Othello: Suicidal behaviour exists on a spectrum

MENTAL Health director at the Health Ministry Dr Hazel Othello said suicidal behaviour exists on a spectrum. She said death by suicide can occur at any life stage, though it is most common in adolescents and those in the working age group.

Speaking at the Health Ministry’s media briefing on Wednesday, Othello said police data showed there had been 92 deaths by suicide in 2019, 104 in 2020, and 108 in 2021. She said people should be concerned about all areas of the spectrum.

“The spectrum runs from suicidal ideation or thoughts about harming oneself or ending one’s life, to non-suicidal self-harm events where someone harms themselves but their intent at that time is not to die, to attempted suicide where the harming of oneself is for the purpose of ending one’s life, as well as completed suicides.

The issue of suicide and self-harm is a complex one, and is not just one type of behaviour. We look at the balance between risk factors versus protective factors. Risk factors include adversities, while protective factors include a caring supportive family background, community support, coping skills, living in a stable environment and positive experiences. I always say we can’t control what happens to us, but we can control how we react to it.”

Othello gave an idea of some of the signs to look out for in people who might be contemplating suicide.

“When people are depressed and decide to end their lives, they feel a sense of relief, and people mistake this for them feeling better. We have to watch what people say or do, and monitor their moods.

"If they begin to talk about ending their lives, this is a red flag. Other signs are if they are hopeless, begin to abuse alcohol or other drugs, withdraw socially, are sleeping all the time, begin to avoid all the things they used to enjoy, or begin to give away things, among others. Each person has individual behaviours, and if you are worried and see something that might be a red flag, encourage them to be evaluated by someone who is trained to do so.”

She urged friends and relatives who were worried about their loved ones and wanted to get them to seek help to listen non-judgementally and show concern in offering to get them help.

Othello outlined some of the steps made toward suicide prevention in Trinidad and Tobago.

Those include the 1978 establishment of Lifeline; mental health services provided by the regional health authorities, including mental health gap training; advocacy by people who had personal experience with suicide; mental health promotion by the ministry, RHAs, NGOs, community-based organisations and individual experts; survivor support groups; and the findcarett.com website, which can also be accessed through the Health Ministry’s website.

She said a national suicide prevention strategy and implementation plan was being developed, as well as a national suicide and self-harm surveillance system so that resources could be allocated where needed.

There are courses on the website of the Pan-American Health Organisation for both members of the public as well as primary practitioners on the topics of Psychological First Aid and Preventing Suicide/Self-Harm respectively.

Othello reminded that the latter course was available to all health-care practitioners, not just those employed by the ministry.