Addressing the rise of suicide cases in Trinidad and Tobago

While death by suicide seemed to have peaked during the pandemic for the twin isle, the increase continued post pandemic, with numbers soaring higher than the previous year and should be alarming to any concerned citizen.

According to mental health director at the health ministry, Dr Hazel Othello, suicidal behaviour exists on a spectrum. She said death by suicide can occur at any life stage, though it is most common in adolescents and those in the working age group.

With police data showing there had been 92 deaths by suicide in 2019, 104 in 2020, and 108 in 2021, people should be concerned about all areas of the spectrum. The spectrum runs from suicidal ideation or thoughts about harming oneself or ending one’s life, to non-suicidal self-harm events where someone harms themselves but their intent at that time is not to die, to attempted suicide where the harming of oneself is for the purpose of ending one’s life, as well as completed suicides.

Although you cannot predict death by suicide, you can identify people who are at increased risk for suicidal behaviour, take precautions, and refer them for effective treatment. The issue of suicide and self-harm is a complex one and is not manifested through just one type of behaviour. We look at the balance between risk factors versus protective factors. Risk factors include adversities, while protective factors include a caring supportive family background, community support, coping skills, living in a stable environment and positive experiences.

When people are depressed and decide to end their lives, they feel a sense of relief, and people mistake this for their feeling better. What is advised is if you notice these signs you should ask the person directly if he or she is having suicidal thoughts/ideas; if he or she has a plan to do so; or if he or she has access to lethal means? Ask direct questions like, “Are you thinking about killing yourself?”  “Have you ever tried to hurt yourself before?”  “Do you think you might try to hurt yourself today?” “Have you thought of ways that you might hurt yourself?” “Do you have pills/weapons in the house?”  This won’t increase the person’s suicidal thoughts. It will give you information that indicates how strongly the person has thought about killing him- or herself. Take seriously all suicide threats and all suicide attempts. A history of suicide attempts is one of the strongest risk factors for death by suicide.

If you think the person might harm him- or herself, do not leave the person alone. Let them know you are willing to get them some help and connect with the nearest crisis centre.

There is no evidence that “non-suicide contracts” prevent suicide. In fact, they may give counselors a false sense of reassurance. What is advisable is to listen and look for red flags for self-destructive behaviour.

Friends and relatives who are concerned for their loved ones and want to get them to seek help should listen and be non-judgmental. Othello outlined some of the steps that have been made toward suicide prevention in Trinidad and Tobago. These include mental health services provided by the regional health authorities, including mental health gap training; advocacy by people who have personal experience with suicide; mental health promotion by the ministry, RHAs, NGOs, community-based organizations and individual experts; survivor support groups that have proven very useful to their communities.

Although more needs to be done to help those struggling in silence, it would be beneficial for family members to learn more about the signs and triggers of suicide since they are the ones closest to the victims. Family members and close friends can help prevent suicide by learning the warning signs early on and knowing that the risk of suicide is greater if a behaviour is new, has increased, and seems related to a painful event, loss or change.

Subrina Hall-Azih is a Trinidadian Educator residing in New York.