Understanding suicide
A relative or a friend confides in you that he or she is thinking of committing suicide. Conventional wisdom states that if someone is able to talk about wanting to commit suicide, he or she won’t push through with the plan.
But mental health experts say that verbalizing a suicide plan may be a sign of that person’s determination, that the person has arrived at a decision. How would you handle such a confession? Some may want to make light of the declaration (“Are you sure? Let me see you do it now!”); others could break down in tears and start bargaining with the suicidal relative or friend (“Don’t leave us! Don’t you love me anymore?”); still others could resort to expressing anger (“How can you think of leaving us?!” “What about your children/spouse/parents/friends?!”).
The truth is that there is no way to tell for sure, no single “right” way to react.
“Suicide First Aid Guidelines for the Philippines,” a slim guidebook based on the recommendations of an international panel of mental health experts, recommends that if you see warning signs (withdrawal, a dramatic change in mood, behavior or appearance) of a person’s suicidal tendencies, you should ask him/her the following questions:
Are you having suicidal thoughts?
Are you thinking of killing yourself?
“Don’t avoid using the word ‘suicide,’” assures the Guidelines. “It is important to discuss the issue directly, without expressing fear or negative judgment. Doing so may help you to appear confident in the face of the suicide crisis, which may have a reassuring effect on the person you’re helping.”
To know for sure if the person is “planning to complete suicide,” the guidelines suggest asking three more questions:
Have you decided how you would kill yourself?
Have you decided when you would do it?
Have you taken any steps to secure the things you would need to carry out your plan?
Not everyone contemplating suicide will be able to verbalize a plan, the Guidelines warns. “All thoughts of suicide must be taken seriously.”
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In the Philippines, however, says Dr. Dinah Nadera, a psychiatrist connected with the University of the Philippines Open University, “suicide is not perceived as a problem.” In an international ranking of countries’ suicide rates (per 100,000 population), the Philippines ranked a distant No. 90, with a suicide rate of 2.1. (In contrast, South Korea ranked second, with a rate of 31.2.)
But several factors indicate that the suicide picture here may be incomplete, if not inaccurate. Dr. Nadera notes that there is still no systematic reporting of nonfatal and fatal suicide here, with reliable data not regularly recorded in institutions that can generate the data (hospitals, police records), making it “difficult to observe general patterns of suicidal behavior.”
Surviving family members are also quite leery of having “suicide” listed as the cause of death, fearing the stigma attached to the term, and the superstitions, if not spiritual and social sanctions, attached to suicide.
On the other hand, there is much curiosity about suicide, especially about what “caused” the suicide, what factors drove the deceased to take his or her own life, and who else is to “blame” for it. The situation worsens if the victim is well-known, with the media going to town with the “human interest” angle, especially on where to point the finger of blame. Another tendency is to romanticize the suicide or valorize the act, painting it as heroic, saintly, or at the very least sympathetic.
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This may be the reason the World Health Organization, Western Pacific Region, invited Dr. Nadera and some media persons to a consultation on “Media and the Prevention of Suicide.” Said Dr. Wang Xiangdong, leader of the team on mental health and injury prevention, “media [are] a king without a crown,” explaining how media coverage of suicide could be employed to reduce the stigma attached to the method, and create greater understanding of the reasons for suicide and the need to reach out to those contemplating it.
“There is no simple explanation for suicide,” added Timothy O’Leary, a consultant with the WHO and himself a former editor with the Dallas Morning News. This is why, he said, it may be futile, if not ultimately harmful, for the media to seek simplistic reasons for a decision to take one’s life.
Among the strategies suggested by the media folk after small group discussions on how the media could better report on suicide: special reports covering “all facets” of suicide; consulting mental health professionals before writing or airing a story on a suicide; putting suicide “in context,” including the international situation; and follow-up stories on the aftermath of suicide, especially how the survivors are coping.
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One notable development is how the average age for suicide in the region has been falling, with the majority of suicides occurring among teenagers and young adults. And while the male to female ratio among completed and attempted suicides globally is 10 men to four women, in Asia, the gap has narrowed to nearly two men to one woman, with the ratio nearly 1:1 in China.
The media should also guard against triggering what mental health professionals call “copycat” suicides, especially if the suicide was committed by a celebrity or anyone with a following. This is why they caution against publicizing the method employed in a suicide or unknowingly “romanticizing” the suicide.
Any suicide triggers questions in the minds of journalists, more so if the deceased is a public figure. But in satisfying our curiosity, we must take care not to misrepresent suicide or create more suicides among the young and vulnerable.
If you or someone you know is in need of assistance, please reach out to the National Center for Mental Health (NCMH). Their crisis hotlines are available at 1553 (Luzon-wide landline toll-free), 0917-899-USAP (8727), 0966-351-4518, and 0908-639-2672. For more information, visit their website: (https://doh.gov.ph/NCMH-Crisis-Hotline)
Alternatively, you can contact Hopeline PH at the following numbers: 0917-5584673, 0918-8734673, 88044673. Additional resources are available at ngf-mindstrong.org, or connect with them on Facebook at Hopeline PH.
