Text by Henrylito D. Tacio
Photo by WHO
In 2014, the Geneva-based World Health Organization (WHO) published “Preventing Suicide: A Global Imperative,” its first report on suicide as a public health issue. Suicide takes place as often as every 40 seconds, the report said.
An earlier WHO report said the Philippines has suicide rates (per 100,000) of 2.5 for men and 1.7 for women.
Suicide is a major contributor to premature mortality around the world. Approximately 32% of the world’s suicides occur in the Western Pacific region. “While acknowledged as an important and neglected health issue, it remains a low priority in most Western Pacific countries due to competing health problems, stigma and poor understanding of the condition,” wrote Maria Theresa Redaniel, May Antonnette Lebanan-Dalida, and David Gunnell, authors of “Suicide in the Philippines: time trend analysis (1974-2005) and literature review.”
According to their study, the incidence of suicide in males increased from 0.23 to 3.59 per 100,000 between 1984 and 2005. Similarly, rates rose from 0.12 to 1.09 per 100,000 in females. Among females, suicide rates were highest among the age bracket of 15-24 years old, while in males, rates were similar in all age groups throughout the study period.
The most commonly used methods of suicide were hanging, shooting, and pesticide ingestion. In non-fatal attempts, the most common methods used were ingestion of drugs or pesticide ingestion. Family and relationship problems were the most common problems reported.
Suicide, the process of purposely ending one’s own life, has always been viewed negatively in most cultures. But not in Asia, where 60% of all the suicide deaths in the world are reported from. In fact, two of the countries with relatively huge suicide rates are Japan and South Korea, which have a very high level of competition that starts right from childhood.
“Although some attempted or completed suicides come as a shock even to family and friends, clear warnings are given in most cases,” points out The Merck Manual of Medical Information. “Any suicide threat or suicide attempt is a plea for help and must be taken seriously. If the threat or attempt is ignored, a life may be lost.”
For health purposes, the Merck manual calls it “suicidal behavior.” It explains: “Suicidal behavior includes attempted suicide, suicide gestures, and completed suicide. An attempted suicide is suicidal action that is not fatal. If an attempted suicide involves a suicidal action unlike to have any potential of being fatal, it is called a suicide gesture. A person taking such an action (for example, ingesting six acetaminophen tablets) may be making a plea for help or attention without having any intention of actually ending his life. A completed suicide is a suicidal action that results in death.”
The Merck manual says suicidal behavior is an all-too-common health problem. Although most suicidal behavior does not result in death, 10% of people who try to kill themselves using potentially fatal means do die from their actions.
“Suicidal behavior is an unmistakable signal that a person has feelings of desperation and hopelessness,” the Merck manual says. Among those with high-risk factors for suicide are males, having painful or disabling illness, living alone, having debt or living in poverty, under bereavement, experiencing humiliation or disgrace, and depression.
Other high-risk factors: persistence of sadness even when other symptoms of depression are getting better, history of drug or alcohol abuse, history of prior suicide attempts, family history of suicide, family violence (including physical or sexual abuse), suicidal preoccupation and talk, and well-defined plans for suicide.
According to some studies, one out of four people complete suicide notes. These notes often refer to personal relationships and events that will follow the person’s death. Notes left by older people often express concern for those left behind, whereas those of younger people may express anger or vindictiveness.
The choice of suicide method is often 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,” the Merck manual noted. “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 is for real, and it is unfathomable why people try to cut their lives short. “It’s difficult to understand how a person could not give value to a survival instinct, which is to stay alive from the standpoint of a non-suicidal person,” wrote Dr. Gia B. Sison, a practicing medical doctor who specializes in occupational medicine and a strong mental health advocate.
Quoting a book, Clinical Manual for Assessment and Treatment of Suicidal Patients, Dr. Sison further wrote: “The thought of suicide most often occurs when a person feels they have run out of solutions to problems that seem inescapable, intolerably painful, and never-ending.”
