ID :
50996
Tue, 03/17/2009 - 16:32
Auther :
Shortlink :
https://www.oananews.org//node/50996
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PROFILING SUICIDE VICTIMS
By Melati Mohd Ariff
The following feature is the first of a three-part series.
KUALA LUMPUR, March 17 (Bernama) -- Chew on this! Out of the 113 suicide cases reported in the country in the second half of 2007, 82 involved men of whom 41 were married.
Those were the startling figures documented by National Suicide Registry
Malaysia (NSRM) for the period of July-December in 2007.
The NSRM also identified that the commonest life event which preceded the
suicidal act was a crisis with their 'other half'. Other problems like
financial, legal and job-related also came into the picture.
This is in contrast to the 31 suicide cases committed by women where 16 were
single and nine, married.
"Generally, men are more resolute when it comes to committing suicide. Women
in a way are not, so much so they could still be saved.
"However, this trend needs a deeper analysis and needs to be observed for a
longer term. Our maiden report covered only a six-month period," NSRM principal
investigator Dr Nor Hayati Ali told Bernama in an interview here recently.
Dr Nor Hayati said data for the NSRM's 2007 report was compiled via a
coordinated effort involving forensic departments in Health Ministry's hospitals
and this would be gradually expanded to include teaching hospitals, which are
hospitals under the Education Ministry.
HOW NSRM FUNCTIONS
According to Dr Nor Hayati, NSRM was established in early 2007 to compile
data on deaths due to 'fatal intentional self-harm' and this is done via its
network of forensic services.
The data compilation involved various levels of staffing at the respective
forensic departments or units. Forensic physicians verified the cases.
The suicide cases' data collection accomplished for 2007 was an early
attempt, she said, adding "We were able to carry out this project after
receiving a research grant from the Ministry of Health in that same year."
The Health Ministry's Forensic Medicine Services and Psychiatric and Mental
Health Services funded the registry while the Clinical Research Centre (CRC)
provides the technical expertise.
In 2008, the Institute of Health Behaviour Research came on board to
spearhead further research in this field.
"NSRM aims to provide detailed statistics on suicides in Malaysia by
creating a nationwide system to capture data on suicide cases in the country.
"This is vital for health prioritizing and identifying areas that health
providers should focus on," said Dr Nor Hayati who is also the Consultant
Psychiatrist and head of Kajang Hospital's Psychiatry Department.
ANALYSED DATA
Dr Nor Hayati said, out of the 113 NSRM-documented cases, 95 of them, or 87
per cent were Malaysians, while the others were foreigners. Three were from
Nepal, Indonesia (six) and one each from the Philippines, Singapore and Myanmar.
Among the Malaysians, Chinese accounted for the most number of cases at 47
or 43 per cent, followed by Indians (31 cases or 27 per cent) and Malays (12
cases or 11 per cent) followed by indigenous groups from Sabah and Sarawak (nine
cases or eight per cent) and others (10 or nine per cent).
She reminded that these figures were 'absolute numbers' and which is not as
accurate as 'suicide rates'.
Dr Nor Hayati said previous compiled data consistently indicated suicide
incidence was highest among the Indian community due to the high number of
suicides despite the ethnic group's relatively small population size.
"The suicide rate can only be calculated when we have the data for a full
year which the NSRM will be able to provide from the 2008 data," she said.
Dr Nor Hayati said based on the 2007 NSRM Report, the majority of the
suicide victims (57 per cent) were employed while 27 per cent were jobless. The
rest were part-timers or temporary workers, retired and on disability pension
while three per cent were housewives.
MORE DATA
According to Dr Nor Hayati, NSRM's analysis further showed that nine
students including six women were among the 113 suicide victims.
"Only one was a Malay, aged 22, while the others were five Indians, two Iban
and one Murut aged between 12 and 17 years old.
"School problems were cited as the cause in two of the cases, intimate
partner problems in another two while for the rest, no life event was
identified," she added.
She said from the 113 suicide cases, 88 per cent were "Brought in Dead"
(BID) by the police for post-mortem, 11 per cent died in the ward and one per
cent died in the emergency unit.
"Those who died in the ward and emergency unit were those who went through
resuscitation. Most of these cases involved poisoning.
"They did not die immediately and were sent to the hospital by their
next-of-kin. However, due to complications brought about by the suicide act, the
vital organs in their body began to fail, subsequently leading to death," she
explained.
SUICIDE FACTS
Of the 113 documented cases, 73 took their own lives at home with one
committing suicide at his girlfriend's home and another at a neighbour's house.
Other locations include farms, commercial buildings, school, graveyard and
street/highway.
"The most likely reason for them to commit suicide at their own homes is
probably because of the easy access and ensured privacy. As the most common life
event that precipitates suicide is intimate partner problems, home may be the
setting where these problems would be most intensely felt," said Dr Nor Hayati.
SUICIDE METHODS
In terms of suicide methods, the NSRM data reported that the most favoured
among Malaysians were hanging, strangulation and suffocation.
Out of the 113 cases, 58 (47 males, 11 females) succumbed to this suicide
methods followed by others such as consuming pesticides (11 males, 7 females)
and plunging down from high spots (10 males, 6 females).
The other suicide methods analysed included inhaling gases and other vapours
(smoke, fire, flames), drowning, jumping or lying in the path before a moving,
object, sharp objects and rifle or shotgun.
She said the data also revealed that the commonest suicide method among the
Chinese, Indians and Malays was hanging.
"This is probably due to the (easy) accessibility and efficiency of this
method. The second most common method chosen by the Chinese and Malays was
jumping down from high places. The Indians tend to use pesticide poisoning,"
said Dr Nor Hayati.
She said based on interviews with informants, 72 out of the 113 suicide
cases did not indicate or tell anybody that they wanted to end their lives. Only
20 per cent had expressed the intent to commit suicide, frequently via verbal
expression.
She said the number of cases might seem rather small because NSRM focused on
cases with 'preponderance of evidence' indicating that the injury was
self-inflicted.
She also said there were cases of "undetermined intent" which were not
included in the said database.
"Data on these categories of death may be captured in the future if Malaysia
has a national violent/non-natural death reporting system.
"Apart from that, with gradual upgrading of forensic services for example by
having designated staffs to handle death documentation and also better
infrastructure such as providing a designated area for families to be
interviewed, the quality of data can be improved," she explained.
SUICIDE RISK FACTORS
According to Dr Nor Hayati, based on previous studies on suicides, several
risk factors were identified to be associated with suicide risk, namely the
history of previous suicide attempts and substance abuse, presence of a chronic
physical illness, mental illness and significant life event.
"Many individuals experience the said risk factors without contemplating
suicide. Thus, risk factors are useful to identify potential target groups for
suicide prevention programmes but not really to single out which individual
among them who will finally die of suicide.
"Cases identified by NSRM in 2007 showed that most of the suicide case
victims did not have any history of previous suicide attempts," she said.
"This may be due to the fact that quite a number of the informants or
next-of-kin did not have regular contact with the deceased and did not know
about the victim's past suicidal behaviours or attempts," she said.
MENTAL AND PHYSICAL ILLNESSES
According to Dr Nor Hayati, when comparing a wide variety of causes, mental
disorder features consistently in the matrix of causation.
She explained that many studies identify mood disorders particularly
depression as the most frequent disorder in persons who committed suicide,
affecting from 30 to 70 per cent.
"Other disorders found more commonly among those who committed suicide
include substance disorders and schizophrenia. Even for those who have previous
history of mental illness, their psychiatric condition may not be the main
precipitating factor," she said.
Dr Nor Hayati further explained that high suicide incidence among
psychiatric patients had been associated with social factors such as living
alone and substance misuse.
From another viewpoint, aspects of being diagnosed with mental health
problem may be implicated.
SOCIAL STIGMA
She said the social stigma linked to mental health problem is of central
significance.
The distaste towards being labelled as 'mentally ill' may explain why only
7.1 per cent of the 113 documented cases were reported to have mental illness,
two were suffering from depression and one had schizophrenia.
Dr Nor Hayati said although some of the informants noticed that the deceased
became recluses or 'cannot work properly' prior to their deaths, the victims had
not sought any formal psychiatric treatment.
Similarly, majority of the deceased (79 or 69.9 per cent) was reported to
have no family history of mental illness.
Studies in the United States had shown a strong link between terminal
illnesses and suicides. However being terminally ill is not a sufficient cause
for suicide.
Such groups of individuals, said Dr Nor Hayati tend to have co-existing
depression caused by social isolation and the strain of being terminally ill.
Dr Nor Hayati said even though the NSRM tried to inquire information on the
presence of physical illness, this prevalence was reported in only 6.2 per cent
of the documented cases and these were actually chronic illnesses like diabetes
and coronary disease.
-- BERNAMA
The following feature is the first of a three-part series.
KUALA LUMPUR, March 17 (Bernama) -- Chew on this! Out of the 113 suicide cases reported in the country in the second half of 2007, 82 involved men of whom 41 were married.
Those were the startling figures documented by National Suicide Registry
Malaysia (NSRM) for the period of July-December in 2007.
The NSRM also identified that the commonest life event which preceded the
suicidal act was a crisis with their 'other half'. Other problems like
financial, legal and job-related also came into the picture.
This is in contrast to the 31 suicide cases committed by women where 16 were
single and nine, married.
"Generally, men are more resolute when it comes to committing suicide. Women
in a way are not, so much so they could still be saved.
"However, this trend needs a deeper analysis and needs to be observed for a
longer term. Our maiden report covered only a six-month period," NSRM principal
investigator Dr Nor Hayati Ali told Bernama in an interview here recently.
Dr Nor Hayati said data for the NSRM's 2007 report was compiled via a
coordinated effort involving forensic departments in Health Ministry's hospitals
and this would be gradually expanded to include teaching hospitals, which are
hospitals under the Education Ministry.
HOW NSRM FUNCTIONS
According to Dr Nor Hayati, NSRM was established in early 2007 to compile
data on deaths due to 'fatal intentional self-harm' and this is done via its
network of forensic services.
The data compilation involved various levels of staffing at the respective
forensic departments or units. Forensic physicians verified the cases.
The suicide cases' data collection accomplished for 2007 was an early
attempt, she said, adding "We were able to carry out this project after
receiving a research grant from the Ministry of Health in that same year."
The Health Ministry's Forensic Medicine Services and Psychiatric and Mental
Health Services funded the registry while the Clinical Research Centre (CRC)
provides the technical expertise.
In 2008, the Institute of Health Behaviour Research came on board to
spearhead further research in this field.
"NSRM aims to provide detailed statistics on suicides in Malaysia by
creating a nationwide system to capture data on suicide cases in the country.
"This is vital for health prioritizing and identifying areas that health
providers should focus on," said Dr Nor Hayati who is also the Consultant
Psychiatrist and head of Kajang Hospital's Psychiatry Department.
ANALYSED DATA
Dr Nor Hayati said, out of the 113 NSRM-documented cases, 95 of them, or 87
per cent were Malaysians, while the others were foreigners. Three were from
Nepal, Indonesia (six) and one each from the Philippines, Singapore and Myanmar.
Among the Malaysians, Chinese accounted for the most number of cases at 47
or 43 per cent, followed by Indians (31 cases or 27 per cent) and Malays (12
cases or 11 per cent) followed by indigenous groups from Sabah and Sarawak (nine
cases or eight per cent) and others (10 or nine per cent).
She reminded that these figures were 'absolute numbers' and which is not as
accurate as 'suicide rates'.
Dr Nor Hayati said previous compiled data consistently indicated suicide
incidence was highest among the Indian community due to the high number of
suicides despite the ethnic group's relatively small population size.
"The suicide rate can only be calculated when we have the data for a full
year which the NSRM will be able to provide from the 2008 data," she said.
Dr Nor Hayati said based on the 2007 NSRM Report, the majority of the
suicide victims (57 per cent) were employed while 27 per cent were jobless. The
rest were part-timers or temporary workers, retired and on disability pension
while three per cent were housewives.
MORE DATA
According to Dr Nor Hayati, NSRM's analysis further showed that nine
students including six women were among the 113 suicide victims.
"Only one was a Malay, aged 22, while the others were five Indians, two Iban
and one Murut aged between 12 and 17 years old.
"School problems were cited as the cause in two of the cases, intimate
partner problems in another two while for the rest, no life event was
identified," she added.
She said from the 113 suicide cases, 88 per cent were "Brought in Dead"
(BID) by the police for post-mortem, 11 per cent died in the ward and one per
cent died in the emergency unit.
"Those who died in the ward and emergency unit were those who went through
resuscitation. Most of these cases involved poisoning.
"They did not die immediately and were sent to the hospital by their
next-of-kin. However, due to complications brought about by the suicide act, the
vital organs in their body began to fail, subsequently leading to death," she
explained.
SUICIDE FACTS
Of the 113 documented cases, 73 took their own lives at home with one
committing suicide at his girlfriend's home and another at a neighbour's house.
Other locations include farms, commercial buildings, school, graveyard and
street/highway.
"The most likely reason for them to commit suicide at their own homes is
probably because of the easy access and ensured privacy. As the most common life
event that precipitates suicide is intimate partner problems, home may be the
setting where these problems would be most intensely felt," said Dr Nor Hayati.
SUICIDE METHODS
In terms of suicide methods, the NSRM data reported that the most favoured
among Malaysians were hanging, strangulation and suffocation.
Out of the 113 cases, 58 (47 males, 11 females) succumbed to this suicide
methods followed by others such as consuming pesticides (11 males, 7 females)
and plunging down from high spots (10 males, 6 females).
The other suicide methods analysed included inhaling gases and other vapours
(smoke, fire, flames), drowning, jumping or lying in the path before a moving,
object, sharp objects and rifle or shotgun.
She said the data also revealed that the commonest suicide method among the
Chinese, Indians and Malays was hanging.
"This is probably due to the (easy) accessibility and efficiency of this
method. The second most common method chosen by the Chinese and Malays was
jumping down from high places. The Indians tend to use pesticide poisoning,"
said Dr Nor Hayati.
She said based on interviews with informants, 72 out of the 113 suicide
cases did not indicate or tell anybody that they wanted to end their lives. Only
20 per cent had expressed the intent to commit suicide, frequently via verbal
expression.
She said the number of cases might seem rather small because NSRM focused on
cases with 'preponderance of evidence' indicating that the injury was
self-inflicted.
She also said there were cases of "undetermined intent" which were not
included in the said database.
"Data on these categories of death may be captured in the future if Malaysia
has a national violent/non-natural death reporting system.
"Apart from that, with gradual upgrading of forensic services for example by
having designated staffs to handle death documentation and also better
infrastructure such as providing a designated area for families to be
interviewed, the quality of data can be improved," she explained.
SUICIDE RISK FACTORS
According to Dr Nor Hayati, based on previous studies on suicides, several
risk factors were identified to be associated with suicide risk, namely the
history of previous suicide attempts and substance abuse, presence of a chronic
physical illness, mental illness and significant life event.
"Many individuals experience the said risk factors without contemplating
suicide. Thus, risk factors are useful to identify potential target groups for
suicide prevention programmes but not really to single out which individual
among them who will finally die of suicide.
"Cases identified by NSRM in 2007 showed that most of the suicide case
victims did not have any history of previous suicide attempts," she said.
"This may be due to the fact that quite a number of the informants or
next-of-kin did not have regular contact with the deceased and did not know
about the victim's past suicidal behaviours or attempts," she said.
MENTAL AND PHYSICAL ILLNESSES
According to Dr Nor Hayati, when comparing a wide variety of causes, mental
disorder features consistently in the matrix of causation.
She explained that many studies identify mood disorders particularly
depression as the most frequent disorder in persons who committed suicide,
affecting from 30 to 70 per cent.
"Other disorders found more commonly among those who committed suicide
include substance disorders and schizophrenia. Even for those who have previous
history of mental illness, their psychiatric condition may not be the main
precipitating factor," she said.
Dr Nor Hayati further explained that high suicide incidence among
psychiatric patients had been associated with social factors such as living
alone and substance misuse.
From another viewpoint, aspects of being diagnosed with mental health
problem may be implicated.
SOCIAL STIGMA
She said the social stigma linked to mental health problem is of central
significance.
The distaste towards being labelled as 'mentally ill' may explain why only
7.1 per cent of the 113 documented cases were reported to have mental illness,
two were suffering from depression and one had schizophrenia.
Dr Nor Hayati said although some of the informants noticed that the deceased
became recluses or 'cannot work properly' prior to their deaths, the victims had
not sought any formal psychiatric treatment.
Similarly, majority of the deceased (79 or 69.9 per cent) was reported to
have no family history of mental illness.
Studies in the United States had shown a strong link between terminal
illnesses and suicides. However being terminally ill is not a sufficient cause
for suicide.
Such groups of individuals, said Dr Nor Hayati tend to have co-existing
depression caused by social isolation and the strain of being terminally ill.
Dr Nor Hayati said even though the NSRM tried to inquire information on the
presence of physical illness, this prevalence was reported in only 6.2 per cent
of the documented cases and these were actually chronic illnesses like diabetes
and coronary disease.
-- BERNAMA
