Suicide is an act of injuring oneself with the intention of killing oneself and causing death. The Indian government classifies an act death It is considered suicide if the following three criteria are met. – It is an unnatural death – The intention to die originates from within the person – There is a reason for that person to end his or her life. The reason may be stated in the suicide note or unknown. Suicide is a major global problem, globally nearly 800,000 people die by suicide each year; Nearly 1/3 of suicides occur among young people. Suicide is the second leading cause of death in the 15-29 age group. The global suicide rate is 12 per 100,000 individuals, making suicide the 14th leading cause of death globally. It is estimated that for every person who dies by suicide, more than 20 others attempt suicide. In fact, suicide attempts are an important risk factor for subsequent suicide.
Because suicide remains a sensitive issue, it is likely underreported due to stigma, criminalization, and weak surveillance systems. Suicide is not a mental illness but a potentially serious consequence of treatable mental disorders, including major depression, bipolar disorder, post-traumatic stress disorder, and bipolar disorder. borderline personality disorder, schizophrenia, substance use disorders, anxiety disorders, and eating disorders such as bulimia nervosa and anorexia nervosa. There are no data to suggest that routine suicide screening in primary care reduces mortality. Additionally, predicting whether suicidal patients will continue to attempt suicide cannot be achieved with high sensitivity or specificity. RISK FACTORS AND WARNING SIGNS: Identifying and managing risk factors and warning signs is most important. Social, psychological, cultural and many other factors can interact to increase the risk of suicidal behavior, but the stigma attached to suicide means many people are needing help feels impossible to seek it out. Risk factors for suicide include previous suicide attempts, mental health problems, harmful alcohol use, drug use, job or financial loss, relationship breakdown, trauma or abuse, violence, conflict or disaster, and chronic pain or illness. Warning signs of suicide: Any of these could be potential warning signs of suicide. Severe sadness or moodiness. Persistent sadness, mood swings and sudden bouts of rage.- Hopelessness: a deep feeling of hopelessness about the future, with little hope that circumstances can improve.- Difficulty sleeping.- Sudden calmness Sudden: suddenly becoming calm after a period of depression or moodiness can be a sign that the person has decided to end his or her life. – Withdrawal: choosing to be alone and staying away from friends or relatives Social activity can also be a symptom of depression, leading cause of suicide. This includes loss of interest or pleasure in activities the person previously enjoyed.- Changes in personality or appearance: A person considering suicide may exhibit a change in attitude or behavior, such as speaking or moving with unusual or slow speech. Additionally, the person may suddenly become less concerned with their personal appearance.- Dangerous behavior or self-harm: Potentially dangerous behavior, such as reckless driving, Unsafe sex and increased drug or alcohol use, may indicate that the person is not taking their life more seriously.- Recent trauma or life crisis: A major life crisis living can cause suicidal thoughts. Crisis includes the death of a loved one or pet, the end of a relationship, diagnosis of a serious illness, loss of job, or serious financial problems. suicidal people will begin to put their personal business in order. This may include visiting friends and family members, giving away personal occupations, making wills, and cleaning their rooms or homes. Some people will write a note before taking their own life. Some would-be buyers will purchase guns or other means such as poison. – Threats or suicide: Between 50% and 75% of suicidal people will give someone a warning sign as a friend or relatives. It may not be a complete threat. They may say many unusual things about death or say things like “it would be better if I wasn’t there.” However, not everyone who is considering suicide says so, and not everyone who threatens suicide will follow through. Any threat of suicide should be taken seriously. Methods of suicide: The most common methods used include ingestion of pesticides, hanging, and firearms. Management: Management of the suicidal individual should include: Medical stabilization Immediate risk reduction and treatment planning Management of underlying factors and psychiatric disorders Monitoring and follow-up. Prevention: Unfortunately, suicide prevention is often not a priority for governments and policymakers. Suicide prevention needs to be prioritized on global public health and public policy agendas, and suicide awareness as a public health concern must be raised using A multi-dimensional approach can recognize psychological and socio-cultural impacts. Simple strategies for management: Known warning signs and precipitating factors Safety or removal of lethal triggers Personal coping Interpersonal coping Professionals can help LIFE Elements of a strategic approach to suicide prevention along with core effective interventions are demonstrated by LIVE LIFE for suicide prevention. Leadership, Intervention, Vision and Assessment and building the pillars of LIFE., i.e. core interventions, which are Fewer Means (limited access to means of suicide), Engage with the media for responsible reporting, Building life skills for young people and Early identification, management and monitoring. LIVE LIFE establishes the key components that underpin the development of a national suicide prevention strategy. WHO SHOULD MANAGE: Primary care providers may be in a unique position to prevent suicide because of their frequent interactions with suicidal patients. Reviews show that among patients who committed suicide, 80% had contact with primary care clinicians, while only 25-30% of decedents had contact with psychiatrists. . INNOVATIONS IN MANAGEMENT: The first priority for patients who have attempted suicide is medical stabilization in a hospital. Patients who attempt to take the drug must be decontaminated and receive an antidote. Knowledge of the most commonly used poisonings is important for both prevention and treatment strategies. For patients with hangover, previous treatment has been a wait-and-see policy with very poor results. Now HYPOTHERAPY TREATMENT where body temperature drops to 32-34ᴼ in a day and warms up again slowly. This improves outcomes along with good functional recovery. When taking oral pesticides along with supportive care, additional body dialysis techniques have been used. This concept improves results and reduces costs significantly. TAKE AT HOME MESSAGE: Suicide is a serious and completely preventable global health problem. Monitoring and correcting risk factors and warning signs is extremely important. Cost-effective and highly restorative treatment options are available. Dr. Muralidhar TR, Head & Senior Consultant, Department of Critical Care, Nursing & Critical Care, Kauvery Hospital Electronic City (Bengaluru)
