Depression, among top killers in Bhutan
Among the risk factors contributing to suicide in Bhutan, depression had the highest impact. Other risk factors included mental health disorders such as bipolar disorder and schizophrenia.
Some of the major factors which lead to suicides are psychosis, impulsive behaviors, crying for help, philosophical desire to help and by mistake.
In Bhutan, suicide ranks in top six leading causes of death after the alcohol liver diseases, other circulatory diseases, cancers, respiratory diseases, and transport deaths.
Today, Bhutan has 361 suicide deaths were documented with the Royal Bhutan Police in a five-year review of suicide cases from 2009 to 2013.
Although the global suicide rate has seen a dropped, however, Bhutan witnessed a rise in the occurrence of suicide case. Dr. Damber K. Nirola, Psychiatrist with national referral hospital, writes in his blog spots, “Suicide rates in Bhutan have re- mained steady and rather increased particularly in the recent years.”
Besides, some of the major contributing social factors identified were lack of job opportunities, the percentage of broken families, and a high rate of domestic violence.
According to Dr. Damber K. Nirola, there are several risk factors that may contribute to thoughts of suicide, attempted suicide, and actual suicide including previous suicide attempts, substance abuse, being exposed to suicidal behavior, family history of suicide, poor job security or low levels of job satisfaction and being diagnosed with a serious medical condition, such as cancer or HIV among others.
Dr. stated that people who have suicidal thoughts are often so overwhelmed by feelings of sadness and hopelessness that they think they have no other option. “If your friend or loved one isn’t in immediate danger but is having suicidal thoughts, then you can simply speak to them about the challenges they may be facing.”
He also writes that bio-psychosocial, environmental and sociocultural are the causes for increased suicide risk. “Environmental factors that increase the risk for suicide often occur due to a stressful life event.”
Dr. Damber K. Nirola added that one of the main socio-cultural causes of suicide is the feeling of being isolated or of not being accepted by others. “Feelings of isolation can be caused by sexual orientation, religious beliefs, and gender identity.”
The reported suicide cases are between the age group of 15 to 40 years, which constitutes about 87 percent in the country. The proportion at a higher risk for suicide was higher in men than in women above 45 years.
It is estimated that about 88 percent has occurred in rural agricultural areas among married at 66 percent with less education and low income.
In Bhutan, for every 4.5 suicide deaths, there is one suicide attempted case recorded, indicating gross under-reporting of the attempted cases.
Policy action must take these state-level differences into account to control this potentially explosive public health situation. The government directed to conduct the study on suicide cases in the country and implemented the suicide prevention program in the ministry of health.
The Health Management Information System (HMIS) of the health ministry has been collecting data on “intentional self-harm” since 2010.
The cases of intentional self-harm reported in the health facilities ranged from 502 to 682 cases while only 3 to 5 deaths due to intentional selfharm. Dr. Damber K. Nirola stated that shows suicide attempt cases end up in health facility care. “Suicide attempts result in an enormous cost to the healthcare, family and individuals due to injury and disability.”
Raising community awareness and breaking down the taboo is important for countries to make progress in preventing suicide. To give awareness, the Ministry of Health observes the world suicide prevention day on 10 September annually.
According to the data published by the World Health Organization, about 800,000 people die due to suicide every year, which is one person every 40 seconds. Suicide is the second leading cause of death among 15 to 29-year-olds globally.
Suicide accounted for 1.4 percent of all deaths worldwide, making it the 18th leading cause of death in 2016. 79 percent of suicides occurred in low and middle-income countries in 2016.
The countries with the highest suicide rates in 2018 according to World Population Review are Sri Lanka with 35.3 suicides, South Korea in East Asia with 28.3 suicides, Eastern European country of Lithuania with 32.7 suicides per 100,000.
A number of other eastern European countries have high suicide rates, including Belarus, Poland, and Latvia, all at around 22 suicides per 100,000.