"High risk individuals" live in certain situations and are more prone to suicides as stated WHO (2001). These are the persons:

• Losing their status, jobs and income
• Facing certain economic loss such as crop failure, natural disaster
• Expressing their loss of confidence, self esteem and faith
• Feeling guilt, shame, hatred, worthlessness, hopelessness and helplessness
• Repeating that "destiny is calling them", "hearing words from God" 
• With history of previous suicidal attempts
• Showing decreasing interest in hobby, sex and other activities which they enjoy earlier
• Recently discharged from hospitals such as cancer, HIV and other chronic diseases

These are the symptoms which are commonly found among suicidal person or high risk individuals. If we know an individual with these symptoms we must reach out and help as early as possible our intervention can save a life or prevent a suicidal act.

CAUSES OF SUICIDE

As far as the causes of the suicide are concerned psychologists and other medical scientists have grouped a number of causes into socio economic factors religious and cultural factors, family system and bio-chemical imbalances.

Socio-Economic Factors:-

Behavioural scientists are of the view that cultural beliefs, social standards, gender bias, education problem, income levels, living status, growing aspirations, pressures of modern life, the need to excel and compete in the modern word, employment issues, marriage related factors, interpersonal conflict, breakdown of family values and systems, serious illness, social isolation and death of a loved one are all responsible for suicidal thoughts among the people. Frequently, these factors (financial losses, family conflict and failure in life etc) are cumulative, repetitive, and progressive may act as building blocks in the process of committing suicide.

Socio-Political Factors:-

There are some cases of suicide due to socio-political factors. Such factors are sudden demise of religious or political leaders. The recent example in this stream is  the mass suicide in Andhra Pradesh as a result of death of Y.S.Reddy Chief Minister of the state. His plane crashed and when the news broke people were not ready to take it. Some had cardiac arrest some committed suicide deliberately and the toll rate rose to 124. (Source: The Times of India, 5 Sept, 2009)

Religious and cultural factors:-

Religious and cultural aspects of suicide emanate from strongly held beliefs and value systems. This association in some individuals is propelled more by tolerance, acceptance and respect. The notion that a person has reached his heavenly abode, is closer to God, has compiled with the wishes of elders, joined the family in heaven, taken the destined way of living earth, followed a self created path of life can only be explained by religious, spiritual and earthly modes of casualty.

Failing Systems:-

Studies reveal that the increasing economic turmoil, political unrest, social upheaval, communal disharmony are the major causal factors of suicide. In these situations serious losses or threats of loss of property, loved ones, job, pride, honour, status, independents and support systems operate in major way to push an individual to the state of despair and rejection. Studies reveal that merely 1000 farmers from the three southern states of India, Karnataka, Andhra Pradesh and Maharashtra have committed suicide.

Bio-Chemical Imbalances:-

Some of the mental health problem such as depression, alcoholism and other substance abused problems and effective disorders cause biological imbalances by themselves it has been seen that suicidal behaviour runs as distinct feature and requires triggering by dis-order or adverse psychological factors. The bio-chemical basis of suicide endorses the fact that the decline of certain neuro transmitters in the brain is a major cause.

Some mental health problems carry a high risk of suicide during the course of illness. Bio chemical imbalances in the brain of such individuals alter the rational thinking and judgement, contributing significantly to the occurrence of suicide.  Depression is one of the commonest conditions leading to suicide. Alcoholism is known to be distinctly associated with suicides specially when drinking start at an early age. Alcoholism, depression and suicide are known to result in a vivacious circle. The drug users are also more prone to suicide.

Thus, suicide is influenced by ecological and environmental characteristics, the social fabric, individual predispositions and current circumstances the causes for suicide are multi factorial interlinked  cumulative often repetitive and progressive over a period of time. It passes through stages of helplessness, hopelessness, and worthlessness.

Cases in consideration

There are certain cases which author has encountered at the time of investigating the facts. These cases are as under:

• "I met a person in the bank who was known to me, what surprised me, that he was transferring all of his money to his son's account. When I asked him, why are you taking such a major decision of your life at this stage? He replied, I want my son to utilize my wealth in whatever he wants to do". At the very next day he hanged himself. Family members of the deceased were not at all aware of the causes of suicide.

Note: This case shows that the victim of suicide was giving hints by transferring his money to his son. This is one of the clear symptom or clinical picture of the suicidal tendency.

• In one of the counselling session a mother was got worried about her daughter that she is attempting to commit suicide. Before attempting to suicide, daughter reportedly hinting suicidal tendency by saying, " hum nahin rahengey to pata chalega". " mere marne k baad meri ahmiyat maloom hogi". The family members were ignoring the suicidal hints which caused an attempt to suicide.

Note: In this case again the victim is giving suicidal hints. Mother took serious note and daughter undergone a rigorous counselling sessions one after the other.

In both the cases victims could be identified through their clinical picture or symptoms. In one case family members were not at all aware the victim consequently lost the father. Where as mother identified the suicidal symptoms the daughter, approached counsellor and saved the life of her daughter.

Role of family members is instrumental in understanding the problems and providing favorable emotional climate. Family member    should know each of their feeling, emotion and temperament. Whenever such maladjustment and abnormality occur, family must get alert and should try their best to solve their problem. If such symptoms are sever in nature then victim should be referred to counsellor.

Member the family should act as counsellor within the family. They must listen to depressed person. Most of the problem can be solved by listening.

Remedial measures:-

The prevention of suicide is a big challenge to the society and the nation as well. With the multiple approaches and meaningful interventions, many lives can be saved. Preventing suicide requires interventions at individual, family and societal levels.

At Individual Level

It is the responsibility of each and every individual of the society to save the life of people who are committing suicide. Individual should monitor the behavioural tendency which is at higher risk. Whenever such people are encountered, one should try to establish contact and find out who they are; listen carefully and allow them to talk about themselves and their feelings. Individual must try to recognize the problem and understanding of high risk individual. One should identify the best possible way of helping them in the crisis and release them from their circle of thoughts, be with them and continue to interact, listen and offer support. It is also advisable that the high risk individual should be engaged in social and recreational activities such as meeting people, talking friends, watching T.V. 

Once a crisis situation has passed it is essential to offer continued support to enable them to overcome challenges in a positive way.

At Family Level

Role of a family is instrumental in molding a negative thought and obsession of high risk individual. The family is the nucleus of all activities in an individual's life. Interpersonal conflicts, disturbed relations and non-harmonious living   are the principal triggering or precipitating factors for suicide. Family members can effectively intervene in a number of ways:

• Identifying warning signals of stress and suicidal tendencies
• Family members must establish a rapport with high risk individual in the family
• Establishing close relation with a person by caring, listening, respecting feelings and understanding emotions
• Trying to minimize conflict at home and developing problems solving exercises jointly with other family members
• Continuing to observe the reaction and behaviour of the person enacting(fast) even at the slightest suspicion or the doubt
• Keeping a specific watch on those who are elderly terminally ill, mentally ill and disable

Thus Family member should encourage the person to see timely help from professional, suitable agencies or hospital. They should give love, understanding and support apart from prescribed medicines following suicidal attempts.

At Community Level

Communities, organizations and agencies have an extremely important goal in developing preventive services, emergency services, after care service and preventive programs. WHO has recommended following activities for preventing suicides:

• Area based help line can be established. 24 hours emergency direct telephone lines can be great help in this regard
• Greater publicity and awareness about these help line can be generated by encouraging people to access these services
• Local volunteer youth services can be developed to act as emergency help line in crisis situation
• Mental and social health promotional activities in schools and colleges, industries, hospitals and high risk communities can be organized through local programs
• Educational programs in local languages by using local dialects and communication strategies can be facilitated

Besides these high risk places such as hospitals, jails and lodging establishments should be monitored. It is important to develop mechanism for preventing suicides in these places by special efforts.

At Mass Media Level

Both print and electronic media have a profound impact on the lives of the people. Media can play a positive role in shaping people's thought and can show the direction, avenue or option to a depressed and high risk individual. There are following suggestions, if implemented by the media, could help in preventing suicide:

• Suicide statistics should be reported to stress the fact that every suicide is a loss to society
• Celebrity suicide should not be given undue emphasis. Special caution should be exercised reporting such incidents
• A realistic description of the impact of suicides on survivors, employers and families should be provided and in short term and long term consequences on individuals
• The mis-conceptions, culture, beliefs and myths about suicide should be explained
• The local press can be given wide publicity about help lines, crisis, prevention centres,poison treatment centres or agencies providing help to individuals and families
• The media should work closely with the local health personnel in ascertaining facts before reporting them

Thus, greater responsibility of media "as a gift to society" is to prepare and inform people that suicide can be prevented.

At Teachers Level

Among the major causes of suicide are examination failure, parental pressure, high expectation of school and colleges, disappointment in love and conflicts. Schools and colleges serve as building blocks of individual life and play a vital role in preventing such activities. Here the role of a teacher becomes instrumental in building value systems setting acceptable individual aspirations and inculcating appropriate goal setting mechanism are of prime importance of preventing suicide. The period of transition from childhood to adolescent is always a turbulent phase. A number of behavioural problems are frequently noticed at this stage such as mood swings, impulsive nature, difficulty in coping, angry behaviour, attraction to the opposite sex etc. a teacher can provide proper supportive help and adequate buffer mechanisms for handling this transformation prices among children effectively.

Child abuse is an emerging problem in India and abroad such children are often traumatized, victimized and afraid to share their problems with others due to family and cultural reasons. Teachers can provide comfort and support in overcoming their mental stress. Teachers should also understand that certain adolescents require special attention in schools and colleges due to their high risk susceptibility to suicide.

Teachers should become more socially and psychologically adaptive to the changing realities. Teacher should identify crisis children at an early stage and school days counseling services should be provided to them. In countries where teachers are held in high esteem they can help in building better role models.

Making the school a healthy place through better development of school activities for greater interpersonal relations and preventing harmful behaviour would promote better interaction amongst students and teachers. According to WHO (2003) setting up crisis intervention programs to resolve interpersonal conflicts, helping children with disorder of substance abuse and promoting trustful communication strategies are vital interventions required in educational institutions. Developing regular counseling and referral services in schools is a crucial step in providing timely help for many children when teachers alone are unable to handle the problem. It is also recommended that regular parent teacher interaction is essential for the development of child's personality in totality.

At Spiritual Level

Spiritual leaders and faith healers occupy a unique position in Indian societies owing to their stature, position, wisdom and capabilities to influence people beliefs and values. Faith healer should be involve in suicide prevention activities at the community level as they are the first level of contact for many health problems. If they play a positive a role in identifying suicidal thoughts, behaviour, depressive states and other emotional support to the people it will be a step in the right direction. In India Sufis and saints have had vital role in providing comfort and emotional support to high risk individuals. These practices to visiting sufis and saints have greater impact in the mind set of the people and resolve conflict in the families and community level.

Conclusion:

Suicide has emerged a global problem. It has socio-economic, cultural, religious, and psychological causes. It has greater impact on human society .suicide can be prevented by individual level, family level, teacher level, Mass media level and religious level.

References