Karachi’s silent suicide problem

KARACHI: Over the past month, two incidents of suicide have shocked the city of Karachi. Two men committed suicide within a week of each other.

Initial reports revealed that both men were unable to support their families due to financial issues. According to reports, both men were the sole bread earners of their families. One left behind a wife and a number of children while the other is survived by his elderly parents and siblings.

Many suicide cases do not make it to the headlines and those that do are not given much coverage.

However, these two suicides hit the headlines and came into discussion probably because one of them had been affiliated with a media organisation before becoming a rickshaw driver to support his family. He ended his life by hanging himself from the ceiling fan in his room. The other committed the deadly act at a popular mall in the city located near the densely populated area of Gulshan-e-Iqbal.

Read more: Young man commits suicide at Lucky One Mall

According to the World Population Review’s Suicide Rate by Country 2021, the rate of suicides in Pakistan is 8.9 per cent with the male suicide rate at 13.3pc and female rate at 4.3pc.

This revealed that the ratio of men ending their lives is three times higher than women. Such numbers of people, especially men, ending their lives is a matter of deep concern. However, it is the government’s responsibility to study this and order investigation as to what can be done to reduce the number of suicides.

Suicide triggers

Many people face loss, trauma, and poverty but the majority of them do not commit suicide. So why do some people commit suicide while others, facing similar situations, do not?

Former president of the International Association for Suicide Prevention (IASP) Dr Murad Moosa Khan told Bol News that suicide can happen due to multiple reasons. “Possible factors include a person having the sense of being a burden on others, having a sense of social alienation from others and a fearlessness to carry out the act.”

Dr Khan added that research on suicide tries to identify those people who are most vulnerable within a certain group of people. “Research also tries to focus on what are such persons’ individual characteristics that make them vulnerable and not others in the same group. Poverty is frequently mentioned as a cause of suicide in Pakistan. There are millions of people in Pakistan who live below the poverty line but only a very tiny number of people kill themselves. So in research, we try to study both macro-level poverty as well as micro-level issues including the clinical depression factor.”

Read more: Who is Nosheen Kazmi? Why She Committed Suicide?

Speaking about suicidal tendencies, he explained, “This is because we are all different biologically as well as psychologically. Our personality traits are unique. Some people are over-sensitive and self-conscious while others may have a ‘couldn’t care less’ attitude’ towards life.

“Each one of us sees the world in our own unique way. Our coping mechanisms and resiliency levels are unique. These attributes are developed partly through our genetic make-up but mostly through our upbringing and our life experiences,” he added.

“Suicide is a complex act and we all need different layers of support and understanding for our overall wellbeing.”

The former IASP president said that our support systems are different and some people have a strong support system. “Others may not have any support. Hence two people in exactly the same situation will have a very different reaction.

“One of the men who committed suicide in Karachi jumped off the third floor inside a busy mall. It was revealed he had attempted suicide at least twice before. This time he was successful in killing himself. In the case that he had survived this time as well, the outcome of another attempt would have depended on many factors. These include method used, discovery, quality and speed of medical help,” he added.

Signs of danger

“If those around the victim realised he was not doing well and [had] given him support or tried to change his circumstances … he would not have attempted to commit suicide again. It depends on what sort of help was available to him and was the problem addressed or not,” observed the expert.

In the case of the mall incident, the two previous attempts by the man were red flags that should have been taken into notice and the right kind of help whether psychiatric, social or financial should have been made available to him, he asserted.

“Prior to his death, [one of the victims] had been posting about problems he was having with a bank regarding a loan. This is different from usual suicide cases in which notes are found after death; he had been showing signs by posting on social media platforms.”

Dr Khan highlighted that this is becoming more common as a way of expressing despair. “In many cases, this is an indirect way of asking for help. Many people, especially men have difficulty asking for help. Hence, posting messages like this is a way of doing that. He was understandably depressed. Many times the person carrying out the act does so because she or he feels they are a burden on their family or that their family is suffering because of them. Hence to them, killing themselves is actually relieving the family of this burden.”

He said that one of the most important psychiatric conditions in suicide is clinical depression. “More than 90pc of those who die by suicide are clinically depressed at the time of suicide. In clinical depression, everything looks black and negative. The person’s problem-solving ability is lost. Hopelessness sets in. When this state is reached, then all protective factors such as family, parents, friends, children and religion do not matter.”

The former IASP president commented that such people reach the endpoint and all considerations of consequences have no meaning for them. “Their depth of despair is beyond all sorts of consequences. All they are consumed by is how to remove themselves from what they see as an intolerable situation.”

Speaking about the man who ended his life by hanging himself from a ceiling fan in his room, Dr Khan said, “The choice of a certain method depends on their knowledge. If they have witnessed, read or seen a particular method, or the availability of the method’s tool such as guns or poisonous substances, then there is a possibility.

“Carrying out the act in a public place may indicate the person is drawing attention to her or his plight and to send a message to others how they have failed them. It is almost like an act of revenge against society that failed the individual,” he noted.

‘Pathway to suicide’

When someone commits suicide, the medical expert explained, it comes as a surprise for those around the victim. “Suicide almost never happens in a vacuum. There is a ‘pathway to suicide’ when people have unresolved issues and their stress levels increase. That is the point they get on the path to killing themselves.”

He claimed that suicide is preventable but it depended on the nature of the problem. “It matters what help is available to the person, how much loss of face or humiliation she or he is facing and how much loss of self-esteem the person may suffer as a result. All of this would determine the progression on the pathway. Most of the time these people are not able to make things right and continue to spin in a continuous vortex of despair.

“If all things work against the person, she or he will keep progressing till they reach a point where nothing matters and removing themselves out of the intolerable situation is the only option. That is the final tipping point, where all protective factors including family, children, job or society no longer matter and the person ends up taking their life,” said the expert.

To avoid incidents of suicide, Dr Khan asserted, prevention strategies should address both macro-level, as well as micro-level factors. “There are some things that can help including alleviating poverty but also providing easily accessible and affordable mental health services to identify and treat clinical depression.”

The writer is a freelance contributor.