SUICIDE is a very complex and multi- factorial phenomenon that over the last few years has quickly become a global health problem. According to the World Health Organisation (WHO), suicide is one of the leading causes of death in the world even though it remains the most preventable cause.

A WHO report has estimated that the rate of suicide in Pakistan in 2019 was 8.9 per 100,000 people. The actual number is suspected to be higher as a lot of cases go unreported. Also, for every death by suicide, there are many more attempts that go unnoticed and undocumented.

Suicide is the most preventable death, with treatment for depression being highly effective. Yet, due to barriers, such as stigma, lack of resources and societal pressures, many suffering individuals do not get the help that they desperately need.

Last year on Dec 23, an announce-ment issued by the President House said Section 325 of the Pakistan Penal Code (PPC) had been repealed. Accor- ding to the said section, suicide or attempted suicide was an offence punishable by imprisonment, fine or both. The act of repealing the section has effectively decriminalised the act of suicide.

Now what? Though amending the law is the first big step in the fight against suicide, efforts to incorporate systems to educate the larger community should quickly follow. The lawmakers and advocates of the cause believed that the spirit of the new amendment to decriminalise suicide attempts was to take a preventative approach as opposed to a punitive approach to suicide attempts, and to better understand the reasons behind why one becomes suicidalin the first place.

Most studies agree that suicide is closely linked to mental health disorders, with several studies stating that 85-90 per cent of those who die by suicide have suffered from at least one undiagnosed mental disorder. Other factors include previous suicide attempt, personality characteristics (i.e. impulsivity, poor problem-solving skills, memory, mood regulation), family structure, cultural barriers, availability of means, and adverse life events.

Efforts must be made to improve the identification, intervention and ultimately prevention of suicide and suicidal behaviour. Educating the larger community, such as providing suicide prevention training to parents, students, schools, and businesses, will prove to be beneficial.

Two prominent schools in Karachi have taken the first step in this endeavour using the question-persuade-refer (QPR) training to faculty, staff and administrators. QPR is an evidence-based suicide prevention training and the most widely taught approach in the world.

According to Julie Cerel and her team of researchers at the University of Kentucky, up to 135 people are affected to some degree by every person lost to suicide. Due to the stigma associated with suicide, many suffering from suicidal thoughts do not speak openly about their suffering out of fear of judgment and rejection.

The majority of our population remains dangerously ill-informed about suicide. We must learn to talk comfortably about suicide, and providing training and education in this regard is the first step in achieving this goal.

Though suicide remains a rare event, the more we work to talk about suicide and change the narrative, the more we can prevent this rare event from occurring.

Sheema Majiduddin
Karachi

Published in Dawn, February 13th, 2023