Aokigahara Forest is associated with suicide in Japan. Hundreds of dead bodies have been found in the forest and many cases of attempted suicide reported. At the entrance of the forest, there is a sign that urges people to seek help and not take their lives.
In 2015, a 71-year-old man in Japan set himself on fire, committing suicide in a train that put the lives of other passengers at risk. A woman died of smoke inhalation during that incident. Many Japanese who commit suicide also throw themselves in front of trains. Suicide is reported to be the single biggest cause of death in males between the ages of 20 and 44 years in Japan.
In America, the Golden Gate Bridge in San Francisco Bay Area is a popular destination for suicide victims. Unofficial estimates say 1,600 people have died after jumping off the bridge. The jump lasts four seconds at an average speed of 120km/hr. The impact of hitting the water at such speed kills; others die of drowning and hypothermia in the cold water.
There are plans underway to build a $204 million (about Sh20.4 billion) suicide barrier at the bridge. Over 800,000 people end their lives by suicide each year worldwide, which loosely translates to someone in the world ending his or her life every 40 seconds. The actual number is likely even higher because suicide is a sensitive matter and illegal in some countries and, therefore, underreported.
Suicide is the act of intentionally taking one's own life. It is associated with mental disorders, such as depression, bipolar, schizophrenia, anxiety disorders and alcohol and other substance abuse. Other risk factors include prior suicide attempts, family history of suicide, access to firearms, physical or sexual abuse, unemployment, relationship difficulties, imprisonment, chronic physical illness, financial difficulties, loneliness and exposure to the suicidal behaviour of others.
There are two peak ages in suicide cases: among young adults and the elderly. More women attempt suicide but more men complete the act. Men are also more likely to engage in methods that are most lethal, for example, shotgun to the head or chest. Other methods of committing suicide include hanging, use of explosives, setting oneself on fire, jumping from a high building, car crash and cyanide poisoning.
In recognising signs of suicide, look out for individuals talking or thinking about death all the time, or signs of depression, such as deep sadness, trouble sleeping and eating or having a "death wish", as evidenced by taking risks that could lead to death, such as driving fast.
Other signs include feeling hopeless, helpless or worthless, putting affairs in order, such as changing a will, and sudden, unexpected switches from being very sad to being very calm or appearing to be happy. Also suggestive are talking about suicide or killing oneself, visiting or calling people to say goodbye, and selling off or giving out one's most valuable possessions.
The Kenyan Context
The World Health Organisation 2012 statistics show that the average rate of suicide in Kenya stands at 10.8./100,000, males at 16.2/100,000 and that of females at 8.4/100,000. In Africa, the highest rate was in Mozambique, with an average of 17.3/100,000 population. Suicide is treated as a crime in Kenya (it is a misdemeanour, if found guilty, an imprisonment follows for a term not exceeding two years), thus there may be many unreported cases of successful and attempted acts.
The good news is that efforts are under way to repeal the law. Culturally, we view suicide as shameful, so many keep it a secret. Not talking about it doesn’t make the problem go away and reduces the chances of victims seeking help, reducing their survival opportunities and making suicide prevention mechanisms futile.
Suicide cases seem to be rising among two groups: the Kenya Police and students. These police officers shoot their spouses and children, friends or lovers before taking their own lives.
Just last year, a female police officer shot herself dead at Jomo Kenyatta International Airport after complaining of work-related stress. Due to the nature of police work, officers have a hard time dealing with stress and domestic problems.
They experience gruesome accidents, see lifeless bodies, deal with riots, work for long hours — all these are likely to lead to mood and anxiety disorders, such as panic attacks and post-traumatic stress disorders.
Students, on the other hand, commit suicide because of dismal performance in school, relationship troubles, substance abuse and stress. The more reason parents and guardians should be keen of their children’s behaviour.
Therapy and Hospitalisation
Any suicidal thoughts or behaviours should be taken very seriously and addressed as soon as possible. Anyone who suspects a family member or friend wants to commit suicide should seek help and call the crisis line.
In Kenya, you could call LVCT Health on 1190 for free. The Health ministry needs to provide services like this to reach more Kenyans. We must all be aware of those signs exhibited by a suicidal individuals even if they are subtle.
Hospitalisation is highly recommended for suicide attempters. It is the first line of treatment to prevent further harm to individuals, and is necessary even if it’s against their will, until they are stable and aware of what’s going on.
Thorough evaluation of the patient needs to be done to assess immediate danger to self and others. Once the patient is stable, intense outpatient care needs to be provided, considering that chances of another suicide attempt are high. Psychotherapy follows in this line of treatment.
DBT (dialectical behaviour therapy), which was adapted from CBT (cognitive behavioural therapy), can be used to treat suicidal patients. It is in two parts: acceptance techniques, which aim to show that even destructive behaviours can be valid coping mechanisms, and change techniques, which aim to change these destructive behaviours for more positive ones.
The overall goal of this form of therapy is to learn to deal with crisis effectively. The problem in the beginning is regulating and tolerating any kind of emotion, but after therapy, one feels connected, valued and develops positive thoughts of themselves. It is a good idea to draw up a contract with the client as a form of commitment so they take responsibility when they recognise the warning signs (call up the therapist or other supportive family members).
Feelings of sadness and hopelessness are common reactions to everyday struggles, and some of us develop suicidal tendencies when our usual coping mechanisms seem to fail us and end up feeling worthless and empty.
In these periods, ask for help, especially if these negative feelings persists for too long. Do not be afraid or feel you are burdening others. You do not have to be alone in these times of trouble. No matter how difficult our circumstances, we may be tempted to end it all and look for ways to numb our pain permanently, but we also have it in us the desire to live out our dreams and to be happy. Charlie Chaplin rightfully said: “Nothing is permanent in this wicked world, not even our troubles.”
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