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Suicide Dr. Neil Fernando Consultant Psychiatrist Outline Introduction Historical background Facts & figures Suicidal process High risk groups What can be done Introduction Definition Process which ends with


  1. Suicide Dr. Neil Fernando Consultant Psychiatrist

  2. Outline  Introduction  Historical background  Facts & figures  Suicidal process  High risk groups  What can be done

  3. Introduction Definition  Process which ends with death  Process initiated & conducted by the person  With the knowledge & expectation of death

  4. Historical background Judas -- Jesus Christ Hara-kiri -- Japanese samurai Sati puja -- Indian widows

  5. Facts & figures Global status  1 million suicides per year  10 – 20 million suicidal attempts per year  Main factor causing death  60% youth

  6. Facts & figures Sri Lanka  Suicide rate in women – world No. 1  Suicide rate in youth – world No. 1 1985 -- 2000  Deaths from war: 50,000  Deaths from suicide: 106,000 Common cause of death

  7. Global suicide rate ( 1950 – 1995 ) 18 16 14 12 10 8 6 4 2 0 1950 1960 1970 1980 1990 Year

  8. Suicide rate in Sri Lanka ( 1950 – 1997 ) 45 40 35 30 25 20 15 10 5 0 1950 1960 1980 1985 1993 1995 1997 Year

  9. Suicide rate in different age groups in Sri Lanka 35 30 25 20 15 10 5 0 <15 16-24 25-34 35-44 45-54 55-64 >65 Age Range

  10. Gender difference 27% Male Female 73%

  11. Mode of suicide – Sri Lanka 30% Poisoning Hanging 70%

  12. Facts & figures Sri Lanka  Suicide rate in women – world No. 1  Suicide rate in youth – world No. 1 1985 -- 2000  Deaths from war: 50,000  Deaths from suicide: 106,000 Common cause of death

  13. Facts & figures Sri Lanka  Suicide rate in women – world No. 1  Suicide rate in youth – world No. 1 1985 -- 2000  Deaths from war: 50,000  Deaths from suicide: 106,000 Common cause of death

  14. Facts & figures Sri Lanka  Suicide rate in women – world No. 1  Suicide rate in youth – world No. 1 1985 -- 2000  Deaths from war: 50,000  Deaths from suicide: 106,000 Common cause of death

  15. Facts & figures Sri Lanka  Suicide rate in women – world No. 1  Suicide rate in youth – world No. 1 1985 -- 2000  Deaths from war: 50,000  Deaths from suicide: 106,000 Common cause of death

  16. Suicide rate No. of suicides per year per 100,000 population

  17. Suicide rate Below 8 – low 8 – 16 -- medium Over 16 – high

  18. Suicide Male / female difference Male – 73% Female – 27%

  19. Method of suicide 70% -- pesticide poisoning 30% -- other methods

  20. Myths & misconceptions  “it can not happen to me”  “those who speak do not commit suicide”  All who commit suicide are mentally ill  Inquiring about suicide will encourage suicide

  21. Suicide Process intention act Attempted suicide

  22. Suicide process  Intention  Act  Out come  Suicide  Attempted suicide

  23. Reasons for suicide Social Health  Old age  Depression  Social isolation  Alcohol dependence  Lack of social cohesion  Schizophrenia  Media publicity  Personality disorder

  24. Suicidal behaviour Mental disorders ( 50% ) Mixed group ( 40% ) Hopelessness ( 10% )

  25. Mental disorders  Depression  Schizophrenia  Alcohol dependence  Personality disorder

  26. Mixed group Intention not to die  Attention seeking  Manipulative  Reaction to stress

  27. Hopelessness  Abject poverty  Social isolation  Miserable life conditions

  28. What can be done assessment of suicide risk  Find out about the intention  Previous suicide attempts  Is the person mentally ill?  Other risk factors

  29. Assessment of suicidal intention  Planning before  precautions to avoid detection  Availability of help  Lethal methods  Last acts

  30. Helping high risk groups  Prevent suicide attempts  Treat any mental illness  Give hope  Problem solving

  31. Helping persons who attempted suicide  Does he still wish to die?  Solving current problems  Treating mental illness  Identifying person’s resources

  32. Suicide prevention Limiting use of pesticide  Restriction of sale  Promoting biological control

  33. Suicide prevention Minimizing the harmful effects  dilute solutions  Powder & crystals  Adding an emetic  Safe storage

  34. Suicide prevention Develop treatment services  Training of staff  Supply of material

  35. Suicide prevention Change of attitudes  Sinful act  Not to blame the living  Useless act

  36. Suicide prevention Role of the media  Highlight the usefulness of life  Not to give heroic status  Analyze the problems deeply

  37. Suicide prevention Mental health promotion  Life skills training  Detection & treatment of mental illness  Providing counseling facilities

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