Suicide in South Africa has always been a concerning issue, with high rates of suicide even before Covid19, especially among men who are four times more likely to die by suicide than women.
But since the beginning of the pandemic, suicide has become a growing concern. The South African Depression and Anxiety Group (SADAG) says they have received over 75 000 suicide calls since January 2021 from people who are really struggling, having serious suicidal thoughts, behaviours, and callers who have previously attempted suicide.
Suicide awareness is in the spotlight, as we observe World Suicide Prevention Day, with this year’s international theme being “Creating Hope Through Action.”
Depression affects more than 260 million people in the world, while around half of all mental health conditions start by age 14. Suicide is the fourth leading cause of death in young people aged 15 to 29. In 2019, South Africa was ranked number 10 in countries with the highest suicide rates, with the World Health Organisation saying that every 40 seconds someone in the world commits suicide.
“Before Covid lockdown in 2020, we were receiving about 600 calls per day. At the beginning of lockdown our call volumes doubled overnight to 1 200 per day. Now 18 months later, we are fielding over 2 200 calls per day. And this figure excludes the hundreds, and thousands more, emails, whatsapps, social media and sms messages from people reaching out for help each day,” says SADAG’s operations director, Cassey Chambers.
Sheila Selfe, clinical social worker and member of South African Association for Social Workers in Private Practice (SAASWIPP) says: “Some of the risk factors for this include isolation, higher levels of depression, loss of livelihoods, financial worries and the loss of loved ones (often under very difficult circumstances). During the pandemic, people with existing mental health conditions have been at increased risk, with their coping mechanisms sometimes being overwhelmed.”
However, suicide is definitely not only linked to times of world crisis. It is an ongoing cause of death, with many factors playing a role. When one looks deeper into the situation of someone who has ended their life by suicide, one often finds that there is not only one cause. Predisposing factors such as mental illness, serious physical illness, the experience of abuse in their childhood or, more recently, witnessing or experiencing violence, social isolation or certain personality factors, all play a role.
“While they may have had thoughts of ending their lives, against the backdrop of these situations, rising stresses may make the person feel trapped or hopeless. They may begin to feel like a burden, or that they have no place in the world, or life has lost its meaning, all of which can start to push someone close to a tipping point,” says Selfe.
Selfe adds that it is not uncommon for people, at times, to experience feelings of wishing they could die. However, she adds that only a relatively small portion of these then go on to think seriously about it and begin to formulate a plan, with even fewer then attempting to implement it. However, even suicidal thoughts should be taken seriously, as they may indicate a higher level of risk.
“It is important to engage with a person whom you may regard as a suicide risk,” stresses Selfe.
“Some indicators could include changes in a loved one’s behaviour such as withdrawal from others, discussing death, giving away their possessions (seemingly saying goodbye), agitation or even changes in sleeping patterns. Sometimes, someone who has decided to end their life could also appear happier and calmer which could be interpreted as them feeling better. Sadly, suicide is very complex, with risk factors fluctuating, and not all suicides are preventable,” she says.
Selfe strongly recommends the assistance of qualified professionals to assist one’s loved one who may be considered a suicide risk.
“There are very good helplines in a crisis (SADAG), but regular counselling is of great importance. It offers continuity of care that provides for a supportive relationship capable of holding the person and their changing moods and emotional states, and to help them manage their feelings so that it does not escalate into self-harm,” Selfe says.
Further, family members of loved ones of someone with high suicidality or who have lost a family member or loved one to suicide, also require help themselves.
“This is not something that anyone should carry on their own. And, as important as it is to try and create a loving climate wherein you can engage with your family member and/ or loved one whom you may consider a suicide risk, so too is it important to receive whatever assistance you need as you navigate an emotionally distressing time,” says Selfe.
Find a counsellor or approach your doctor or healthcare facility who will be able to refer you for emotional support.
For World Suicide Prevention Day, and every other day of the year, SADAG is encouraging South African’s to “Create Hope Through Action” by:
1. Learning the warning signs of suicide and symptoms of depression
2. Changing the way we talk about or refer to mental health and suicide in our day-to-day conversations (Visit SADAG’s website www.sadag.org for a Language Guide on Suicide)
3. Take the time to reach out to someone who is not coping – a family member, friend, colleague, or even a stranger – checking in, asking directly if they are feeling suicidal or asking how they are really doing, knowing what to do or who to speak to for help for someone who may be feeling suicidal could change the course of their life and open an important conversation.
4. Creating awareness – change starts with us. Sharing resources and helpful information on mental health and suicide can help educate others, normalise conversations around difficult topics and link people to treatment and support
5.Contact a social worker, psychologist, family doctor or healthcare facility.
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