Suicide August 2024

SUICIDE
BEATRICE CYNTHIA CHITALAH

LEARNING OBJECTIVES
 By the end of this presentation we should be able to;

 Define suicide
 Determine the incidence of suicide
 Identify the factors that affect suicide
 Understand the modes of suicide
 Recognize the measures of preventing suicide
INTRODUCTION
 Every year more than 700,000 people take their own life
and for every suicide there are an estimated 20 suicide
attempts.
 Suicide can occur at any stage of life and in all regions of
the world.
 In 2019 suicide was the forth leading cause of death
among 15-29year olds globally and 77% of all suicides
happened in low middle income countries.
CONT
 Almost 20% of global suicides were due to pesticide self

poisoning
 Every suicide is a tragedy that affects families,
communities and the entire countries and has long
lasting effects on the people left
 Suicide is a serious public health problem , however
suicides are preventable with timely, evidence based
and often low cost interventions
DEFINITION OF SUICIDE
 Originally, the word suicide founded on Latin language

 “Sui” (oneself) and “caedes” (killing)
 suicide constitutes all cases of death directly or
indirectly resulting from an act of a person who is aware
of the consequences of the behavior
CONT
 “suicide is a permanent solution to a temporary problem “
 If this is so obvious, then why is suicide so distressingly common?

PREVALENCE IN MALAWI
 According to police statistics, the current rate of suicide rate is at 11.6per 100,000
people higher than the global average of 10.5per 100,000
FACTORS AFFECTING SUICIDE
sex
 men are better at suicide than women .
Four times as complete suicide , but women
make more attempts
 male suicide are more lethal because men
typically use fatal methods
AGE
 : For all groups, suicide is rare before puberty. Suicide

rates increase with age and underscore the significance
of the midlife crisis.
 Among men, suicides peak after age 45; among
women, the greatest number of completed suicides
occurs after age 55.
 Older persons attempt suicide less often than younger
persons, but are more often successful.
 Although they represent only 13 % of the total
population, older persons account for 16 % of suicides.
MARITAL STATUS
 Marriage lessens the risk of suicide significantly,

especially if there are children in the home.
 Single, never-married persons register an overall rate
nearly double that of married ones.
 Divorce increases suicide risk, with divorced men 3
times more likely to kill themselves as divorced women.
 Suicide occurs more frequently in persons who are
socially isolated and have a family history of suicide
OCCUPATION
 The higher the person's social status, the greater the risk of
suicide, but a drop in social status also increases the risk.
Work, in general, protects against suicide.
 Suicide is higher among unemployed persons.
HEALTH FACTORS
 Physical Health: serious /chronic health condition

/pain
 About 1/3rd of all persons who commit suicide have had
medical attention within 6 months of death, and a
physical illness is an important contributing factor in
about half of all suicides.
 The secondary effects of illness – such as disruption of
relationships and loss of occupational status - are
prognostic factors.
MENTAL ILLNESS
 Almost 95 % of all persons who commit or attempt suicide have a

diagnosed mental disorder.
 Depressive disorders account for 80 % of this figure, schizophrenia for
10 %, and dementia or delirium for 5 %.
 Among all persons with mental disorders, 25 % are also alcohol
dependent & have dual diagnoses Psychiatric Patients:
 Their risk for suicide is 3 to 12 times that of non patients. Male & female
psychiatric patients who have at been inpatients have 5 & 10 times
higher suicide risks, respectively.
 The psychiatric diagnosis with greatest risk of suicide in both sexes is a
mood disorder. The period after discharge from the hospital is also a
time of increased suicide risk.
HISTORY OF PREVIOUS SUICIDAL
BEHAVIOR
A past suicide attempt is perhaps the best indicator that
a patient is at increased risk of suicide.
 Studies show that about 40 percent of depressed
patients who commit suicide have made a previous
attempt.
 The risk of a second suicide attempt is highest within 3
months of the first attempt
OTHER FACTORS
 Family history of suicide

 Difficulties in accessing health care and receiving the care
needed
 Stigmatizing people who seek help for suicidal behavior
 Discrimination
 Sense of isolation
 Abuse
 Violence and conflicts in relationships
MODES OF SUICIDE
SUICIDE POD
MODE
WARNING SIGNS
FEELINGS
Hopelessness  Sadness
 Helplessness
 Isolation
 Loneliness
 Anger
 Disconnection
 Worthlessness  Exhaustion
 Powerlessness  Trapped
 Irritability
 Shame
 Rejection
SPEECH
 Helplessness: “Nothing I do makes a bit of difference, it’s

beyond my control and no one can help me.”
 Talking about suicide or death
 Planning for suicide
 Feeling trapped: “I can’t see any way out of this mess.”
 Feeling like a burden: “They’d be better off without me.”
 Lack of belonging: “I just don’t fit in anywhere.”
SPEECH CONT.
 Hopeless: “What is the point? Things are never going to get any
better.”
 Guilt: “It’s my fault, I’m to blame.”
 Escape: “I just can’t take this anymore.”
 Alone: “I’m on my own… no one cares about me; no one would
even notice if I was gone.”
 Damaged: “I’ve been irreparably damaged… I’ll never be the
same again
BEHAVIOR
 Self harming
 Uncharacteristic risk-taking or recklessness
 Fighting and/or breaking the law
 Unexplained crying
 Emotional outbursts, mood swings
 Increased irritability
BEHAVIOR CONT.
 Prior suicidal behavior

 Alcohol and drug misuse
 Withdrawal from family and friends
 Quitting activities which were previously important
 Putting affairs in order
 Writing suicide notes or goodbye letters to loved ones
PHYSICAL CHANGES
 Major changes to sleeping patterns; usually too little, though maybe too
much
 Loss of energy
 Loss of interest in personal hygiene or appearance
 Loss of interest in sex
 Sudden and extreme changes in eating habits; either a loss of appetite or
an increase in appetite
 Weight gain or weight loss
 Chronic illness and pain
HOW TO ARREST THE SITUATION
WHO (2014)proposes three strategies to

arrest suicide:
Universal prevention strategies
Selective prevention strategies
Indicated prevention strategies
UNIVERSAL PREVENTION STRATEGIES
Aims at reaching the general population; nation ,

community or school
They are designed to influence everyone by;
Reducing suicide risk through removing barrier to care
Enhancing knowledge of what to do and say to help
suicidal individuals
Increasing access to help and information
Strengthening protective processes like social support and
coping skills
UNIVERSAL INTERVENTIONS
 Universal public campaigns

 School based suicide awareness programs
 Education programs for the media on reporting
practices related to suicide
 School based crisis responses plans and teams
SELECTIVE PREVENTIVE STRATEGIES
Addresses the subset of the general population.

Focuses on groups at risk and have a greater
probability of becoming suicidal
 They aim at Preventing the onset of suicidal
behavior's among specific subpopulations
INTERVENTIONS/ PROGRAMS
 Screening programs
 Gatekeeper/ primary health worker training for front
line adult caregivers and peer natural helpers
 Support and skill building groups for at risk groups in
the population
 Enhance accessible crisis services and referral sources
INDICATED PREVENTION STRATEGIES
Meant to address specific high-risk individuals

within the population- those evidencing early
signs of suicide potential.
 programs are designed and delivered in groups
or individually to reduce risk factors and increase
protective factors
INTERVENTIONS/PROGRAMS
 Skill building support groups in schools and communities

 Referral sources for crisis intervention and treatment
ADDITIONAL PREVENTIVE STRATEGIES
Economic development through its ability to

reduce poverty may be able to decrease
suicide rates
Prevention of childhood trauma may provide
an opportunity for suicide prevention.
ADDITIONAL READING
 Mental Health Action Plan (2013-2020). Geneva.

 World Health Organization (2008). Mental Health Gap
Action Programme
 World Health Organization (2014). Preventing suicide: A
global imperative. WHO
REFERENCE
 Nordqvist, C (2018). What are suicidal thoughts? Medical

News Today
 Dzamalala, C. P., Milner, D. A. & Liomba, N. G. (2006).
Suicide in Blantyre, Malawi. Journal of Clinical Forensic
Medicine, 13(2), 65-69

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SUICIDE

BEATRICE CYNTHIA CHITALAH

 By the end of this presentation we should be able to;

 Almost 20% of global suicides were due to pesticide self

 Originally, the word suicide founded on Latin language

 “suicide is a permanent solution to a temporary problem “

 If this is so obvious, then why is suicide so distressingly common?

 : For all groups, suicide is rare before puberty. Suicide

 Marriage lessens the risk of suicide significantly,

 Physical Health: serious /chronic health condition

 Almost 95 % of all persons who commit or attempt suicide have a

 Family history of suicide

 Helplessness: “Nothing I do makes a bit of difference, it’s

 Prior suicidal behavior

WHO (2014)proposes three strategies to

Aims at reaching the general population; nation ,

 Universal public campaigns

Addresses the subset of the general population.

Meant to address specific high-risk individuals

 Skill building support groups in schools and communities

Economic development through its ability to

 Mental Health Action Plan (2013-2020). Geneva.

 Nordqvist, C (2018). What are suicidal thoughts? Medical

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