Suicide not usually result of single source of stress, says IMH doctor

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SINGAPORE: Family and interpersonal relationships are the main causes that get teenagers thinking of suicide – although exam stress is often a contributing factor, according to Dr Ong Say How of the Institute of Mental Health.

Last year, 27 teenagers aged 10 to 19 killed themselves – the highest number in Singapore in 15 years. While it might be tempting to attribute the deaths to growing stress from school, said the chief of Child and Adolescent Psychiatry, it is important to recognise that acts of suicide tend to occur not because of one particular source of stress, but out of several factors.

These include interpersonal relationships which can make one teenager more vulnerable than others, said Dr Ong, speaking to the programme On the Red Dot in a recent episode on suicide. (Watch the episode on Toggle.)

Stresses from work and interpersonal relationships are the leading cause for suicide ideation in some other age groups. In total, 409 people in Singapore killed themselves last year, and 6,455 calls that related to suicide risk were made to the Samaritans of Singapore hotline from April 2015 to March 2016.

Featured in the episode, for example, is suicide survivor Nicole K, who struggled for years with her parents’ unhappy marriage and eventual divorce. Blaming herself, she began to hurt herself, she said: “Because I just couldn’t deal with what’s happening between my parents and I felt very powerless.”

Watch: Nicole’s story 

At 26, Nicole was diagnosed with major depressive disorder and general anxiety, and came close to killing herself several times. She eventually came out of that “dark place” with psychiatric help and her husband’s support – and today runs The Tapestry Project, that shares stories of people who have grappled with mental illness.

“I needed to relate to somebody who is in my situation,” she said. “Even though each person’s story is so diverse and so different, when we come together we can hold on to each other and encourage each other.”

DON’T SAY THIS

If you know someone who may be contemplating suicide, phrases that are not helpful to say, according to the experts, are: “You will get over it”, “Don’t think too much about it”, or “Cheer up”.

These statements are dismissive to the person’s feelings and serve to minimise their problems rather than be helpful, said Dr Ong.

What is helpful instead, is to tell them things like: “I notice you’ve been feeling down, can I help?”, “It pains me to see you going through that”, “Would you like to share with me what you’re going through?”, and, “I’ll be here if you need me”.

Experts also emphasise that it is vital for parents to acknowledge and validate their children’s problems. Otherwise they may feel isolated, and without other avenues to resolve their problems, they may contemplate suicide. (Read more about what was said at a Talking Point forum on teen suicide.)

Dr Ong reiterate that while we seek to understand suicide, it remains a complex human behaviour that cannot fully be attributed to a single cause.

“The important thing is to increase mental health literacy,” he said. “Then we can actually start talking about issues that are relevant and important in Singapore about mental health. And that can translate to fewer suicides over the long term.”

Catch On the Red Dot every Friday at 9.30pm on Mediacorp Channel 5. Upcoming episodes in its ‘Secrets’ series deal with problem gambling, family violence and living with a criminal record.

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