More proactive strategy needed to combat suicides

by Michelle Nurse
Guyana Chronicle
May 24, 2001

GUYANA needs to take a more proactive stance and put policies in place to effectively deal with the alarming increase of suicides which represent a leading cause of death of the young, particularly male, East Indian members of the populace and pose a serious public health problem.

This was underscored by persons who made presentations yesterday morning at the Hotel Tower launching of a study on suicides in Guyana. The study, titled "Shadow of Death, a Recent Study of Suicides in Guyana: Incidences, Causes and Solutions" was funded by Psychiatrist Dr. Frank Beckles and conducted by Professor Dr. Ken Danns of the Centre for Economic and Social Research and Action (CESRA) during October and November last year.

Health Minister Dr. Leslie Ramsammy, who spoke at the launching, has pledged to "make something happen" in terms of putting into reality a programme to stem the cases of suicide. He acknowledged that it was a major public health issue which cannot be put on the back-burner. Dr. Beckles, who dedicated the study to his 34-year-old son, Professor of Political Psychology, Dr. Collin Anthony Beckles, who committed suicide in 1999 after suffering from manic depression, stated that the exercise was an attempt at putting conversations on the topic of suicide in Guyana in a "correct context". Two out of every three persons who commit suicide in Guyana are young people below the age of 35. Young adults between the ages of 20 and 24 are "over-represented" among those who kill themselves, the study found. Pointing to the constant threat of suicide, the study said that between 1996 and 1999, suicides in Guyana increased by 128.3 per cent. Although acknowledging that there is under-reporting of suicides and attempted suicides, Dr. Danns quoted Police summary statistics which said that there were 501 reported cases of suicidal deaths in Guyana from 1995 to 1999.

In 1999 alone, there were 164 suicide deaths, Danns said.

A "predominant majority" of these, eight out of every ten suicide deaths, which represent 81.6 per cent or 409, were males, compared to 18.4 per cent or 92 females, the study said.

Just over three out of every four citizens who committed suicide in 1997 were East Indians. East Indians, who comprise 48.3 per cent of Guyana's population, represented 76.2 per cent of all suicide cases reported in 1999.

In comparison, Blacks, who comprise 32 per cent of the population, register 11 per cent of the suicide deaths. Mixed and other ethnic groups who make up 22.7 per cent of the population represent 8.5 per cent of suicide deaths. Amerindians, who comprise 6.3 per cent of the population, represent 2.4 per cent of suicide deaths. Based on data available from countries like the United States, there is one successful suicide for every 16 attempts.

"Given this ratio, it is estimated that between five and six persons attempt suicide in Guyana everyday. In 1999, approximately every other day, a suicide has occurred in Guyana. Current figures on suicide for 2000/2001 were not available at the time this study was conducted. What is known, however, is that suicide has been increasing over the past decade. Further, there is significant under-reporting of both suicides and attempted suicides in this country," Danns said. He added that the illegal nature of the act of suicide and the stigma attached to it are the main reasons for the under-reporting.

"Suicide is the act of taking one's own life voluntarily and intentionally. It is an act of ultimate personal intimacy which individuals embrace to escape a pained existence generally occasioned by perceived hopelessness, depression, or uncontrollable anger. "Despite its widespread occurrence, suicide is not treated by governmental authorities as a serious health problem. The number of deaths by suicide is as significant as other deaths from unnatural causes. In 1999, there were 199 fatal road accidents and 91 murders. In the year 2000, there were 165 fatal road accidents and 74 murders. The 164 reported suicide deaths in 1999 neither received institutional attention nor resources given to the prevention of road accidents," Danns lamented.

Pointing to the reluctance of the Police and health authorities to divulge information on suicides, Danns surmised that this may be another reason for its non-recognition as a public health issue and a social problem.

The study has recommended that since it takes as many lives as AIDS, suicide should be announced as a public health problem. In brief remarks, Pan American Health Organisation/World Health Organisation (PAHO/WHO) representative, Ms Bernadette Theodore-Gandi, argued that suicide is a major public health problem in both Guyana and neighouring Trinidad and Tobago.

The situation here, she said, reflects a "chronic state of unhappiness and poor mental health" and requires urgent action.

Dr Theodore-Gandi cautioned that the route of denial on the part of the authorities must be avoided.

Among the reasons people commit suicide, the 231-page document found are: domestic/family problems, problems with love relationships, alcoholism, domestic violence, parental pressure, bankruptcy/economic problems, infidelity, depression, conflict with the law, the accusation of having AIDS and demonic/spirit possession. But Professor Danns cited more deep-seated reasons for the recourse to self-destruction. These include: a difficulty in communicating rage, particularly among teenage East Indians; no readily available mechanism of "externalising stress and frustration"; and the authoritarian nature of East Indian families which precludes freedom of choice and expression. "Parents still seek to decide who their children should marry and befriend, where they can or cannot go and in other ways restrict their personal autonomy even when they are young adults. The East Indian female is particularly affected by such restrictions on personal autonomy which extends into and may even increase when she marries," the study said. August, September and October are the months in which more suicides are committed, most times on weekends.

Rise Organise and Rebuild Parliamentarian Mr. Ravi Dev, who has been addressing the subject for some time now and who spoke at the launching, described August at the "killing month".

The study said "popular times" for self-death are between 17:00 hours (5 p.m.) and 21:00 hours (9 p.m.). Many persons bent on suicide would ingest poisonous substances such as monocrotophus, gramaxone, malathion and other weedicides, insecticides and pesticides. Others, particularly men, hang themselves, set themselves on fire, overdose on pills and alcohol, stab or slash themselves or drown themselves.

Shooting is said to be a rare method of choice because of the unavailability of guns. Nine out of every ten victims kill themselves in their own homes. The title of the study suggested itself after researchers visited Guyana's major suicide `nest' - Black Bush Polder in Berbice.

Berbice has more cases of suicide than any other part of Guyana. Fifty-two point seven per cent of all suicide cases occur in that county alone. The other large suicide`nest' is Region Two. Black Bush Polder, according to Danns, is a "massive suicide nest that led us to entitle the study `The Shadow of Death'. Almost one in every four houses in this community had a least one person who had committed suicide or attempted it. In many instances, there were multiple victims in the same household. Another household reported as many as 13 family members who committed suicide over a 15-year period. And at least three other households reported losing as many as ten family members to suicide".

"In any gathering of four or more males in this East Indian farming community, it is very likely that at least one would have attempted to take his own life. Not only is suicide and attempted suicide prevalent in this community, it is also both normal and expected by residents, Police and health officials," Danns added.

But ironically, cradled in the Black Bush Polder farming community, is a Black village called `Zambia' where there is no evidence of suicide although they are farmers and live a remote existence, the study found.

Zambia's population is about 300.

"Blacks attribute their non-involvement in suicide to their belief in God, their greater involvement in their church and a belief that only God should take life," the study said. Resident Instructor of the Institute of Distance and Continuing Education (IDCE) in New Amsterdam, Ms Paulette Henry, acknowledged the "culture of acceptance" in the Berbice area as it relates to suicide. "We have found that in particular communities, people expect people to commit the act, and it serves as a self-fulfilling prophecy, more or less, because if there is a cultural acceptance, then obviously the end result would be suicide," she said. Noting that there is a need to consider how the men in Guyana respond to stress, Ms Henry said:

"If you are to check the New Amsterdam Psychiatric Hospital, the report there for 1999 shows that there were 210 inmates at that institution and of that number 135 were men. Of that number too, 79 were Black men. Here we have, in terms of mental health issue, Black men responding, by `going mad'. On the other hand, our East Indian males are opting out via suicide." Addressing the small gathering, economist, Professor Clive Thomas said the study comes at a period when Guyana is now struggling to achieve demographic and health transition with the striving for a life expectancy rate of 70 years or more, and decline in fertility and death rates, and the principal causes of death which, in the past, were infectious communicable diseases.

The results of the study should make Guyanese feel ashamed that the problem was not tackled before and the situation was not engaged more frontally, Dr Thomas said. He added that one of the public health challenges Guyana has to face is coping with the broader aspect of preventable causes of death among the young.