My Post-Editorial on "Silent Epidemic", published today, Daily Observer, Bangladesh 14/09/2018 Friday, 14 September, 2018, 10:32 AM Home Op-Ed Suicide: The silent epidemic of 21st century Published : Friday, 14 September, 2018 at 12:00 AM Count : 1604 Avik Gangopadhyay Since 2003 the International Association for Suicide Prevention has been collaborating with the World Health Organization and the World Federation for Mental Health to host World Suicide Prevention Day, an awareness day observed on September 10 every year, in order to provide worldwide commitment and action to prevent suicides. In past years, over 300 activities in around 70 countries were reported, including educational and commemorative events, press briefings and conferences, as well as Facebook and Twitter coverage, yet it appears to have passed by silently. An estimated one million people per year die by suicide or about one person in 10,000, or "a death every 40 seconds or about 3,000 every day". The number of people who die by suicide is expected to reach 1.5 million per year by 2020. Suicide is a global phenomenon. It knows no social, racial or economic barriers. 79 per cent of suicides occurred in low-and middle-income countries in 2016. Suicide accounted for 1.4 per cent of all deaths worldwide, making it the 18th leading cause of death in 2016. According to WHO's Mental Health Atlas released in 2014, no low-income country reported having a National Suicide Prevention Strategy, while less than 10 per cent of lower-middle income countries, and almost a third of upper-middle and high-income countries had. About 800,000 people commit suicide worldwide every year, of these 135,000 (17 per cent) are residents of India, a nation with 17.5 per cent of world population. Between 1987 and 2007, the suicide rate increased from 7.9 to 10.3 per 100,000, with higher suicide rates in southern and eastern states of India. A report by Shaheed Suhrawardy Medical College Hospital, Dhaka, published in 2010, says, around 6,500,000 people of Bangladesh are prone to suicide. 128.08 people per 100,000 commit suicide in Bangladesh every year. Japan's suicide rate is the sixth highest in the world and the second worst among eight major industrialized nations, according to the latest government white paper. Suicide is still the leading cause of death for women aged 15-34 in Japan. Japan's suicide rate (the number of suicides per 100,000 people) stood at 19.5 as of 2014. Russia topped the list of eight major economies at 21.8, 15.1 in France, 13.4 in the U.S., 12.6 in Germany, 11.3 in Canada, 7.5 in Britain and 7.2 in Italy. The 11.7 suicide rate for Japanese women was the third highest, following South Korea's 17.3 and Suriname's 13.4. The highest rate was observed in Lithuania, where 30.8 out of 100,000 were recorded as having taken their own lives. It was followed by 28.5 in South Korea and 24.2 in Suriname. There is a gender paradox in suicide. European and American societies report a higher male mortality by suicide than any other, while various Asian a much lower. A recent data provided by WHO, suggests that about 40,000 females of the global three hundred thousand female suicides and 150,000 males of the global half million male suicides, deliberately take their own life every year in Europe and the Americas. As of 2015, apart from a few South and East Asian countries home to twenty percent of world population, Morocco, Lesotho, and two Caribbean countries, because of changing gender roles suicide rates are globally higher among men than women. Nearly everyone experiences suicidal thoughts at one point or another throughout their existence. It is important to recognize that pain is an inevitable part of life and everyone deals with pain to a certain extent. Escaping the everyday pain and suffering associated with life is impossible. The Youth Risk Behavioral Surveillance System (YRBS) is a global survey, conducted by the Centers for Disease Control and Prevention, that includes national, state, and local school-based representative samples from 9th to college students. The purpose is to monitor priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth. Its 2016-Report indicates that Suicide is the SECOND leading cause of death for ages 10-24; it is the SECOND leading cause of death for college-age youth and ages 12-18; more teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease, combined; each day there are an average of over 3,041 attempts by young people in grades 9-12; 4 out of 5 teens who attempt suicide have given clear warning signs. There is a "Silent Epidemic" sweeping through nations that claim an average of more than 100 young lives each week. This "Silent Epidemic" is youth suicide. According to the Centers for Disease Control and Prevention's 2015 Youth Risk Behavioral Survey over 1 out of every 12 young people attempted suicide only in USA in 2014-15. It is difficult for adults to understand what would motivate a young person to take his/her own life. Changes in the behaviour of a child are often seen as a phase they are going through--just a part of adolescence. We need to recognize signs of concern and know how to react and get professional help if needed. Are we well informed about this "Silent Epidemic" of youth suicide? Do we believe that "Suicide is Preventable?" Then who's at risk? The good news is that 11 out of 12 did not attempt suicide. But ONE is too many, especially if it is your son or daughter, grandson or granddaughter or the young person next door. 4 out of 5 completed suicides gave clear warning signs before the attempt. While death is an uncomfortable subject for many people, it is important to be able to talk about it openly and honestly. An open discussion can help decrease some of the anxiety experienced by suicidal youth and come as a relief to them that someone else cares about them and wants to help them. Talking about suicide can help youth see the other options they have. Since people who are contemplating suicide feel so alone and helpless, the most important thing to do, if one thinks a friend or loved one is suicidal, is to communicate with him or her openly and frequently. It is important to observe whether one is depressed, psychotic, impulsive, silently crying out for help, has a philosophical desire to die, made a mistake-that means if someone is suffering from depression, bipolar disorder, schizophrenia, anxiety disorders or personality disorders. For this one doesn't need to be a psychiatrist. There are exhaustive campaigns about the "Common Causes" for people killing themselves yet it appears to fall short: mental illness, traumatic experience, bullying, personality disorders, drug addiction / substance abuse, eating disorders, unemployment, social isolation / loneliness, relationship problems, genetics / family history, philosophical desire / existential crisis, terminal illness, chronic pain and financial problems. One can't see what a person is feeling on the inside, however, some outward warning signs that a person may be contemplating suicide include: talking about feeling hopeless, talking about having no reason to go on living, making a will or giving away personal possessions, searching for a means of doing personal harm, such as buying a gun, sleeping too much or too little, eating too little or eating too much, resulting in significant weight gain or weight loss, engaging in reckless behaviours, including excessive alcohol or drug consumption, avoiding social interactions with others, expressing rage or intentions to seek revenge and showing signs of anxiousness or agitation. Widespread misconceptions too ring around that have been proven false: "People who talk about suicide won't really do it," "If a person is determined to kill him/herself, nothing is going to stop him/her," "Talking about suicide may give someone the idea," and "People who attempt suicide and do not complete suicide are just trying to get attention and are not really serious." Recognizing the signs and symptoms of suicidal behaviour such as -- feel hopeless, feel trapped, feel alone, feel anxious or agitated, feel as if there is no reason to go on living, think of suicide as a way out, experience mood swings, are abusing alcohol or drugs-will be our moment to prevent our children from taking their own lives, lead them to consultation centres that can respond to various kinds of problems and promote mental health in life and living. Is there any mapping out of policy principles on suicide countermeasures in this part of the world, except compromising with the quality of education? The government need to take a series of steps, including strengthening research on the medical and social causes of suicide, holding seminars for municipal leaders, and beefing up support for people who attempted suicide and for next of kin. Serious dedication is required to prevent suicidal behaviour, alleviate its effects, and provide a forum for academics, mental health professionals, crisis workers, volunteers and suicide survivors. More people die from suicide than from murder and war as it is the leading cause of death worldwide. According to WHO there are twenty people who have a failed suicide attempt for every one that is successful, at a rate approximately 1 every 3 seconds. A suicide attempt, even half-hearted, is an attempt to seek help and help must be sought for the individual. Avik Gangopadhyay, an author, critic and columnist, writes from Kolkata, India View in Publication Site