Sept 09, Colombo: Her best friend ended her life one day and Sarani* couldn't believe it. "I told everyone that it must be an accident, I was lying to myself too... she never said anything, she wasn't that type of person. I felt guilty too. How could I have not known? I could have saved her."
This Sunday (September 10) is World Suicide Prevention Day. On this day, hundreds of survivors, friends, family and allies will walk from Diyatha Uyana at 3.30 pm to the Viharamahadevi Park Amphitheatre in memory of loved ones and those that struggle every day.
The walk is also in support of the survivors of suicide, says co-organizer Nivendra Uduman. "Survivor guilt is a phenomenon that is often overlooked in Sri Lanka," he says. "There is a 'wall of silence' that builds around families who have lost loved ones to suicide." The walk is organized by Nivendra together with Giselle Dias, with the primary support of the Theme Institute.
Nivendra is a counselling psychologist by profession. He was inspired to organize this event on Sunday because he believes that suicide prevention is not spoken about enough, and because the approach many of us use to respond to those having suicidal thoughts is flawed.
He was also moved by the plight of survivors, saying "There is very little support available for survivors of suicide loss. This is an area that requires a great deal of attention from both the public health sector and mental health professionals working in the private sector. This must be a part of the mental health agenda in the country. You cannot ignore those who are left behind."
In Sri Lanka the numbers for suicide remain high. Globally, one person dies due to suicide every 40 seconds. In Sri Lanka, nearly 3,000 people died in 2015 due to suicide according to the Department of Police.
To understand the numbers, one must examine the root cause. Mental illness can be an experience anyone can have at any point in their life, says Nivendra.
There is no exclusivity when it comes to who develops mental health problems and who doesn't- though some individuals and groups could be more vulnerable than others. Genetic, biological and environmental factors often combine to increase the risk of someone developing a mental illness and it is often difficult to narrow it down to one causal factor.
"Suicide is a complex phenomenon without one specific reason, and there are a number of reasons as to why the suicide rate in Sri Lanka is high," he says.
"Depression combined with alcohol and substance misuse is often seen as a reason why one might attempt to take his or her life. Loneliness, and the concept of shame that is so embedded in our culture are also factors that contribute to people attempting suicide in both urban and rural settings in Sri Lanka."
There are also other stressors like examination pressure, parental conflict, relationship issues, fear of failure, etc. that cause young people especially to engage in self-harming behaviors. The lack of coping skills often leads to people seeing suicide as a permanent solution to temporary problems. There are also psychosocial issues, especially as a result of war and other calamities that have taken place in the country. In addition debt, domestic violence, alcoholism are often cited as reasons for suicide, Nivendra says.
"However, we must also acknowledge that there could be many other reasons that we are not so aware of, as there has been very little research done on suicide in Sri Lanka."
If you think that a loved one or a friend may be contemplating suicide, don't be afraid to ask them, he says. "Asking provides a permissive environment and an opening for the person to talk about what they are feeling. It does not put thoughts in their mind, or give them ideas that they do not already have- so, be direct and do not beat around the bush. Take every indication of suicidal ideation seriously."
Nivendra also shared some advice on listening without judgement. Active listening is of crucial importance when someone is sharing their thoughts and feelings with you. Communicating to them that they have your full attention and that you are fully present can make a huge difference when someone is in crisis, he notes. Simple strategies such as making eye contact, nodding your head occasionally to demonstrate that you are listening, minimal verbal encouragers such as 'mmm' and 'uh huh' can go a long way in helping someone express their feelings. Reflecting back on what they are saying, by simply repeating key words they use can also help to keep the conversation going. Demonstrating empathy by putting yourself in their shoes and seeing their world from their eyes can be very helpful for someone who may be suicidal. It can also be helpful to ask 'what can I do to help?' rather than forcing help on someone who might be in crisis.
Nivendra also added, "It is important that one avoids giving advice and providing solutions and I must stress on the importance of not saying 'I understand how you feel' because you probably don't. Phrases like 'just get over it', 'everything will be okay', 'don't be silly' should be avoided as that can cause someone to feel like their problems and feelings are being trivialized."
"To ensure their safety, do not leave a person who is at risk of suicide alone-this is also a very positive way of showing them that you care. Remove potentially dangerous objects like knives and pills from their vicinity, and help them develop a safety plan. This can include coping strategies, and phone numbers of people and organizations they can reach out to. The main thing to do is to listen non-judgmentally and to provide a space for them to share their thoughts and fears, stresses Nivendra. "A person who is suicidal can be gently persuaded to seek support, and in the event that an individual refuses help, do not take it personally. Be persistent and reassure the person that you can also accompany a loved one or a friend to seek help. This will prevent one from feeling alone. Following up through phone or in person can also be very helpful."
He hopes that Sunday's event will raise awareness, and more importantly let those with suicidal thoughts know that they are not alone. Join Giselle, Nivendra and their friends at 3.30 pm at the Diyatha Uyana Amphitheatre for the walk, followed by the 6 pm tribute concert to Linkin Park, "Somewhere I Belong", at the Viharamahadevi Amphitheatre.
Support is available on the following helplines for anyone who needs it: Sumithrayo - 0112696666/0112692909, CCC Line - 1333, Shanthi Maargam - 0717639898.
These are a few early warning signs if a loved one, friend or colleague is contemplating suicide:
- Loss of interest in once pleasurable activities
- Acting anxious and agitated
- Sudden reckless behaviour
- Sudden changes in sleep and appetite
- Mood fluctuations
- Alcohol and substance misuse
- Talking/writing about death
- Indicating that he/she feels like a burden to others and that others would be better off without him/her in their lives
- Talking about feeling trapped, looking for a way out
- Indicating that one feels hopeless
- Giving away possessions to others
- Premature writing of a will, attending to unfinished business
- Saying ‘good-bye’ to friends and family
- Purchase of materials such as rope, poison, knives, large quantities of pills, etc.
- A sudden positive change in mood after being agitated and low. A person suddenly appearing very calm and collected can be a cause for concern.
*name has been changed