Prof Rajesh Sagar, Department of Psychiatry, Delhi-AIIMS, shared his views with DTMT on suicide prevention. Dr Sagar says that there should be national plan for suicide prevention while removing stigma attached to suicides, proper treatment, and early identification to reduce the suicide risks. Dr Sagar points out that there should be responsible media reporting on suicides.
DTMT: How can suicides be prevented?
Dr Sagar: Suicide prevention requires involvement of all stakeholders. In fact, suicide prevention should be the integral part of framework policy. However, National Mental Health Policy includes suicide prevention and we have National Mental Health Program but there is need to have national strategy for suicide prevention.
DTMT: How can it be planned?
Dr Sagar: For this we have to see how we involve stakeholders and treat vulnerable groups including students, college students, people suffering from chronic medical illness, the elderly, people with disability, farmers, women and those who are below poverty line.
We have to address their needs. For example, for farmers, we have to involve the agriculture minister. We need to involve concerned officials. For students, we need to involve schools, colleges, HRD ministry, and Women and Child Development Ministry. Focus would be on creating awareness.
We need to make a person self empowered so that he or she can seek help because psychiatric illness or suicide has stigma attached to it.
DTMT: Role of awareness in preventing suicide?
Dr Sagar: We need to develop some strategy for mental health first aid. If a person is exhibiting high risk for suicide, what can the family do, what can the teacher do and what can the employer do, because even to take him or her to a hospital takes time. We need to have some awareness program on immediate mental health care provider.
There is a need to assess what are early signs of psychiatric illness, its management, removing its stigma, proper follow up and continuity of care, proper medication. To tackle this, it requires multidimensional approach.
DTMT: Have cases of suicide increased?
Dr Sagar: Yes, cases of suicide have increased due to media reporting and awareness. But there is no authentic data to validate it.
DTMT: How can one identify suicide symptoms?
Dr Sagar: Changes in behaviour of a person like talking less, changes in his personality, not eating, not mixing with people, not going to school or college, taking more alcohol and substance use and feeling low.
DTMT: How much time does it take to have a feeling of suicide?
Dr Sagar: There is no such thing as time. This can be immediate.
DTMT: How do you see suicides in the medical fraternity?
Dr Sagar: Medical course itself is a stress as any stress leads to suicide. They feel there is no help available and think this is the only means available. Basically, they cry for help. That is where our society needs to change. We have to provide support and empathy to people. We have to understand them. That is the job of people. There are cases when society labels a person who have survived a suicide attempt as a weak person. Such people are humiliated and embarrassed. These feelings can be nasty for him. These things can create problems because you stigmatize and discriminate such a persons. It is a very sensitive issue.
Awareness on mental health should start in families. Parents should speak to their child. Education on mental health program should also start in schools. There should be responsible media reporting on suicides. Media should not sensationalize or glamorize suicides. Media reports on sucicides in Janakpuri in Delhi were sensational. People follow these steps for suicides.