Some years ago, a 19-year-old girl neighbour of mine collapsed at home after swallowing some sleeping tablets and 20 tablets of paracetamol. A night before that, she had an argument with her father who forbade her from meeting her boyfriend. She was rushed to the hospital and was later found to have complication of liver failure due to paracetamol intoxication. Over the subsequent two months, she remained unconscious and hooked to the respirator machine until she was finally pronounced dead. It was certainly a devastating experience for her family and friends.
About one million people commit suicide each year. That means on the average, 3,000 people kill themselves every day. That works out to about one person taking his or her life every minute.
For each individual who takes his own life, at least another 20 more had attempted to do so. In other words, 20 million people attempt to take their own lives every year. Statistics show that globally, suicide is the second leading cause of death for those between the ages of 15 and 29.
Reported suicide cases are on the rise in Cambodia. The National Police began recording suicides in 2011 and noted that the number of suicides has been increasing from 513 in year 2011 to 609 in year 2013 and 749 in year 2015. According to the latest WHO data published in 2017, suicide deaths in Cambodia reached 1,857 or 2.20 percent of total deaths.
While life is so precious to most of us, there are so many who just want to die. The number of people killing themselves is high and increasing. We need to take a serious look at why these people think of nothing but ending their own lives.
Suicide is not a trivial matter related to one or two unpleasant moments or problems as often reported in the media. These are often mere triggers of the more serious underlying root causes such as cumulative stress, mental health crises, family conflicts, social issues and substance abuse. Nonetheless, acute stress that overwhelms one’s capacity to deal with loss can sometimes lead to suicide.
Life is certainly stressful and full of suffering. In Cambodia, it is made tougher by poverty, post-war traumatic stress, alcoholism, poor health care and the lack of mental health services and professionals.
The number of people seeking help for mental health problems is rising rapidly. However, the mental health facilities and number of psychiatrists and counsellors are incredibly limited in Cambodia. Perhaps Cambodians could tap into their unique rich heritage to help lessen the strain of their mental health facilities and the limited number of mental health personnel.
Theravada Buddhism has been the Cambodian state religion since the 13th century AD (except the Khmer Rouge period), and is currently estimated to be the religion of 97 percent of the population.
Buddhist monasteries and monks are everywhere all over the country. Could this rich heritage be integrated as extended mental health facilities to help ease the strain of the existing mental health facilities and personnel? After all, monks’ training largely comprises mind development and they, too, look forward to lessen the mental suffering of all people around them, especially those directly supporting them in their endeavour.
Mental health professionals can offer a structured training programme on basic counselling to the monks and later refer some of the more stable patients to them for follow-up counselling. Counselling sessions are time consuming and monks have much more time to do it. Also, the spiritual ambience of the monastery can be of great help. On top of that, the monks can probably do it better with their more relax, compassionate and caring mental disposition.
On the other hand, the more difficult new or follow-up cases of mental health problems can be referred to the mental health professionals for more intensive treatment that may or may not require medications. By doing so, the limited number of mental health professionals can have more time to deal with the more complex cases effectively. (If anyone initiates such move and feel that I can be of any help in the planning of such a programme, kindly contact me.)
A similar approach was carried out in Malaysia in 1969 to recruit untrained traditional village midwives for training and absorption into the national rural health system to improve on the annual maternal mortality rate. The approach was a great success that repeatedly received encouraging positive appraisal from the World Health Organisation.
Surfing through the net, it is indeed appalling to find that there is a serious lack of the much-needed suicide hotlines in the country. It appears to me that anyone experiencing extreme suicidal tendencies in Cambodia has only the emergency service numbers 117 and 118 to contact. Over the past one year, I have managed to successfully counsel one of my expat patients in Cambodia out of his depression using Messenger chat while in Penang.
It is hoped that a proper suicide hotline be established in this country as soon as possible. Perhaps a caring monastery with monks trained in the art of counselling can seriously look into this wholesome development.
My next column will be on ‘Feeling hopeless, helpless and worthless’.
Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases, excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skills in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected] Tel: 023900446 or Whatsapp: +60164122977