With 3000 cases of suicide reported annually and 8-9 incidents reported daily, suicide is a major public health issue in Sri Lanka.

Although less frequently spoken of, its prevention is no easy task, and requires much attention, especially during an economic crisis where inflation and unemployment are high.

It is also more prevalent in marginalized communities, such as the LGBT+ community. In such communities, it is not their sexuality or gender identity that leads to suicide, but prejudice discrimination, family rejection and isolation. 

Risk factors for suicide can arise from oneself, relationships, and the community/society. Such individual risk factors can include previous suicide attempts, illnesses, legal or financial issues, adverse childhood experiences or substance abuse. Harmful experiences within relationships such as conflict, loss, isolation and bullying also contribute to risk, along with challenging issues from a community such as discrimination, violence, trauma, stress or lack of access to healthcare. Finally, cultural and environmental factors within society, such as stigma to mental illness, unsafe media portrayals of suicide and access to lethal means are also risk factors. 

Furthermore, psychological factors such as negative events, negative thoughts, negative emotions, and negative personality traits influence suicide.

What are the warning signs? 

Warning signs are behaviors that indicate that someone may be at immediate risk for suicide. It can be through active verbal markers, such as, “I want to kill myself” or passive verbal markers such as, “It will be fine if I got hit by a vehicle”, “Everyone would be better off without me.”, “I wish I was never born”, “I have no purpose” etc. Both active and passive verbal markers, as well as conversation about feeling trapped, being a burden, unbearable pain, and having no reason to live should all be given utmost attention. 

Mood swings, depression, lack of interest, irritability, anger, embarrassment and anxiety are all warning signs, along with other behavioural traits such as researching means to suicide and making plans for suicide, posting about wanting to die, withdrawing from activities and isolating, acting recklessly and expressing hopelessness, sleeping too much or little, and giving away possessions. Take these seriously and refer the suffering person for help.

What are the protective factors?

Risk factors can be balanced out by protective factors, and can be grouped into individual, relationship, community and societal factors. 

Individual factors such as academic achievements and life skills, self-esteem, and strong identity, and healthy relationships factors such as positive relationships with family and friends, support, and feeling connected to others prevent suicide. Community and society factors such as having a sense of belonging to something bigger than themselves, moral obligations, lack of access to lethal means and increasing of access to healthcare protect against suicide risk.

What can be done?

Suicide is complicated and tragic, but it is often preventable. Knowing warning signs, risk factors and how to assist can help save lives. 

• Remove the stigma by starting conversations, to enable the doors of communication to those suffering from suicidal thoughts. 
• Educate yourself, debunk the misconceptions, and learn about the warning signs. 
• Check in on your loved ones and be present for them.
• Take all talk of suicide seriously and engage and connect in a personal, caring way and ask how they are feeling, while listening in a non-judgmental manner and validating their thoughts. 
• Explore risk by asking if they have a plan to attempt suicide and whether they have attempted suicide in the past.
• Do not leave the person alone and help keep them safe by removing weapons, medications, and objects that could be used for hanging. Stay with them till they are evaluated by a professional and have a friend or family member to be with them.  
• Engage the person in a plan for safety, by providing information of crisis service, and encouraging them to seek professional help as soon as possible. 

Where can you go for help?

While it can be difficult to know where to turn when you're struggling with your mental health, you can call a helpline to seek support whether you're going through a tough time, or you're concerned about a loved one. 

• The National Mental Health Helpline on 1926 is dedicated to providing 24/7, free and confidential support by phone and text message. 
• Sumithrayo offers emotional support to those who are lonely, depressed, despairing and in danger of taking their own lives.
• Shanthi Maaragam provides support for children and adolescents to improve their emotional wellbeing with a goal of breaking the cycle of violence 
• CCC1333 is a free telephone counselling service that provides emotional support and guidance for people facing difficulties. 
• The "Alokaya" Counseling Center at the FPA allows one to express their problems freely through active listening, and empathetic responses without pre-judgment. Counseling techniques to change the negative outlook on life are used to help solve problems and find alternative solutions, and to revive hope about their responsibilities, life, and the future.

These helplines will provide you with the lifeline you need when you need it the most. Your life and that of your loved one is important, hence when in need, do make that call. 

Suicide is not inevitable for anyone and the right action at the right time can save lives. 



References

Andrew M, Sri Lanka’s suicide on the rise after worst currency crisis, economynext, 26th April 2023,  https://economynext.com/sri-lankas-suicide-on-the-rise-after-worst-currency-crisis-118954/ 

Johns, M. M., Lowry, R., Haderxhanaj, L. T., et al. (2020). Trends in violence victimization and suicide risk by sexual identity among high school students — Youth Risk Behavior Survey, United States, 2015– 2019. Morbidity and Mortality Weekly Report 69 (Suppl-1):19–27.