There comes a situation in life when a person thinks dying by suicide is a lot easier than dealing with emotional pain. And people in Tharparkar are being pushed to take that decision.
Thar is an extremely underdeveloped part of Sindh and that too contributes to the reasons why Tharis commit suicide along with prolonged spell of drought, use of drugs and domestic violence.
According to the SSP Tharparkar, Abdullah Ahmed, around 100 people died by suicide in the region in 2018 alone, while this year 44 people have taken their lives so far.
“When a mentally ill person develops extremes of pessimism and learns helplessness then he/she starts getting suicidal thoughts,” explains Dr Raza ur Rahman, the meritorious professor and former chairman of the Psychiatry Department at the Dow University.
In Pakistan, not just in Thar, there are a number of reasons why mental illnesses are prevalent:
- Lack of basic necessities of life
- Lack of peace and political instability
- Unemployment
- Health issues
- Poverty
- Homelessness
- Family disputes and a range of social pressures.
(The Hymen Right Commission Report of Pakistan 2018)
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Dr Rahman says that the causes of depression contribute towards development of suicidal thoughts.
On the other hand, Dr Quratul Ain, who works as a consultant psychiatrist in Karachi, says that while there are many factors which can influence a person’s decision to end their life, in most cases the person has severe depression and bipolar disorder.
“There are stages of depression: mid stage, moderate stage and severe stage. In moderate and severe stage, mostly, a person has overwhelming feelings and great emotional pain. Dealing with emotional pain is difficult for them and they think death is easy,” she says.
More women die by suicide in Thar
The number of women dying by suicide is higher than men in Pakistan than just Thar. According to Dr Rahman, one of the reasons is that females are readier to admit depressive symptoms than men.
Secondly, many depressed males start abusing alcohol and drugs so they are diagnosed as alcoholic or drug addict rather than depressed.
Thirdly, hormones of menstruation and parturition make women prone to depression.
Related: Is Being Single The Only Cause Of Depression Among Pakistani Women
On the other hand, Dr Quratul Ain says women are vulnerable to depression because of our patriarchal society, unfair practices and socio-economic problems. Ahmed agrees that in most cases they find out the married woman who died by suicide had a tussle with her mother-in-law or was in an unhappy marriage.
“Poverty, domestic violence and unfair treatment makes women’s lives miserable. Most of the women either jump into a well or hang themselves from a ceiling fan,” says Ahmed and claims that most of the women who committed suicide in Thar belonged to the Hindu community. It is no secret that the minorities in Thar face a lot of problems that can adversely affect their mental health.
The figures related to suicide are sketchy in Pakistan but mental health professionals see an increased number of such cases in their practice.
According to the Human Rights Commission Pakistan (HRCP) report 2018, 1,338 people died by suicide in the country. “Domestic problems were the most common causes for suicide among both women and men. Negligence on the part of husband and conflict with in-laws was the main reason that forced women to commit suicide while most men faced financial problems.”
Is suicide preventable?
This year’s theme of World Mental Health Day, which is on October 10, is ‘suicide prevention’ as it can be prevented.
However, Dr Quratul Ain says depression is not considered an illness in Pakistan and thus, people don’t seek professional help.
“But suicide is basically a cry for help by victims. Most suicidal people do not want death; they want the pain to stop. The impulse to end it all, however, overpowering, does not last forever so proper intervention will help,” says Dr Rahman.
For prevention the assessment of suicide risk is most important, he says, adding that there are many risk factors for suicide. These include but are not limited to previous suicide attempt, presence of a psychiatric disorder, family history of suicide, losses, emotional pain and sexual abuse.
Dr Rahman elaborates that proper psycho-social intervention can save many lives. These interventions include effective management of mental, physical and substance use disorders, easy accessibility of different clinical interventions and support for those seeking help, restricted access to lethal methods of suicide, availability of family and community support, learning skills for problem solving and conflict resolution.
Related: 8 Things People With Depression Want Their Friends To Know
Mental health and stigma
As compared to other countries, reported rate of suicide in Pakistan is low due to social stigma and legal issues that envelop the problem. Ahmed says that people don’t report suicides and try their best to hide the cause of death. “But, in 90% of the cases the police somehow find out and register a case under 174 of criminal procedure,” he shares.
According to Dr Rahman, suicide is prohibited in Islam, therefore, various obstacles restrict open discussion of the phenomenon.
“Another reason of underreporting of suicide is because it is considered a criminal offence under the Pakistan Penal Code (PPC), with punitive laws imposed for attempted suicide punishable by a fine of Rs10,000 and/or imprisonment,” he adds.
Recently, the Mental Health Act (MHA) of 2013 has documented suicide as an illness and cry for help rather than a crime but this disparity in MHA & PPC has to be removed.
“It is a pity that despite its importance no official data on suicide is available and it is neither included in the national annual mortality statistics of Pakistan,” points out Dr Rahman. The compilation of accurate data is important in persuading health policymakers regarding seriousness of the issue, he says.
Keeping in view the gravity of the situation, the Sindh government has appointed a full-time psychiatrist at the Civil Hospital but it is important to note that the total population of Thar is around 1.8 million. While such an effort is good but more needs to be done before the region becomes the suicide capital of the country.