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Suicide attempts undermine social progress

Daljit Kaur (not her real name) is 17 years old and is in school.

In the past year, she attempted to harm herself three times by taking an overdose of her father’s anti-diabetic medication. It happened for the first time about eight months ago when her mother found her unconscious. She was admitted to a hospital and remained under observation for four days. A psychiatric team assessed her but Daljit did not attend follow-up sessions.

About 10 weeks later, she told her close friend that she was planning to do away with herself.

Daljit believes that her parents are more lenient towards her younger brother and give him more freedom. She is keen to integrate into the broader New Zealand culture but feels that she is held back.

Indian Diaspora

The act of harming oneself by using overdoses, cutting or by ingesting harmful substances are all forms of self-harm.

The Indian diaspora in many countries including UK, Fiji, Malaysia, Guyana, Surinam and Trinidad & Tobago shows high rates of self-harm, especially among young women aged between 18 and 24 years of age.

These women are nearly three times more likely to harm themselves compared with their white counterparts and over seven times more likely to commit suicide than South Asian men.

Unclear intent

Self-harm is often equated with attempted suicide, although the actual intention of the act may well be somewhat different.

Like Daljit, people may feel trapped, depressed or stressed out and may resort to such methods as a way out of a difficult situation.

Symptoms of depression include feeling low in mood, a lack of energy, a lack of interest in surroundings, general severe sadness, and unhappiness.

Some people may feel hopeless, helpless and tired. They may have little or too much sleep, may not eat or overeat leading to weight-loss or weight gain. Suicidal intent may not always be clear.

The reasons

There are cultural and genetic reasons for such behaviour. History of suicide runs in families as shown in Indian epic Ramayana according to which suryavanshis had a strong family history of depression and suicide.

It is therefore important to identify vulnerability factors so that individuals at risk can be helped and supported at an early stage.

The act of self-harm may be a cry for help. Feeling trapped, sexual and emotional abuse as well as certain personality characteristics and drug and alcohol abuse in the family with or without domestic violence can contribute to the feelings of hopelessness.

Not meeting one’s aspirations, and sexuality related issues may also contribute to the likelihood of self-harm.

If you feel trapped and lonely, try to talk to those in whom you have confidence. Family members have a major role to play in identifying the needs and supporting the sufferers. You must see a counsellor at your school or university, your general practitioner who may be able to point you in the right direction for counselling or specialist treatment.

Families must be cautious if someone is socially withdrawn. Gender role expectations play an important role in creating a sense of high expectations and feelings of being let down as a result.

Various local and national organisations can provide further information and help in times of crisis.

Professor Dinesh Bhugra is Professor of Mental Health and Cultural Diversity at the Institute of Psychiatry, King’s College London and Honorary Consultant at the Maudsley Hospital, where he runs a sexual and couple therapy clinic. He was earlier President of the Royal College of Psychiatrists and Chair of the Mental Health Foundation. He is a Trustee of Care-if. He will take charges as President of the World Psychiatric Association in September 2014. In early 2012, Queen Elizabeth II honoured him as a Commander of the British of the British Empire (CBE).

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