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Suicide and Suicide Prevention

Suicide: “ an act with a fatal outcome, that is deliberately initiated and performed by the person in the knowledge or expectation of its fatal outcome”

Suicide-Worldwide Context:

· 3 males to 1 female observed in completed suicides (more females attempt suicide and more males complete suicide)

· 10.9 per 100,000 suicidal deaths worldwide (over 700,00 persons die by suicide) (WHO, Suicide Report)

· risk among the elderly; there is a bimodal distribution in adolescence and elderly persons

· Ingestion of pesticide, hanging and firearms are among the most common methods of suicide globally (WHO, Suicide Report)

Suicide-The Bahamian Context

· Overall rate of suicide is 2.8 per 100,000 (approx. 3/100,000); rate highest among 35-44yrs (David Allen et al)

· There were 11 completed suicides in 2020 (Royal Bahamas Police Force (RBPF)

· There were 8 completed suicides in 2019 (RBPF)

· A Bahamian male is 5.13 times more likely than his female counterpart to commit suicide (David Allen et al)

· Majority of victims hung themselves (64%); fall (8%); overdose (6%) (period 2008-2012)

· High incidence of completed suicides in the months of January and February could be possibly attributed to the post-Christmas blues (this is anecdotal and more empirical data is needed)

· High incidence in October, could possibly be associated with the stress of the hurricane season (this is anecdotal and more empirical data is required) (David Allen et al)

Suicide Risk Factors Include:

· Underlying Mood Disorder (observed in 60-70% of suicide victims):

· Schizophrenia (observed in 10% of completed suicides)

· Alcoholic Dependence (observed in 7%-10% of completed suicides):

· Personality Disorder (33.33%-50%): Borderline and Antisocial Personality Disorders implicated

· Substance Use Disorders: associated with Cocaine Use Disorders; polysubstance pattern of abuse (alcohol, marijuana, cocaine)

- Social Class: unemployed; highest risk in social class V (unskilled workers) followed by social class 1 (professionals)

· Occupations: veterinary surgeons, pharmacists, farmers, medical practitioners, dentists

· Prisoners, especially those on remand

Suicide Red Flag Warning Signs:

· Person wishes to die; reporting to friends and family that life is not worth living

· Person makes a direct statement of suicidal intent or of a clear suicidal plan

· Person has history of a failed suicide attempt

· pre-mediated or impulsive

· making efforts to conceal their intent and plan and become very secretive in their movements and their activities

· putting affairs in order in preparation for death

· talks about being a burden to others

· increases the use of alcohol and other drugs

· sleeps too little or too much

· acts recklessly, for example, driving whilst under the influence of alcohol; spending excessive amounts of money; spending frivolously

· withdraws from activities

· isolates from friends and families

· visits or calls people to say goodbye

Recognizing suicidal behaviour as soon as it occurs and seeking help from your primary physician (first contact of care) is extremely important.

With prompt treatment a person with suicidal ideation or thoughts can return to a happier life and a healthier outlook.

If you or a loved one is experiencing suicidal ideations or thoughts, do not be dismissive of the symptoms but schedule an urgent appointment with your primary physician i.e., family medicine practitioner; general physician; internal medicine specialist.

The primary care practitioner will complete the initial assessment and then refer you on to a mental health professional (a psychologist or a psychiatrist) for treatment and care, if it is indicated

Alternatively, if the person has suicidal thoughts and a specific suicidal plan, do accompany them to the emergency room for an assessment, treatment and care by trained mental health professionals (DO NOT BE DISMISSIVE---->LISTEN--->ACT--->FOLLOW UP--->OFFER SUPPORT)


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