brief description about etiology,features........

1. •S suicide
•Pprevention
• what can we do?
• Dddd DR.BINOY D.RAJ
•

2. introduction
• Suicide-defined as an act with fatal outcome that is
deliberately initiated and performed by the person in
the knowledge or expectation of its fatal outcome.
• Latin word sui= oneself
• cidium=killing

3. • Suicide is a mysterious enigma that challenges most
people on many levels.
• The biggest aspect of challenge is that we can never ask
the person who died
“ Why? ”

4. Myth- once someone is suicidal he/she will always
remain suicidal
• Heightened suicidal risk is often short term and
situation specific.
• While suicidal thoughts may return they are not
permanent.
• An individual with previous suicidal thoughts and
attempts can go on to live a long life.

5. Myth-People who talk about suicide do not mean to do it
• People who talk about suicide may be reaching out for
help or support.
• A significant number of people who contemplating
suicide are experiencing anxiety , depression and
hopelessness and may feel that there is no option.

6. Myth-Most suicides happen suddenly without
warning
Fact-Majority of suicides have been preceded by warning
signs whether verbal or behavioral.
There are some suicides that occur without warning.
It is important to understand what the warning signs are
and look out for them.

7. Myth-Someone who is suicidal is determined to die
• Suicidal people are often ambivalent about living or
dying.
• Someone may act impulsively by drinking pesticides , for
instance, and die a few days later , eventhough they
would have liked to live on.
• Access to emotional support at the right time can
prevent suicide.

8. Myth-Talking about suicide is a bad idea and can
be interpreted as encouragement
• Given the widespread stigma around suicide , most
people who are contemplating suicide do not know
who to speak to.
• Talking openly can give an individual other options or
the time to rethink his/her decision , thereby
preventing suicide

9. Myth-Only people with mental disorders are suicidal
• Suicidal behaviour indicates deep unhappiness but
not necessarily mental disorders.
• Many people living with mental disorders are not
affected by suicidal behaviours,and not all people
who take their own lives have a mental disorder.

10. Global issue
• Close to
8,00,000
people die due to
suicide every year.

12. • For each adult who died by suicide there may have
been more than 20 others
attempting suicide

13. • It was the second leading cause of
death among 15-29 year olds,
claiming 200,000 lives in 2016, topped only by
road injury.

14. •75%of suicide occur in low and middle
income countries

18. Suicide in kerala
• Suicide rate in kerala-21.5/ lakh population

19. epidemiology
• Gender difference- males 4 times than women.
• SDR in women was 2·1 times higher in India than the
global average in 2016
• 71% of women suicide between 15-39 years
• Married women-highest proportion

20. • Age-increases with age
• Mean age- above 45 years
• A bimodal pattern for suicide deaths was seen for
women , with a peak in suicide rates in
younger women and then an increase after 70
years of age.
( lancet public health)

21. Marital status-marriage lessen the risk?
• Married women account for the highest proportion of
suicide deaths among women in India.
• Marriage is known to be less protective against suicide
for women because of arranged and early marriage,
young motherhood, low social status, domestic violence,
and economic dependence.
Lancet Public Health 2018;

22. • Occupation –higher social status greater risk
• unemployed higher risk than employed

23. An emerging threat
• Suicide is the second leading cause of death
among 15-29 year-oldsglobally.

24. • Failure in examinations led to 2,413 suicides by students
in 2016 or seven every day -- accounting for 25 per cent
of student suicides.
• The National Crime Records Bureau (NCRB) in its 2015
data made a shocking revelation that in India, one
student attempt for suicide every hour.

25. Risk factors
Genetic/biol
ogical factors
Environmental
factors
Recent stress
(Psychache)
psychological
pain
Block seeing
other solutions
Overcome
the instinct
for self
preservation
Desire of
death
+
deathofalovedone,
Psychological
/personaliy
factors

26. BURDEN TO OTHERS
(BURDERSOMENESS)
SOCIAL DISCONNECTION
ACQUIRED CAPACITY FOR
SUICIDE
Desire of
death

27. Environmental factors
• Prolonged stressful life events
– GENDER DISADVANTAGE
• Exposure to another persons suicide
• - COPY CAT SUICIDE
• Access to lethal means -drugs/firearms
– HIGH BULDINGS,PESTICIDES,KEROSENE
• Isolation/lack of social/family support
• long-term pain or a disabling or terminal illness
• Academic pressures/relationship issues

28. Possible signs of poor mental
health(young)
• Frequent absenteeism and poor academic performance.
• Frequent irritability and problems with peers and
teachers.
• Distress due to relationship issues (romantic)
• Expressing feeling that they cannot cope .

29. Warning signs for suicide
(young)
• Talking about committing suicide.
• Developing eating and sleeping problems
• Withdrawing from friends and social activities

30. • Giving away prized possession
• Having made previous suicidal attempts
• Taking unnecessary risks

31. • Using drugs/alcohol.
• Losing interest in personal appearance

32. POSSIBLE SIGNS OF POOR MENTAL
HEALTH IN ADULTS
• Repeated presentation of medically unexplained
symptoms
• Repeated visits/admissions in the hospital

33. Warning signs for suicide
(adults)
• Expresses wishes to die
• Looking excessively sad/ moodiness
• Sleep problems
• Sudden calmness after a period of distress
• Poor social activities

34. • Increased consumption of alcohol
• Changes in personality and/or appearance
• Putting personal business/family in
order/making a will
• Reckless driving
• Recent life crisis

35. • Warning signs may be
cry for a help

36. How does one help?
• Notice any of the warning signs?

37. Warning signs?
• Giving away prized possession
• Having made previous suicidal
attempts
• Taking unnecessary risks
Talking about committing suicide.
Developing eating and sleeping
problems
Withdrawing from friends and
social activities
Expresses wishes to die
Looking excessively sad/
moodiness
Sleep problems
Sudden calmness after a period of
distress
Poor social activities
Increased consumption of alcohol
Changes in personality and/or
appearance
Putting personal business/family in
order/making a will
Reckless driving
Recent life crisis

38. HOW DOES ONE HELP?
• Talk about feelings and the behaviours you have seen
that cause you to feel concerned.
– You don't need to solve the problem or give advice.

39. HOW DOES ONE HELP?
• Ask about suicide/Take talk of suicide seriously and use
the word “suicide.”
• Talking about suicide doesn't cause suicide—but
avoiding what's on the persons' mind may make him/her
feel truly alone and uncared for.
• Talking about suicide is the best form of letting the
person vent out his thoughts and problems

40. HOW DOES ONE HELP?
• Listen
– Validate distress
– Empathetic
– Non judgemental

41. HOW DOES ONE HELP?
. In a crisis
• Attempt to develop a strategy to make things
better.
– How did you cope earlier?
• Ensure safety as possible

42. HOW DOES ONE HELP?
• Get professional help.
– Psychotherapy
– Pharmacotherapy if indicated
– Even when the immediate crisis passes, the risk of
suicidal behaviour remains

43. System level interventions
1.Mental health promotion and life skill training
2.Restriction of means
3.Student guidance committee
4.Online counselling services.
5.Accessible professional services.

44. To conclude
• Epidemiology
• Risk factors
– issues
• Warning signs
• Interventions
– issues

45. THANK YOU