II Monograph: Suicide Free Society (Contd.): What Can You Do ?
Can you reduce social isolation, prevent social disintegration, and help treat mental illness ? Yes , you undoubtedly can. If you can identify those who suffer from social isolation, the people at risk we talked of earlier, you can do something about it, or put them on to someone who can. If you see disintegration, of values and norms in the social network around you, because of whatever reasons, and in whatever guise, you should stand up and protest against it, and help those who are its victims. You should resist attempts of instant messiahs in a hurry to do good, you should seek such social change that does not disrupt. When you know that suicide is preventable and psychiatric treatment can get a person rid of his suicidal thoughts, you must motivate a colleague, a relative or a friend, to seek professional help and savor the immense mental satisfaction of a life saved. That is what you can do.
This calls for an integrated outlook wherein the approach of saving life after a suicidal attempt must combine with psychiatric treatment, including crisis intervention and drug treatment, counselling and sociotherapy. This is at the individual level. But it must be combined with measures to tackle poverty, unemployment and attempt to change value systems at the social level. We realize, therefore, that suicide prevention and control is a movement. It involves the State, professionals, lay volunteers and the public (Venkoba Rao, 1999). But the great need is to first of all identify it as a public health issue (Sartorius, 1996). Just as we think in terms of Malaria or Polio eradication, or have achieved small pox eradication, the effort has to be put in to bring about suicide eradication. On a similar war-footing, with a similar concerted total effort.
Permit us to present some more statistics, which further establish the connection between psychiatric illness and suicide.
Why must you know all these morbid statistics about the association between psychiatric illness and suicide ? Because psychiatric illnesses are treatable. Because a patient of Major Depression or Schizophrenia, or other psychiatric disorders, can be helped to get rid of his suicidal thoughts and impulses by taking treatment. Moreover, suicide risk is lifelong for patients with mental disorders (Baxter and Appleby, 1999). 15% of mood disorder patients subsequently commit suicide and 45-70% of suicides have mood disorder. 19-24% of suicides have made a prior suicide attempt and 10% of suicide attempters subsequently commit suicide in 10 years (Roy, 2001).
Helping such people out of their problems is what mental health professionals all the world over are doing day in and day out. This is where you can help if you come to know of someone with suicidal ideas. You can help him by convincing him, or his family members, to seek suitable psychiatric help. A past suicidal attempt is perhaps the best indicator that a patient is at increased risk of suicide. Epidemiological studies show that persons who commit suicide may be poorly integrated into society. Social isolation increases suicidal tendencies among depressed patients (Sadock and Sadock, 2003).
Hence what you can do is this : if someone has made a past suicidal attempt and survived, note that he is at increased risk. See that he doesn’t suffer from social isolation, he gets integrated into the social mainstream and takes treatment, if necessary, for any psychiatric disorder so as to remain psychologically fit and/or not get a relapse. Moreover, suicide has been linked with being chronically ill . For example, one out of every six long-term dialysis patient over the age of 60 stops treatment, resulting in death (Neu and Kjellstrand, 1986). Suicide rate among cancer patients is one and half times greater than that among non-ill adults. (Marshall et al, 1983), and suicide among men with AIDS is estimated at more than 36 times the national rate for their age group (Mazurk et al, 1988). What do you do here? All patients with chronic sickness need to be protected from social isolation. See that they are not left out, uncared for, neglected. It is tiring and taxing to care for them allright. But they have a right to live on with dignity as long as they can, and your effort in that direction can never go a waste.