Eulalee Thompson
Contrary to the general perception, Jamaica's suicide rate is among the lowest in the world. Data from the Ministry of Health indicate a range of between 2.1 and 3 per 100,000 over the last five years.
These data compare well with countries such as Trinidad and Tobago with a suicide rate of 10 per 100,000; United States with 11 per 100,000 and Scandinavian countries with a rate of 30 per 100,000.
Based on the data, linking suicide rates only to social and economic factors is not enough. Dr. Earl Wright, director, Mental Health Services and Substance Abuse, Ministry of Health, supports this view, pointing to the importance of emotional intelligence and learning to manage one's emotions.
"So, it (suicide) has nothing to do with whether it is a developing or developed country, it is more about how people deal with their emotions, whether they engage in externalising or internalising behaviours," he said.
Jamaicans are more inclined to engage in the externalising of their feelings, and this would probably explain the low suicide rates but high homicide rates, according to Dr. Wright. On the other hand, populations which are more developed and educated tend to internalise their feelings which could partially explain their higher suicide rates.
Linked to depression
Cases of suicides are, therefore, closely linked to issues of mental health and mental disorders. Dr. Wright, in fact, states that 60 per cent of the suicide cases in Jamaica are linked to a diagnosis of major depression with the balance of cases linked to other mental illnesses such as schizophrenia, substance abuse and personality disorders.
The mental illness/suicide link is not peculiar to Jamaica. Under the theme, 'Building Awareness - Reducing Risk: Mental Illness and Suicide', the 2006 World Mental Health Day campaign points out that in the United Kingdom, 50 per cent of all suicide cases occur in current or former diagnosed psychiatric patients and that the lifetime risk for suicide among people experiencing a mood disorder (primarily depression) is six to 15 per cent, while for schizophrenia, the risk is four to 10 per cent. The campaign further notes that those suffering from mental illnesses are more likely to die by suicide if they are not being treated or receiving inadequate treatment.
"Since most persons who commit suicide have identifiable mental disorders it is a matter of understanding how to express our feelings and emotions as well as diagnosing the disorders," Dr. Wright said.
However, he said many people are uncomfortable discussing feelings and seeking help for mental disorders and so their mental disorders are not diagnosed and treated. In fact, in Jamaica, suicide tends to occur among young males with undiagnosed and untreated mental disorders.
"Many people who commit suicide could have been treated successfully and we would like people to recognise that mental illnesses can be successfully treated," stressed Dr. Wright.
Depression instrument'
It seems, therefore, that if mental illnesses are more widely diagnosed, then the suicide rate could be significantly decreased.
"We are proposing that just as there is routine screening for hypertension at the primary health care level, there should be routine screening for depression and so we are training primary health workers to use a simple depression instrument. We are also training primary health care physicians and nurse practitioners to treat major depression because it is the main cause of suicide," Dr. Wright said.
Graduating doctors should also be competent in the use of the depression instrument in routine medical screens and in treating depression.
Send your feedback to eulalee.thompson@gleanerjm.com.
Suicide rate in Jamaica 2001 - 2005
YEAR| PERSONS | POPULATION |
| 2005 | 58 | 2.3/100,000 |
| 2004 | 42 | 1.7/100,000 |
| 2003 | 64 | 2.6/100,000 |
| 2002 | 56 | 2.2/100,000 |
| 2001 | 73 | 3/100,000 |
Source: Ministry of Health
