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by Nalini Ellawala

The recommendations of the Presidential Task Force as set out in 1996 could be summarized in the following manner:

* Reduce the easy and quick access to highly lethal methods of harming oneself through the control of the issue of poisonous agro-chemicals. Also explore measures to reduce the lethality of pesticides. Educate the community about the importance of safe storage.

* Enlist media support to minimize harmful influences and improve awareness and educational levels so as to discourage suicidal behaviour.

* Improve medical management and hospital facilities to improve survival and recovery rates. Offer specialized support to drug users and depressives.

* Remove Section 302 of the Penal Code and introduce medical support and counselling for attempted suicides, compulsorily. Remove legal barriers to the helpful management of those who are at risk of suicide and those who have survived suicide attempts.

* Set up a research unit to identify and clarify issues related to suicide.

* Set up pilot projects in the heavy suicide areas to check out whether social support centers can reduce the trend for suicide.

The above recommendations were set out after lengthy deliberations by a committee that comprised men and women drawn from a wide range of skills, knowledge and experience. Many intervention strategies have been set up since then and we have witnessed a steady decrease in the number of deaths as seen in the statistics provided by the Police. Table 1 indicates a considerable reduction in the phenomenon but much still remains to be done.

Many Government and Non-Government organizations have been engaged in preventive efforts during this time and it is highly probable that this change in the position is the fruit of their labours.

While acknowledging the importance of the above recommendations it is also important to work on eliminating many of the harmful opinions and beliefs relating to the act of suicide that tends to encourage this unhealthy behavioural practice. The position that almost all social behaviours have multiple implications i.e. biological, sociological and psychological is well established.

However the community persists on the false premise that issues like the following can give rise to suicide:

* Broken love affairs

* Poverty

* Unemployment

* Incurable sicknesses

* Failure at examinations

* Unwanted pregnancies

While we recognize these issues as trigger factors, the real reasons are found elsewhere. Much effort has been expanded to clear these misconceptions that promote the idea that suicide is the answer for ones difficulties.

Mental illness

Depression and Schizophrenia accounts for as much as 30 - 40% of all suicides in our country. Some end their lives while under treatment while others have not been diagnosed as needing treatment. In many instances, poor management of the illness both by the individual and the family leads to suicide.

Alcoholism and drug dependency

We have seen a serious rise in the suicide rates in the 90s along with the increase in the production and consumption of both licit and illicit alcohol. 80% of the Alcohol dependent persons who seek help at Mel Medura (Sumithrayo Drug Demand Reduction Unit) admit to attempted suicide. Either the user or the family member finds that they have lost control over their lives through long-term drug use and decide to "end it all". Drug dependency leads to loss of productivity that leads to economic stress that leads to family distress and finally to mental and physical degeneration.

Coping skills

The trigger factors mentioned earlier lead to harmful behavioural responses accompanied by negative feelings like shame, disappointment, fear, hopelessness, emotional hurt etc. This category of person is the victim of poor coping skills and is therefore unable to rationalize life's difficulties and face them as the majority of the population is able to do. Some, especially the youth, try to manipulate their elders with the suicide threat. Other immature people use it as a tool to gain their ends e.g. fast unto death.

Each of the above situations demands sensitive management and different approaches. While tender loving care is appropriate when someone is in an unremitting state of hopelessness, people suffering from mental illness or even addicted to drugs, need specialist help.

The community must be educated to understand that suicide is not acceptable under any circumstances whatsoever. The habit of rationalizing the act under certain circumstances must be questioned while the practice is recognized as the response of an immature and weak person.

Counselling centres

There is also a false perception that the availability of counselling centres, per se, will reduce this phenomenon. While recognizing the importance of such centres for relieving stress and other related difficulties, there is a greater need for intervention strategies to change those community perceptions that give validity to this social practice. Many programmes have been set up to educate and train community workers who will take a lead role in this area and thus set off a ripple effect.

The role of the media

Insensitive handling of the issue in both the print and electronic media has from time to time unwittingly promoted this unhealthy social practice. Sensationalism and projection of suicide as a heroic deed, has given a value to a social practice that needs a more enlightened but empathic response.

We need to enlist the positive support of the media if we are to change community perceptions about not only suicide but also many of the other unhealthy social practices that rob the community of well-being.

Social well-being

The time is now opportune to set up an ongoing forum to discuss and research common social concerns with a view to diminishing harmful opinions and beliefs. The huge emphasis that is being placed on economic recovery and growth must be seen as a lop-sided effort if we continue to neglect community well-being at a holistic level. The social concerns that are known to prevent national growth must be recognized without further delay. If productivity is to improve, no amount of social benefits, whether Samurdhi or Janasaviya can have an impact as long as the community is crippled with harmful practices like:"

* Alcohol and drug use

* Suicide

* Child Abuse

* Sexual Abuse

* Domestic violence

* Bribery and Corruption

* Post Trauma Stress disorder

* Social violence

* Politicization

A National Resource Centre to train Service Providers

Much good work has been done by the Presidential Task Force set up in the past several years. Sadly, because their recommendations have been devoid of political flavour, they tend to be shelved. Social well-being does not and cannot have a political dimension.

Politicization is yet another disease that has eroded the entire social fabric of this nation.

Besides, compartmentalised efforts to cope with these issues tend to waste our meagre resources. A better outcome is possible if we begin to look at the well-being of the community in a more holistic manner and unify the various pockets of action under one roof.

Government red - tape and Legal Enactments have jeopardized and stultified the goodwill of the wider community. A National Resource Centre for the training of service providers will not only help to improve the quality of the public but also the private sector where men and women will be encouraged to humanize social interaction. Such a Resource Centre would be focused on training all service providers in skills like:

* Healthy interpersonal relationships and communication

* Coping with negative feeling in a positive manner

* Decision Making

* Self-Awareness

But can this be done without politicization? Will the hidden agenda of those in places of power permit an honest appraisal of the situation to set up remedial measures that could bring health to a sick nation, without looking for personal gain?

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