catholic faith which frowns upon suicide discouraging families from reporting.
Suicide has become prevalent among young people. In Davao City, for instance, a 22-year-old man from Kidapawan City committed suicide by jumping off from the fifth floor of a noted mall.
Before him, there were several others who did the same in the same mall: “Nestor” on August 20, 2013, “Pete” on March 17, 2014, “Joy” on November 6, 2015, and “Mark” on February 11, 2017.
The recent incident, by the way, happened three days after the country observed the World Suicide Prevention Day. Awareness campaign is needed in order for this mental problem to be prevented, if not solved, experts urged.
“Every single person is priceless, and any loss to suicide is a terrible misfortune,” wrote Constanza Daniela Gonzales, a board member of Global Dignity Philippines. “Nothing, including suicidal thoughts or behaviour, can take away the inherent value of human life.
“When people are feeling hopeless or unworthy due to mental illness or an extreme life circumstance, they most need the caring support of their loved ones, healthcare professionals and communities. They need to be assured of their inherent worth and instilled with hope. May we open our hearts and be willing to support each other through our darkest hours.”
Curtailing suicide is not a job for health department only but for everyone. As the WHO puts it: “Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labor, agriculture, business, justice, law, defense, politics, and the media.”