Stigma associated with mental health contribute to suicide ?

By Zanita Careem

Fathima Amra Ali Anwer Bsc. (Hons) in Psychology (UK) Msc. In Clinical and Health Psychology (University of West London, UK) Trainee EMDR Therapist serves as the Consultant Psychologist at the Civil Society Organization, Child Protection Force, in Sri Lanka. With a robust academic background and extensive practical experience, she specializes in providing pyschological support to children, adolescents, and adults. Her expertise encompasses a range of therapeutic techniques, with a focus on clinical and health psychology. Her work is characterized by compassionate approach and a commitment to fostering resilience and healing in individuals affected by trauma and adverse experiences.

(Q) What’s behind the suicides of Sri Lankan teenagers?

In the past few weeks, this topic has been widely sensationalized and discussed. However, it has been a persistent issue in Sri Lanka for a much longer time. The escalating number of suicides among Sri Lankan teenagers can be attributed to a complex blend of factors. Some of them include long-standing social stigma surrounding mental health, academic pressure, and bullying. In Sri Lanka, many children are subjected to unrealistic expectations by their families and are expected to excel academically which often leads to severe anxiety and stress.

Secondly, the stigma associated with mental health problems also contribute immensely towards the emerging epidemic in Sri Lanka. Many young people are discouraged from seeking help because of the fear of being labelled and viewed negatively by society. At a nationwide level there is an urgent need for increased awareness as well as education about mental health along with better availability of mental health services. Also, creating a more supportive environment for the young people in schools and communities can help them feel safe enough to share their thoughts, fears, and anything concerning them as well as asking for help when needed.

Notably also, there is the role of social media and cyberbullying. Many teenagers are subjected to online bullying that results in severe psychological effects on them. Parents, teachers, policymakers and mental health advocates should work together to address these concerns with a multifaceted approach. This way we can start reducing the factors behind this trend and give our adolescents’ the necessary tools and resilience to navigate their challenges.

(Q) Identifying of risk factors?

Preventing suicidal acts requires the identification of risk factors and recognizing those risk factors can enable us to identify victims who require immediate intervention. These may include a past history of mental health problems such as major depressive disorder, generalized anxiety disorder or bipolar disorder. The effects of these conditions which are likely to have an effect in their lives greatly hinder them from tackling stressful situations and also increases the risk of suicidal thoughts. Secondly, certain age groups are also thought to be at higher risk due to various challenges that they undergo during their lives. These age groups include teenagers, as well as individuals over the age of 45. Also, teenagers are more predisposed to commit suicides if they have a family history that includes suicidal actions or mental illness. Moreover, trauma like physical abuse, emotional abuse, sexual abuse and neglect is another major or risk factor this is because it causes feelings of worthlessness and low mood. Another crucial factor is substance dependence such as alcoholism or drug addiction whereby it impairs judgment hence making it more likely for someone to act on their suicidal thoughts. Finally, there are several other factors which could trigger suicidal thoughts for instance; family issues, financial issues, death of a loved one, relationship issues, lack of a support system, having an organzied plan for suicide among other culminating into suicidal decision-making processes. Therefore, early detection of these risk factors coupled with timely support through resources can save many lives.

(Q) Is mental health issues a risk factor for suicide?

Mental health issues, as discussed before, is one of the most significant risk factors for suicide. Conditions such as depression, bipolar disorder and anxiety disorders can result in intense feelings of hopelessness, despair or worthlessness. These emotions may lead individuals to see no other way out of their suffering and resort to more extreme measures to escape their agony. Also, mental illness impairs judgment and decision-making hence making it difficult for persons to adopt healthy coping mechanisms. People with mental illness often struggle to cope with daily stressors and challenges, which puts them at a higher risk for suicidal thoughts if they feel trapped by their pain. These individuals may resort to unproductive and maladaptive methods of coping such as alcohol, or substance use which may further perpetuate their issues. Therefore, it’s imperative that mental health issues are addressed using a more holistic approach, which may include therapy, medication, and support from family and friends.

Abuse, alcohol, addiction, chronic disease, family crisis loneliness, financial loss.

(Q) Can these issues contribute to increase of suicide in Sri Lanka ?

Suicide in Sri Lanka is often caused by a number of all these factors. The mental health of a person can be deeply affected by abuse, whether it is physical, emotional, or sexual and can cause someone going through these issues to contemplate suicide. Abuse, trauma and the scars it leaves on one’s emotions can leave them feeling helpless and trapped. It can cause someone to think about ways to end their suffering permanently. Additionally, substance abuse often starts when individuals try to cope with their emotional pain in maladaptive ways but this vicious cycle leads to worsening mental health conditions and addiction that increases the risk of suicide.

Moreover, family crises, such as domestic violence, severe financial problems, or parental separation, can create a stressful and unstable environment. This too could make an individual feel helpless and distressed. Furthermore, these issues end up being aggravated by feelings of loneliness and social isolation making young people find no way out of their distress. A teenager may lack someone to talk to, as well as improve his or her situation without a good supportive network around him. It’s a combination of these factors that can push someone to the brink.

(Q) Are suicides common among women or men?

First and Foremost, Sri Lanka continues to record a higher than global average rate of suicide. The figure shows that most suicides in Sri Lanka occur among men. This could be explained by the fact that men usually go for more lethal methods. However, women tend to try to commit suicide more often but with less lethal means. Societal norms and expectations may contribute to this gender disparity by making it unacceptable for men to show vulnerability or seek assistance. Men are often expected to be tough and independent, which can cause reluctance in sharing their burdens when they need help. In contrast, women might be more willing to ask for support or talk about their feelings, sometimes leading to early intervention and assistance before it is too late.

(Q) Sri Lanka highest suicide rates, most common reasons are personal — love affairs, domestic issues and family issues — comment?

Yes, there are a number of personal relationships and domestic issues that trigger the act of committing suicide in Sri Lanka as well. Love affairs, especially those ending badly, cause very intense emotional pain and rejection. The identity and self-esteem of many youths is often built around these relationships hence once the relationship fails they may lose all hope of ever having a normal life again. Family issues such as domestic conflicts, parental conflict, and high expectations can make one’s home a stressful place where one cannot wait to run away from. If a society is one where family and social standing are placed on a high pedestal, these issues can make them feel ashamed and inadequate. The pressure to conform to societal expectations and the stigma around seeking help for personal problems make it even harder for individuals to find support. This combination of personal and relational stressors can feel overwhelming, leading some to see suicide as their only escape.

(Q) How do you actually help a suicide teen?

The first step in helping a teenager who contemplates suicide is to create an environment that is safe and without judgment for the teenager. Active listening is important. The most significant aspect of it all is letting them know that they have support from people around them; encouraging them to seek professional help from psychologists and other mental health professionals who can provide the appropriate support and intervention. As psychologists, it is important to involve their family and close friends to build a strong support network. Help comes in many forms including giving information about helplines or connecting with groups that will offer necessary support. What I often do with my clients is also educate them on adaptive coping mechanisms as well as encouraging them to do activities which bring them joy and satisfaction which in turn can help them find hope and purpose. Above all, showing them that they are not alone and that there is hope can be incredibly powerful.

(Q) Are we comparatively low in suicide rates in comparison to other countries?

It is worth noting that the present suicide rate of Sri Lanka population is significantly less than it was in 1990s. However, Sri Lanka still has one of the highest suicide rates globally. This high rate is due to a combination of several factors discussed earlier, including mental health issues, bullying, substance abuse and family crises, and society-related pressures. Community awareness campaigns have been initiated to address this problem but there is still a long way to go in terms of prevention through mental health programs. Comparing our rates to those from other countries demonstrates the need for more robust mental health services and societal support system.

(Q) How do you stay motivated as a therapist working with these complex issues?

Staying motivated in this field requires a deep commitment to helping others and a passion for making a difference. As a person who mainly deals with victims of abuse and domestic violence, I come across extreme situations in my work which at first affected my mental wellbeing greatly, but we learn how to separate our personal lives from work as time passes by. Moreover, seeing even small improvements in my clients’ lives is incredibly rewarding and brings me great satisfaction. Self-care is essential, too – I make sure to take time for activities that rejuvenate me, like spending time with loved ones, pursuing hobbies such as painting, and continuing my own education. Staying connected with other professionals in the field such as my supervisors for support and advice also helps me stay grounded and motivated.

(Q) How would you describe alternatives to suicide?

Alternatives to suicide include Cognitive Behavior Therapy (CBT) help individuals acquire adaptive ways of dealing with issues and work through their concerns in a supportive environment. It is important to have a strong support system: friends, family, or support groups play a crucial role in this regard. We always advise our clients to get involved in activities that make them happy— be it sports, art, music, or any other hobby because such engagements can bring about a sense of purpose and keep them distracted from negative thoughts while also enjoyable Adopting healthy coping strategies— for example mindfulness, meditation, or physical exercise— goes a long way in stress management. Sometimes finding creative outlets like writing, art or music may act as an alternative form of expression and help deal with emotions in a therapeutic way as well.

(Q) As a psychologist how will you deal with a boy or girl with suicidal tendencies?

My approach involves establishing trust, opening a free and non-judgmental space for them, where they can openly express their thoughts and feelings without fear of judgment. I determine the risk level through direct questions on various aspects of their suicidal ideation such as thoughts, plans, and means. Based on this assessment, I create a tailored intervention plan involving their family and social network. The underlying causes need to be addressed — whether they stem from mental health, family ties, or societal pressures. Regular follow-ups and continuous support are essential to ensure they stay on a path to recovery.

(Q) Why do you think its important for people struggling with suicidality to have access to peer support?

When facing suicidality, peer support plays an essential role because it helps foster a sense of connection and understanding. Sharing stories with others who have walked similar paths can inspire hope — as well as provide practical coping mechanisms. It fosters an environment where those experiencing with mental health challenges do not feel alone or alienated but encourages them to reach out for assistance. Peer support also nurtures a sense of community and belonging which goes far beyond emotional recovery— it is just as important. By creating this empathy-based support system, the peer support complements professional treatment by offering empathy and lived experiences that can be incredibly reassuring and motivating for those in crisis.