Daily Times

A global issue, suicide is a challenge to the political, economic and social systems and their legitimacy, including their contemporary forms and nomenclatures across the world. According to the World Health Organisation, close to 800,000 people die due to suicide every year. Suicide is the third leading cause of death in 15 to 19-year-olds. As many as 79 per cent of suicides occur in low- and middle-income countries.

Pakistan, too, is braving this menace. In recent times, a significant increase has been reported in the incidents of suicide in Tharparkar in the province of Sindh. While this has particularly brought the area into the limelight, the phenomenon of suicide prevails countrywide. According to a research paper, “Suicide Prevention in Pakistan: an impossible challenge?” authored by a renowned psychiatrist, Murad Moosa Khan, suicide cuts across all ethnic, provincial and rural/urban boundaries in Pakistan.

Generally, it is argued that Islamic law considers suiciding a sin. This works as a deterrence to suicide in the Muslim communities, including in Pakistan. However, the reported rising rate of suicides in the province of Sindh seems to challenge this notion.

According to the Statistical Report for the year of 2018 developed by the Police Surgeon Office Karachi, out of 31,718 cases recorded in Karachi only for medicolegal reasons, 7,144 cases are related to poison. According to Karachi Police Surgeon Dr Qarar Ahmed Abbasi, these poison cases are mostly related to suicide attempts.

In many cases, the risk of suicide is increased by mental health issues, including depression

Suicide has socio-economic and cultural dimensions embedded in financial crises, family issues, breakups, poverty, joblessness, failures, frustration and so on. However, in many cases, the risk is increased by mental health issues, including depression and its various manifestations. According to the World Health Organisation (WHO), at its worst, depression can also lead to suicide. However, according to a research study, “Case-control study of suicide in Karachi, Pakistan,” suicide in Pakistan is strongly associated with depression.

Tragically, mental health issues are extremely stigmatised at the society level and remain most neglected at the policy level in the country. On one hand, people do not like to disclose and share mental health issues on the account of the taboos and social stigma associated with it. Those who dare to share are unfortunately called “pagal” (lunatic). On the other hand, the state and its policies are least concerned with this pressing issue, rather a crisis.

Concerning the province of Sindh, in addition to a few facilities for the mental health at the government level in Karachi, there is only one such facility in Hyderabad, Sir Cowasji Jehangir Institute of Psychiatry (commonly known as Giddu Badar) for the rest of Sindh.

The Sindh Mental Health Act, 2013, was passed in Sindh. The law, inter alia, envisages the formation of Sindh Mental Health Authority, which was established back in 2017. The Authority faces budgetary and other issues and, thus, remains least successful in performing its tasks.

Most importantly, the law necessitates the establishment of psychiatric facilities across the provinces. However, it remains a forgotten task so far against the fact that every taluka and district in Sindh needs these facilities resourced in every way, including the immediate appointment of psychiatrists and psychologists.

“Psychiatric facilities” could be interpreted in a wider sense. In addition to the establishment of the psychiatric hospitals and wards, suicide prevention hotlines/helplines could also be established in the province. Such services are working worldwide and have gained many successes and recognition in many countries.

General awareness among the masses with the behavioural change strategy is also essential for destigmatising mental health issues. This is essential so that people with these issues do not feel ashamed and hesitant in sharing these problems, take proper medicines and make use of other psychological support.

In the research paper, “Suicides in the Developing World: Case Study from Pakistan,” Murad Musa Khan et al wrote that campaigns, through the media and other public forums, to raise public awareness about mental health issues, in general, and suicidal behaviour, in particular, would help lessen the stigma.

According to the WHO, stigmas surrounding mental ill-health are widespread. Despite the existence of effective treatments for mental disorders, there remains a belief that they are untreatable or that people with mental disorders are difficult, unintelligent or incapable of making decisions. This stigma can lead to abuse, rejection and isolation; excluding people from health care or support. Within the health system, people are often treated in institutions, which resemble human warehouses rather than places of healing.

Furthermore, Sindh Mental Health Authority should take other measures to prevent the suicides in the province. According to the research studies, the most common ways that people use to commit suicide in Pakistan are self-hanging and use of poisonous substances. According to the research article, “Suicide Prevention in Pakistan: an impossible challenge?” authored by Murad Musa Khan, while hanging is difficult to control, restricting the availability of the latter two can potentially prevent 50 per cent of suicides. Sindh Mental Health Authority should, thus, make efforts in improving the stringent regulation of the sale of such substances in the province where even the acid is commonly sold in the grocery shops.

The writer is a graduate in human rights and democratisation from the University of Sydney