Crisis hotlines, training seen as part of suicide prevention strategy

Several measures, including setting up crisis hotlines for people burdened with problems and teaching coping strategies to students in schools, were outlined during a recent two-day regional workshop on suicide prevention.

Dr Sonia Chehil, Advisor to the Ministry of Health on Mental Health and one of the facilitators during the workshop called the sessions important because “suicide is an issue here and we want to change that”. She said the discussions focused on what systems of suicide prevention could be implemented in the participating countries.

“Because suicide is a complex issue, we wanted to get together as individuals who are facing the same problems but we also included experts on the subject from WHO and PAHO to determine what works and what doesn’t and to follow the strategies which have been successful in reducing the number of cases in various countries,” Chehil said in a recent interview.

She said examples were presented of what is happening internationally, but noted that the measures to be taken would have to be placed within the context of what is possible here and in the neighbouring countries. “What is it that we can do here in Guyana, or say Trinidad and Tobago or Suriname to impact and change what is happening with suicide?”  This, she said, was the fundamental question and the issue most pertinent to the workshop.

Dr Chehil stressed how critical is it for social workers, health care workers and persons generally in care professions to receive training as part of a strengthened suicide prevention strategy. Across the board, she said, need for a high level of training has been recognized since “detecting early signs is important”. She said the training is aimed at equipping persons with the skills necessary to pinpoint problems even when the people they are interacting with never mention a word of their problems. “This type of awareness is the foundation of any mental health strategy,” she added.

Still on the issue of training, she observed it must be linked to services, specifically support services for persons at risk and underscored that people with problems must have access to appropriate care. She said too that persons working with such individuals must also feel comfortable in providing that care. But she also identified communities as playing an integral role. Since persons with mental health disorders are considered high risk recommendations, coming out of the workshop included a call for risk factors to be identified in order to determine the more vulnerable.

“Who are the protectors in communities, this is what we are seeking to find out and to strengthen their responses,” she said while pointing out that the next step includes identifying gate keepers in the communities. She explained that gate keepers are individuals or groups within a community that people can turn to when they are in a crisis.

She mentioned also the follow-back programme which was recently initiated by Health Minister Dr Leslie Ramsammy and aims at studying suicidal behaviour in an attempt to identify early signs saying that it is not only about targeting communities with a large number of suicide cases, but any community where a case would have emanated from.

Questioned on whether there are any specific regional strategies which have been implemented to curb suicide, Chehil said she is aware of none. However, she said measures have been put in place in various countries to stem the problem and that they appear to be working. She stressed that she could not speak authoritatively on this particular area.

According to her, the number of cases in Trinidad and Tobago and Suriname did not appear to be vastly different from Guyana but she made the point that this does not necessarily mean other countries in the region are not recording similar and or higher numbers of cases, adding that it might be a question of how many cases are being captured.

Stabroek News also spoke with Dr Brian Mishara, President of the International Association of Suicide Prevention who was here for the workshop. During his presentation he talked about suicide prevention and strategies that might be feasible in the region while stressing the importance of drawing the link between suicide and mental health disorders.

Dr Mishara said suicide prevention involves giving hope to people “by helping them learn there are other ways of getting help for the pain and suffering they are going through”. He proposed setting up hotlines for persons in crisis situations saying they can prove extremely useful when people have nowhere to turn. “People in these situations feel that their problems are interminable ones that will never end and are insupportable which is why such a thing would be good,” he added.

The suicide rate locally is approximately 20-25 per 100,000 population and it has been consistent for years. Suicide has also ranked seventh of the ten major causes of death in Guyana for years, averaging around 200 deaths annually. Ramsammy recently said that mental health has been neglected for years, but he declared it is now occupying a priority space on the health agenda.