We need to talk about suicide: according to the Namibia Crime Bulletin, five people--one woman and four men--took their lives by suicide over the weekend of 18/19 January 2006. They died by either shooting or hanging themselves. The eldest suicide victim was 93 years old, the youngest 17.

Attempted suicides and deaths by suicide are on the increase in Namibia. People who decide to take their own life come from all cultures, ages, and socioeconomic backgrounds.

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The increase is, however, more marked in black communities and among young teens. Unfortunately there are no statistics available in Namibia, but looking at world statistics and statistics on southern Africa, the situation is as follows:

* Worldwide 16 out of 100 000 people die by suicide.

* In South Africa, 172 out of 100 000 people die by taking their own lives. This is more than ten times the world average. The majority of South Africans who take their own lives are young black men between 15 and 35.

* In most parts of the world, five times more women than men attempt suicide, but more men than women actually die by suicide, because they choose more lethal methods such as hanging or shooting themselves. The only exceptions are China and Japan, where the majority of people who die through suicide are women.

Factors contributing to increased suicide rates

Twenty years ago, suicides were not a common feature in Namibian black communities. Today, caregivers, friends and teachers, nurses, pastors and counsellors are increasingly faced with suicide in their families, schools and communities. "Suicide is on the increase like an infectious disease," one volunteer counsellor recently said at a workshop in Windhoek. What has brought about this change?

Stories of suicide are windows onto the soul of a culture. The stories of people with HIV and Aids show how they experience social stigma, discrimination, isolation, lack of support from families and friends and social devaluation. These experiences generate depression, anxiety, and feelings of worthlessness which all enhance suicide risk.

The stories of poverty, unemployment, teenage and unwanted pregnancy and alcoholism in our society tell us about feelings of despair, hopelessness and loss of control. And the tension between modern and traditional life in our country generate tales of disorientation and loss, of violent conflict, of too high expectations and feelings of failure.

When does a person consider suicide?

* Testing HIV positive is a common situation for people to consider suicide. Research in South Africa has shown that people with HIV and Aids are 36 times more likely to complete suicide than people without the disease.

* Also according to research in South Africa, the main reasons for children to attempt to take their own life are extreme poverty, abusive families, peer pressure, failure to achieve at school and serious illness.

* The death of a loved one, a divorce, teenage pregnancy, a failed relationship, the loss of a job and income, major legal problems or even major disappointments such as a failed examination or a missed job promotion can trigger suicidal thoughts.

* Sometimes the suicide of a family member, a friend or even a public figure can lead to suicidal ideas.

* Mental disorder and depression are also important factors that might lead to suicide.

Warning signals

Although there are some suicides that nobody can prevent, there are warning signals which even laypersons can learn to recognise and react on.

People who are considering suicide want to talk about it and often make desperate attempts to invite friends or family members to ask questions and listen to them. However, many-a-time friends and family do not wish to talk about suicide. They are afraid to get involved, afraid to take responsibility and afraid to touch on a taboo subject. For this reason many family members and friends miss or ignore the signs until it is too late.

The following list of warning signals is only a guideline. They include feelings and thoughts, actions, and general changes in behaviour. No suicidal person displays all these characteristics--and some persons may express these thought and actions without being suicidal.

Feelings and thoughts include: Feeling isolated and alone, feeling that nobody understands them, and feeling unbearable pain from which they see no they way out.

Specific actions include: Giving away possessions, engaging in strange rituals, for example when saying good-bye, abuse of alcohol and drugs, reckless behaviour, self mutilation, extreme behaviour changes such as being very euphoric and suddenly being very depressed.

More general behaviour includes: Withdrawal from family and friends, loss of interest in hobbies or in outer appearance, being irritable and impulsive, loss of interest in sex, disturbed sleep, loss of appetite.

NOTE: A really serious danger sign is when people who have been distressed and openly suicidal suddenly become outwardly calm or even seemingly happier. This may mean many things, including their quiet resolution to complete their suicide plan.

Behavioural changes in troubled teens can be: Declining school performance, extreme behaviour and mood change, loss of previous interests, risk-taking behaviour, drug or alcohol use, social withdrawal or a break in a key relationship.

Some statistics suggest that only one in ten children who make suicide threats will carry them out. For this reason adults often dismiss or misinterpret suicidal tendencies in teenagers as a "passing phase" or as manipulative tactics, born out of immaturity. However, it can never be predicted under which circumstances these threats may actually lead to a suicide attempt.

Listen and understand, assess and assist

Research has found that professional counselling helps tremendously to prevent suicidal people from taking their own lives. However, even if there is no professional counselling available in your community, friends and family members can do much to help. The following steps could assist you to deal with friends or family members who are thinking of suicide:

Step 1: LISTEN

Finding someone to listen often takes away the edge of distress in suicidal persons. Listen with warmth, empathy, respect and acceptance. If possible, ask direct questions about their suicidal thoughts. Acknowledge the person's pain. Don't say: "It will be okay," or "It will get better soon."

Step 2: UNDERSTAND

Understand their reasons for wanting to die: Try to enter the person's world and stand in his or her shoes. Listen to their reasons for wanting to die. Understand the extent of their pain.

Search for possible reasons for living: Try to discover reasons why the person should go on living. These can include internal reasons like the love for a child, the hope to get healthy again, the belief in God, or the value of family responsibility that help a person to stay alive. You can also find external reasons such as caring family members or friends, organisations like a church or sport club, hobbies and interests.

Step 3: ASSESS

Find out if the person has a plan how to kill himself or herself and details of that plan. Ask about methods, resources (weapons, pills etc.), planned time, and about previous suicide attempts.

NOTE: A person who has a plan is at much greater risk than someone who simply talks about not wanting to live any longer.

Step 4: ASSIST

Make a safety plan including the following:

* Involve family and friends-you can also ask the suicidal person to identify people who could be called for support.

* Make a plan so that he/she is not alone.

* Remove guns, medication or whatever means the person would use to kill herself/himself.

* Make a plan of action for when he or she is feeling suicidal, for example calling a friend, going to a family member's house, going for a walk or getting exercise, calling a hotline.

* Identify situations which increase suicidal thoughts, for example drinking alcohol or being alone. Find ways how to avoid or reduce them.

Fortunately there are ways to assist suicidal persons and to prevent them from taking the final step. This is, however, only possible if we acknowledge that we have the problem of suicide among us and if we speak about it as about any other disease or problem in our community. Suicide shouldn't be a secret or taboo.

Once we acknowledge that suicide is happening in our society we can learn to recognise signs which can help us detect suicidal thoughts and behaviour in others, and give "emotional first aid". As with all first aid, this could make a difference between life and death.

If you need assistance with dealing with suicidal persons or if you need counselling yourself, you can call Lifeline/Childline at 061-23 2221 or 061-22 6889

RELATED ARTICLE: THE RIGHT WORDS TO USE WHEN SPEAKING ABOUT SUICIDE

We should take care to use sensitive language when speaking of suicide. For example, instead of saying "Mr. X committed suicide" (which sounds like "committing a crime"), we should rather use phrases such as: "X took his life by suicide" or "X died by suicide". Also, instead of talking of "successful suicides", when people actually managed to kill themselves, we should rather talk about people who "completed suicide".