Suicide is getting more and more attention worldwide day by day. According to the World Health Organization, nearly one million people die from suicide every year, or a person dies every 40 seconds. Moreover, the rates of suicide have increased in the last 45 years by 60 percent worldwide. It is a leading cause of death in some countries. The group of highest risk is young people, aged 15-44, especially males.
The risk factors for suicide include mental illnesses, such as depression, violence, alcohol abuse, financial problems. Among other mental disorders are schizophrenia, bipolar disorder, drug abuse, and social background.
Nowadays it is a challenge for countries and world health care organizations to prevent suicides. A number of strategies imply care about the population’s mental health, increased attention to risk groups, restriction of access to the means of suicide, improved access to social services and identification of people, suffering from suicide, and help him or to cope with the problem.
The research is analyzed in the main three studies, which are found out to be the most effective. The research in different countries such as India, Denmark, and in different age groups are drawn in order to realize the link between the density, economic welfare, and the quality of medical service.
Suicidal Behaviour in Special Population: Elderly, Women and Adolescent in Special Reference to India
According to Rohit Garg, J.K. Trivedi, and Mohan Dhyani, “Suicide is a fatal self-inflicted destructive act with explicit or inferred intent to die” (2007). Suicidal behavior depends on many aspects of personality. The solving of this global problem is complicated as there are difficulties in diagnosing, treatment, and support of people, who intend to commit suicide.
In India, more than 100.000 lives are lost every year. The risk group is younger than 44 years old, especially males, though women die from suicide more often than in other countries. The high rate may be understood as a reaction to serious social and economic problems of Indian society. But recent studies prove that the real rate of suicide is nine times higher than the official rate because the registration system is not operative enough.
The chosen method of suicide reflects personal characteristics, cultural and traditional values, seriousness of the situation, and motives. The most popular acts to end one’s life in South India are hanging and posing.
The suicide of the elderly is determined by psychiatric illnesses, neuroticism, isolation, poor health, and financial problems. Elder people often live alone, their signs are not sensed, they often have depressions. These lead to death from drug abuse of people over 67.7 years old. The problem is some people, including medical workers, suppose that suicide among old people is absolutely rational, deliberated, reasonable, and must not be prevented.
Some people think that elderly people, who want to end their life do not need attention, and their choice is the right philosophical decision, though it has not been proved yet. These may be prevented by providing care to old people, improving community medical services, treating depressions, and other psychical disorders.
Women’s’ suicide is caused by psychiatric disorders, depressions, the status of divorced or widowed, susceptible to violence, child’s death, and suicide among family members. Women’s suicide rate may be reduced by pregnancy, marriage, employment in traditional jobs.
Males commit suicide more often than women do, though the number of attempts is equal. Males use more serious methods of suicide, they are less protected by the government and they do not use health services as often as women.
Children’s suicide behavior is motivated by attracting parent’s attention, distracting the family from other issues, absence of love, and care among family members. These factors may be precluded by careful observation of children’s psychical health by social workers, noticing direct and indirect signs, effective clinical care, and attentive attitude towards them by adults.
The United States is plagued by a countless number of social dilemmas. Although not in constant public scrutiny, suicide is a serious problem that has seemed to have lost importance. When suicide is coupled with arrest and incarceration it becomes an increasingly complex situation. In fact, research indicates that the jail suicide rate ranges from 2.5 to 13 times greater than the rate of the general population (Winkler 1992). Motivation, prediction, and prevention of suicidal behavior are grossly unclear, which only adds to the already existing complexity.
Many factors involved with arrest and incarceration only serve as a catalyst for suicidal tendencies. Suicide is the primary cause of death in this country’s jails. In 1986 there were 401 successful [jail] suicides (Winkler 19992). There are many general assumptions made with regard to suicide. Most believe suicide to be caused by mental illness such as major depression or bipolar disorder.
Another belief is that the emotional escalation leading to action takes place over a long period of time. Such is not the case in jail suicides. Much of the research shows that ? of all [jail] suicides occur within the first twenty-four hours of incarceration, and an overwhelming number of these take place in the first three hours of isolation which is referred to as the “crisis period” (Hess 1987).
The crisis period is reflective of arrest and incarceration as producing extreme confusion, fear, and anxiety. The crisis period is also the result of isolation. Isolation causes an individual to lose all social support systems. Placing an individual in isolation may be a form of protection, but this gives the individual an opportunity to concentrate on feelings of hopelessness (Winkler 1992).
Hopelessness can be defined as the presence of despair and negative feelings about the future (Shneidman 1987). Isolation can also produce a severe threat to those inmates who have difficulty with coping abilities as this only encourages future deterioration.
Undoubtedly, isolation is often necessary to contain a person or to prevent injury to the individual and, or other inmates. Individuals who are experiencing obvious mental stress should certainly not be held in isolation for obvious reasons. According to Hess (1983), many facilities have regulations which state, “The action taken must be responsible under the circumstances and represent a good-faith judgment that the action was the least restrictive alternative available.
Regulations such as this not only serve as a guideline for officers but as a preventive measure against legal action as a result of isolation. Aside from these emotional factors of the physical environment which are the impetus of suicidal attempts. Isolation cells more often than not tend to have poor lighting, ventilation, and the surroundings are extremely noisy (Winkler 1992). They are minor modifications that can be made to reduce risk. These include the removal of bars, sinks, or any other object which may facilitate a suicide attempt (Kunzman 1992).
There are certain characteristics of the “act” of jail suicide. The major characteristic which seems to be consistent in almost all cases is that the method used is hanging. In fact, according to Hess(1983), 96% of the [jail] suicides are successfully completed in this fashion, and the instruments most often used are clothing, bedding, shoelaces, or belts.
This trend is attributed to the fact that other avenues for suicide are not available. In cases in which officers are aware of the person’s fragile mental state, attempts are made to extinguish the availability of instruments. This is done by stripping the inmate of clothing, and, or accessories.
All too often the objects and particularly the mental states are overlooked. Since this does occur, officers now carry the Stephans 9-11 knife which can effectively cut through sheets, bedding, belts, and other material (Winkler 1992).
Some other rather interesting statistics have been compiled regarding the jail suicide act in reference to month, day, and time in which it is most likely to occur. The majority of inmates commit suicide between the hours of midnight and eight A.M., usually occurring on a Saturday in the month of September (Winkler 1992). The acts take place at these specific times and days due to the fact that officer supervision is greatly decreased at these intervals. Despite the fact that supervision is so decreased, the victims are usually found within 15 minutes.
Research has also been consistent in identifying other typical aspects of jail suicide. The prominent factors are age, race, marital status, and type of offense. The person is usually a 22-year-old single white male who has been arrested for an alcohol-related offense. Many times an individual who is incarcerated because of a murder offense is automatically placed on suicide watch.
The Federal Bureau of Prisons has warned local jailers that persons held for murder or any other offense involving possible death penalty be watched closely for any suicidal tendencies? (Winkler 1992). Jail suicide in this case is usually caused by extreme feelings of remorse, particularly if the death of a relative is involved. Other characteristics include being under the influence of drugs or alcohol at the time of the arrest, the individual having no significant prior arrest, and being held in urban county jail.
Many feel correctional officials are responsible for an inmate’s well being. If this is the case, such personal characteristics as listed above are enormously inadequate to form a prediction judgment, and apply techniques to offenders who are at risk for a suicide attempt. These characteristics are especially inadequate considering the fact they also represent much of the general inmate population.
Officers are unquestionably the key players in prevention. Considering the fact that 78% of jail suicides show no prediction signs at the time of intake (Winkler 1992)., new standards need to be implemented. Accurate predictions are not the only aspect needing regulation. According to research(1986),?an inmate suicide prevention program must address the four P?s of prevention:
- the procedure
- physical environment.
Winkler contends that if a standardized profile is to be operational, it needs to be limited to a manageable number of features. The Lane County Adult Correctional Center (LCACC), located in Oregon, has implemented new regulations in regard to suicide profiles.
Reports say that this profile includes: suicidal statements these are not to be taken lightly, and officers are instructed to dispel the myth that those who talk of suicide will not attempt prior attempts-inmates who have previously attempted suicide are at much greater risk: depression this especially applies to the concept of hopelessness mentioned earlier:intoxication-reports reveal 60% of victims had been intoxicated; mental/emotional disturbances-the mentally ill are at much greater risk; crisis event-this is an event which the inmate feels to be life-shattering (although it is impossible to know what the inmate is feeling, officers must keep some sense of sympathy to be able to relate to the individual); and time in custody as mentioned before, most suicides occur within the first 24 hours.
The second and third components, procedures, and personnel are interrelated. Inmates coming through the intake process should be assessed by officers using a questionnaire regarding medical history, mental health status and history, and security issues. All of the corrections staff who are involved in the intake process should be formally educated in identifying and dealing with at-risk offenders. “In addition to standard correctional staff, personnel should include specially trained mental health professionals either staff or on call.” (Winkler 1992)
The last component, the physical environment was mentioned earlier. Aside from the suggested structural modifications, many authorities believe suicidal inmates should be placed in group housing. Placing suicidal inmates in a group housing environment often solves the problem of isolation, and offers an available social support structure.
This also implements intervention techniques by an avenue of other inmates physically stopping the attempt, or alerting officers. Prevention techniques thus far have a considerable lack of imagination and cooperation.
The United States is neglecting its responsibility for jail suicides. “As of 1989, only 13 of 35 states responding to a survey had prevention standards for jails.” (Kunzman 1995) Nationwide prevention standards need to be implemented so as to not only reduce the several hundred deaths per year attributed to jail suicides but also prevent legalities. Legal actions cost money, time, and more importantly, they disrupt the fundamental objective of the criminal justice system.
Disruptions of the system in this way may cause correction officers to view inmates with high-risk factors as a burden of liability. There are various cost-efficient methods for reducing suicides such as cell structure modification, or double cell occupancy. The most cost-effective method is instilling sensitivity in correctional personnel. Understanding, relating, and simply speaking to an inmate as a human being may save a life.
The topic that I have chosen for this paper is Suicide Prevention in your Area. Suicide is a serious problem that has affected the entire country. Recent studies have shown that suicide is the eleventh leading cause of death in the United States.
It is my belief that if more and more people are educated about suicide, the warning signs, whose most at risk, and how to help prevent suicide; perhaps, the suicide mortality rate will decrease in the United States.
The need for suicide prevention should be quite obvious because suicide is like a contagious disease in the United States. Suicide affects people of all different age groups, different ethnic and cultural groups. To the best of my knowledge, it is difficult getting accurate data on the number of suicidal attempts and deaths, because many suicide attempts are not reported each year; also, perhaps the number of deaths by suicide is not reported as actual suicides but as accidental deaths.
According to the National Center for Health Statistics (1998), more Americans take their own lives each year than are murdered by someone else and that, over the last five years, more people have died by suicide than AIDS. When I came across this statistic I for one was shocked that such a thing could be true, but it leads me to realize that the prevention of suicide in this country is even more important and should not be taken lightly.
Suicide is the eleventh leading cause of death and is responsible for more than 30,000 deaths in the United States each year. The rates of deaths by suicide vary somewhat for different age and ethnic groups. The American Foundation for Suicide Prevention (1998) showed that suicide is the second leading cause of death among college students, and the third among 15-24-year-olds.
Some of the risk factors for adolescent suicide include psychiatric disorders (like depression, impulsive aggressive behavior, anxiety disorders), drug and/or alcohol abuse, and any previous suicidal attempts.
The National Institute of Mental Health (1997) says, that major depression is a key factor for suicide among older adults, it is often an under-recognized and undertreated medical illness. In 1997, individuals who were 65 years of age and up accounted for about 19 percent of the suicidal deaths in the country.
The most recent data that I was able to find for the suicide rates of my home state New York, was according to the Morbidity and Mortality weekly report (1997); which, says that between the years of 1990-1994 there was 7,551 deaths by suicide in the state of New York. Unfortunately, I was unable to find any suicidal rates for my home area in Brooklyn.
One major component of suicide prevention is being able to recognize the warning signs. Most research suggests that the majorities of people who attempt suicide usually give out some sort of a warning sign. These “warning signs”, consist of personal behaviors, verbal and non-verbal communications; also, may or may not include the following:
- change in personality: withdrawn, sad, anxious, and tired
- change in behavior: lack of concentration in school, work, daily tasks
- change in there sleep pattern
- change in their eating habits
- loss of interest in friends, hobbies, sex, and previously enjoyed activities
- giving away prized possessions
- previous suicide attempts
Depression is a major factor among individuals who tend to be suicidal. According to the Samaritans of New York (a suicide prevention crisis center), the risk of suicide may be at its greatest if the depression begins to lift. Even though many different individuals get depressed from time to time and may or may not try to attempt suicide the warning signs are basically the same at any age.
When dealing with children and adolescent’s if they begin to socially isolate themselves this is a warning of depression that can lead to attempted suicide.
There are many successful suicide prevention centers all over the United States such as the American Foundation of Suicide Prevention, which educates professionals in the treatment of individuals who are at risk of suicide. The American Foundation of Suicide Prevention also focuses on educating society on suicidal behavior and that if a person who is suicidal most likely they are suffering from a medical and/or psychiatric condition that must be treated.
The American Foundation of Suicide Prevention and the Samaritans of the United States prevention centers have been quite successful in preventing suicide for various age groups. I feel that any type of suicide prevention that educates not only professionals but also society about suicide and the warning signs of suicide are successful, because if more people are aware then more attempted suicides and death by suicide can be prevented.
The Samaritans of New York, which is located in Manhattan is one of the suicide prevention centers in my area. It is a local branch of the international humanitarian movement with more than 400 branches in 32 countries. The Samaritans help those people who are in crisis and are feeling suicidal through a volunteer-run program; which, focuses on listening to the person’s problems without expressing any personal judgment.
This hotline operates 24 hours a day, seven days a week, and has over 100 trained volunteers. There is also a Public Educational Program, which provides support to those that have been affected by suicide, or the Safe Place Suicide Survivor Groups.
Also, there is Contract Services and Consultations, which provide assistance to schools, agencies, and corporations that require individually modified suicide prevention programs to meet the organization and staff needs including the NYPD Early Intervention, NYC Health, and Hospitals Corporation.
Is there an age bias when it comes to suicide attempts and deaths by suicide? Before doing research for this paper I would have never believed that there could be an age bias in suicide, yet according to the National Institute of Mental Health (1997), suicide among the elderly tends to receive less attention in most scientific literature then suicide in adolescents and young adults. At this point in time research has shown that suicide is viewed as more acceptable for an older adult then it is for a younger adult.
In recent polls, an increasingly larger amount of the population has approved assisted suicide; which, is an issue that is more important to older adults than to younger adults, because of the likely hood of the terminal and debilitating illnesses among the elderly. Suicidal behaviors among the elderly are more fatal than those of other age groups because older adults are more prone to self-injuries that may result in death.
The usual risk patterns for suicide among people of different ethnic groups can vary from those who are accepted into the white majority population. According to the National Service Framework of the Department of Mental Health (1999), young-unmarried men make up a high-risk group for suicide.
Although, research has shown evidence that suggests that among the south Asian people living in England and Wales, young, married women are also a high risk for suicide. People from different ethnic backgrounds may have different risk factors for suicide that should be taken into account, which suggests that:
- Irish-born people living in the UK have particular susceptibility to suicidal behavior.
- For young South Asian people, cultural conflict can be a precipitating fact in suicide
- Social risk factors may precipitate schizophrenia and possibly suicidal behavior in African and African-Caribbean people living in the UK.
The little research that I have found on suicide and the differences in ethnic groups had to more with statistical finding, as opposed to having different warning signs for suicide, between the different ethnic and cultural groups. Risk factors and warning signs among the different ethnic groups may not vary as much as they did in with the different age groups.
In conclusion, I feel that suicide is a very serious issue that has affected our entire country. Deaths by suicide in the United States are one of the leading causes of death, in this country over 30,000 deaths caused by suicide that occurs in the United States. This is why I feel that it is important to have suicide prevention centers and consultations available to the public community, so they can give people a better perspective on suicidal deaths and what can be done to help these suicides from occurring each year.
Teen suicide is an increasing phenomenon in Bangladesh. Data regarding teen suicide is quite insufficient for Bangladesh perspective, still from further studying, it was found out that psychologists have identified the teenage years as one of the most difficult phases of human life. It is as a time to enjoy friendship and perform other activities that adults would not usually do, still, sometimes period cause teens a large amount of stress. Many changes in the human mind take place during this period of life.
To some, death may be an unknown idea and result in a great sense of worry. Others may accept death and suicide from watching news reports or from reading a novel depicting a suicidal character. Awareness and proper parenting regarding suicide will help the youth to prevent themselves from committing suicide.
During my research I tried to find out the following factors regarding the fact “suicide” and it is also important to say that these questions were intended to find out suicidal facts in Bangladesh:
- What is the view of today’s youth towards the phenomenon “suicide”?
- What is the proportion of today’s youth who have actually been through a phase where they thought about committing suicide?
- What are the reasons that they thought was appropriate enough to think about or to actually attempt to commit suicide.
- What ways are compelling for the youth to commit suicide?
- Does a suicidal person think rationally, or is it just a rash decision?
- At which part of life does a person think about committing suicide?
- What are the solutions for committing suicide?
Almost 80% of today’s youth in Bangladesh has actually gone through a phase where they thought about committing suicide. Also, the main reason for youth to think about committing suicide is having relationship problems with their close ones.
It is a fact that the people in the age group 18 – 25 are quite vulnerable. At this age, people are more prone to making rash decisions without thinking forward. At this age, people are driven by emotions. So it is quite normal for them to think about committing suicide if any sort of complicated problem occurs.
Also in my research paper, I would like to find out the reasons why youths in Bangladesh are more prone to committing suicide, also I would like to show some solutions to this problem.
For my primary research, I will conduct a survey of a representative of the general people in Dhaka including students of NSU. I will also prepare a set of questionnaires with different types of questions so that I can get a range of useful data to answer my research questions. I will also try to conduct interviews with 1 or 2 people who have attempted committing suicide.
For my secondary research, I will use the internet and use standard search engines like Google.
My paper will be divided into several sections, the most important which are the introduction, background, data presentation-analysis, and summary of findings. Within the sections, my organization will be based on my research questions.
I hope to complete my primary & secondary research and submit the draft copy of my research paper on due time.
Request for Approval:
I hereby request your approval for my research proposal. If you wish me to modify or improve my proposal, I will submit it after incorporating the necessary changes. I would be grateful for your advice and help, also in conducting my research and completing the project.