Suicide prevention---- deepression-occupational disease of 21st century


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Suicide prevention---- deepression-occupational disease of 21st century

  1. 1. Suicide-Prevention Occupational Health By  Dr.Ashok laddha  Occupational Health Physician  MBBS, PGDC ,PGDD, PGDEM, AFIH ,ACLS,BLS  Diploma in Workplace Health and safety. MBA-HA
  2. 2. Definition  the action of killing oneself intentionally.  Latin word -------suicidium------"to kill oneself"
  3. 3. History-India  The story of suicide is probably as old as that of man himself. Through the ages, suicide has variously been glorified, romanticized, bemoaned, and even condemned. Be it the tragic Greek heroes Aegeus, Lycurgus, Cato, Socrates, Zeno, Domesthenes or Seneca; or the Roman figures Brutus, Cassius, Mark Anthony or the Egyptian princess, Cleopatra; or Samson, Saul, Abimelech and Achitophel of the Old Testament; or the suicide bombers in the present world, the universality of suicide transcends religion and culture
  4. 4. History-India  An understanding of suicide in the Indian context calls for an appreciation of the literary, religious, and cultural ethos of the subcontinent because tradition has rarely permeated the lives of people for as long as it has in India. Ancient Indian texts contain stories of valor in which suicide as a means to avoid shame and disgrace was glorified. Suicide has been mentioned in the great epics of Ramayana and Mahabharata. When Lord Sri Ram died, there was an epidemic of suicide in his kingdom, Ayodhya. The sage Dadhichi sacrificed his life so that the Gods may use his bones in the war against the demons. The Bhagavad Gita condemns suicide for selfish reasons and posits that such a death cannot have “shraddha’, the all-important last rites. Brahmanical view had held that those who attempt suicide should fast for a stipulated period. Upanishads, the Holy Scriptures, condemn suicide and state that ‘he who takes his own life will enter the sunless areas covered by impenetrable darkness after death’.
  5. 5. History-India  However, the Vedas permit suicide for religious reasons and consider that the best sacrifice was that of one's own life. Suicide by starvation, also known as ‘sallekhana’, was linked to the attainment of ‘moksha’ (liberation from the cycle of life and death), and is still practiced to this day. Sati, where a woman immolated herself on the pyre of her husband rather than live the life of a widow and Jahuar (Johar), in which Rajput women killed themselves to avoid humiliation at the hands of the invading Muslim armies, were practiced until as recently as the early half of the 20th century; stray cases continue to be reported*
  6. 6. Epidemiology  Approximately 0.5% to 1.8% of people die by suicide globally  2nd leading cause of death  Mortality rate ---of 11.8 per 100,000 persons per year  Rates of suicide have increased by 70% from the 1960s to 2014  Increase of suicidal is primarily in developing country  For every suicide that results in death there are between 10 and 40 attempted suicides
  7. 7. Epidemiology-India  3rd leading cause of death among young and Adolescents  Rates per 100,000 -------India 23.2  The countries with the greatest absolute numbers of suicides are China and India accounting for over half the total  male ratio in the rate of suicide is higher  Mental disorders (particularly depression and alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries impulsiveness plays an important role. Suicide is complex with psychological, social, biological, cultural and environmental factors involved.
  8. 8. Statistics About College Depression  second leading cause of death in college students ages 20-24.  Teens diagnosed with depression are five times more likely to attempt suicide than adults.  Over two-thirds of young people do not talk about or seek help for mental health problems.  64 percent of Indian college students reported feeling symptoms of depression.  differences in opinion, persistent pecking, high expectations and lack of inter-connectivity may be the major reasons for teens opting for the extreme step.  Depression is the No 1 occupational disease of the 21st century says WHO
  9. 9. causes  The pressure to do well in school-----pressure is not from teachers but from parents too  Not getting admission in college of their choice  academic pressure  Lack of social support  Depression  Family background ------chaotic family environment  difficulty in a romantic relationship  students in India are unaware of how to deal with stress and it's ill-effects  Impusiveness
  10. 10. Other causes  Financial crunch  Lack of opportunity to talk and vent out frustrations with parents  Fear of being put down and ridiculed by them, and lack of family support  Parental disharmony  Constant comparison to other siblings who are doing well
  11. 11. Challenges and obstacles  the prevention of suicide has not been adequately addressed due to basically a lack of awareness of suicide as a major problem and the taboo in many societies to discuss openly about it.  In fact, only a few countries have included prevention of suicide among their priorities.  Reliability of suicide certification and reporting is an issue in great need of improvement.  It is clear that suicide prevention requires intervention also from outside the health sector and calls for an innovative, comprehensive multi-sectoral approach, including both health and non-health sectors, e.g. education, labour, police, justice, religion, law, politics, the media.
  12. 12. Symptoms  Drastic changes in mood or behavior.  Extreme and unusual anger.  Sudden withdrawal from society.  Complete apathy towards others or things that might have concerned the person earlier.  Changes in eating or sleeping habits.  Illnesses that occur without cause and which cannot be explained.  Extreme loss of energy and fatigue.  Changes in social habits – either over-socializing or backing off from all socializing.  Inappropriate behavior.  Loss of pleasure in simple things.  Loss of interest in life.  Risk-taking.  Extreme depression, accompanied by deep sadness and a lot of crying.  Preoccupation with death. Talk of suicide, even in jest. Sudden abuse of alcohol or drugs.
  13. 13. Risk Factors  There are some people who are more at risk of committing suicide than others. These categories of people are as follows:  Males are more at risk of suicide than females.  Those younger than 19 years of age and those older than 45 years of age.  People who are clinically depressed.  Anyone who has earlier attempted to commit suicide, especially if the suicide plan was organized.  People who are divorced, separated or widowed. This could also apply to people who have been in a very close relationship which was broken.  People who have received any kind of mental health service.  People with little or no support socially.  Those who abuse drugs or alcohol.  Those who have lost the ability to think rationally  People with chronic medical illnesses.
  14. 14. Strategies  Promote awareness that suicide is a public health problem that is preventable  Develop broad-based support for suicide prevention  Develop and implement strategies to reduce the stigma associated with being a consumer of mental health, substance abuse and suicide prevention services  Develop and implement community-based suicide prevention programs  Promote efforts to reduce access to lethal means and methods of self-harm  Implement training for recognition of at-risk behavior and delivery of effective treatment  Develop and promote effective clinical and professional practices  Increase access to and community linkages with mental health and substance abuse services  Improve reporting and portrayals of suicidal behavior, mental illness and substance abuse in the entertainment and news media  Promote and support research on suicide and suicide prevention  Improve and expand surveillance systems
  15. 15. Specific strategies  Selection and training of volunteer citizen groups offering confidential referral services.  Promoting mental resilience through optimism and connectedness.  Education about suicide, including risk factors, warning signs and the availability of help.  Increasing the proficiency of health and welfare services at responding to people in need. This includes better training for health professionals and employing crisis counseling organization.  Reducing domestic violence and substance abuse are long-term strategies to reduce many mental health problems.  Reducing access to convenient means of suicide (e.g. toxic substances, handguns). Reducing the quantity of dosages supplied in packages of non-prescription medicines e.g. aspirin. Interventions targeted at high risk groups.
  16. 16. Suicide prevention  Suicide prevention is an umbrella term for the collective efforts of local citizen organizations, mental health practitioners and related professionals to reduce the incidence of suicide.  Beyond just direct interevention to stop an impending suicide, methods also involve  a) treating the psychological and psychophysiological symptoms of depression,  b) improving the coping strategies of persons who would otherwise seriously consider suicide,  c) reducing the prevalence of conditions believed to constitute risk factors for suicide, and  d) giving people hope for a better life after current problems are resolved.
  17. 17. Suicide Prevention and Intervention  Implement a school/college-based prevention program  Implement a gate keeping program.  Create a comprehensive school/college crisis plan.  Be prepared to engage in postvention.
  18. 18. Suicide Prevention and Intervention  Each school / district have a plan for how it will handle emotional and behavioral distress, including suicidal thinking, behavior, and threats of violence.  The attached draft, model Plan will help districts and schools develop their own plans to respond quickly and effectively in a crisis.  Understands dimensions and indicators of health (emotional, physical, intellectual, and social).  Appropriately responding to a tragedy that may put students at risk is an essential part of any crisis or suicide prevention plan.
  19. 19. Multi-sectoral Partnership  Media  Parents  Teachers  Social worker  Ngo  Government  Health Professionals  Use of Alternative medicine  Local community centers  Spiritual and religious leaders.Police etc
  20. 20. Why MULTI-SECTORAL COLLABORATION  increased access to resources.  more efficient use of resources.  enhancement of accountability.  development of innovations.  broadened awareness.  lasting relationships.  sustainable development of activities.  broad sharing of responsibility for different activities;  stronger ownership.  use of strengths of different partners.  sharing of knowledge and technology.  better balanced design of projects.
  21. 21. Simple techniques for stress management  Morning walk  Surya Namaskar  8 hrs sleep  Improve inter-personal relationship  Reading—authentic books  Yoga  Meditation  Aerobics  Positive Thinking
  22. 22. Suggestion  Preservation of culture  Introduction of change in gradual manner  Employment generation  Population control  Decrease study burden  Change of education pattern  Lastly----Get connected with each other to get rid of with target in mind--------zero suicide in coming years