Author: Yap Xin Yi, Intern @ ARKCC
Date: 30 Oct 2021
Suicide is the death caused by the action of injuring oneself with the intent to take one's own life. A suicide attempt is when a person harmed himself or herself with the intention to die but the results did not meet their intention. According to World Health Organization (WHO), suicide occurred in low- and middle-income countries with about 77% globally (WHO, 2021). A systematic review showed that men were more likely to die by suicide where higher risk among age 15 to 44-year-old while women were more likely to self-harm with women around 14 to 40-year-old account for the majority (Amitage, Panagioti, Abdul Rahim, Rowe & O'Connor, 2015). In addition, Indian ethnicity took a higher percentage of suicide and self-harm incidents than other ethnicities. On the other hand, currently, the situation is affected by the Covid-19 pandemic, so the suicide rate is rising. In Malaysia. Looking into the statistic reported by the Royal Police Malaysia (PDRM), the suicide rate during January to May 2021 have been doubled when comparing to 2019 (Sheralyn, 2021). This rising statistic showed the high attention needed regarding suicide in Malaysia in order to prevent it.
The determinants of suicide are varying among people. There was research done on the socioeconomic, lifestyles and health determinants of suicidal behaviour among Malaysians (Cheah, Azahadi, Phang, & Abdul Manaf, 2018). The research indicated that individual income is negatively associated with suicidal ideation where people who are lower-income are more likely to have suicide ideation. This is because lower-income results in social regulation and personal problems which can also result in lower levels of well-being, thus, a higher tendency to engage with suicidal behaviour. On the other hand, younger individuals, women and Indians which have been mentioned earlier are more likely to be involved in suicidal behaviour. Marital status is also one of the determinants where people who are unmarried are more likely to have suicide ideation or suicide plan because of the feelings of loneliness and the lack of support from the spouse. Also, people who rated their health in a poorer condition are more associated with suicidal ideation, plan and attempt than those who did not.
On the other hand, according to the investigations during the Covid-19 pandemic in Malaysia, the three main causes of suicide are family problems, emotional problems as well as financial problems (Sheralyn, 2021). Other than the determinants found earlier, the American Foundation for Suicide Prevention (n.d.) mentioned depression is the condition that is most associated with suicide, especially those undiagnosed or untreated. In addition, when one does not have the ability to deal with life stress such as chronic illness, financial problems, relationship problems or life transitions could also lead to suicide.
Therefore, those who have a higher risk to attempt or complete suicide are those with:
Mental health problems (Depression, Anxiety disorders and others)
Minority groups (LGBTQ+ and other marginalized/ discriminated groups)
People who have experienced violence, abuse, neglect and other trauma
Chronic illness or chronic pain
People who are socially isolated
Drug and Alcohol Problems
Life transitions (financial crisis, relationship break-ups, unemployment)
Prolonged stress (harassment, bullying)
People who have attempted suicide before
When a person is having suicidal thoughts, plans or attempts, there are always signs that can be observed especially when the behaviours changed or the presence of entirely new behaviour that is related to a painful event, loss or change. The warning signs of suicidal behaviour can be observed based on what they say or do.
Below is the list of suicide warning signs that everyone should be aware of according to the American Psychological Association (APA, 2019).
Talks about committing suicide
Has trouble eating or sleeping
Exhibits drastic changes in behaviour
Withdraws from friends or social activities
Loses interest in school, work or hobbies
Prepares for death by writing a will and making final arrangements
Gives away prized possessions
Has attempted suicide before
Takes unnecessary risks
Has recently experienced serious losses
Seems preoccupied with death and dying
Loses interest in his or her personal appearance
Increases alcohol or drug use
How to seek help?
If you realise that you are having suicidal thoughts, you have to know that seeking help is not a sign of weakness. It is also not an embarrassing action, and you are encouraged to raise your concerns.
Talk to someone that you are comfortable and trust with, express your thoughts and feelings (For example, telling them about your true thoughts and feelings about the suicidal thought; If you feel it is difficult to tell them, try to write it down and show them after)
If they did not understand stand, there is still someone who will listen to you which are those suicide crises hotlines. In Malaysia, we have Befrienders, Talian Kasih, Malaysia Mental Health Association, Life Line Association Malaysia and more. (Details will be provided below)
Seek professional help (Working with counsellors or therapists in order to look for the reasons or the triggers that lead to suicidal thoughts and work on it)
Make a safety plan (Develop a plan of steps that you can follow during a suicidal crisis, including the emergency contact of therapist/ suicidal hotline/ family or friends who can help immediately)
How to help?
Check-in regularly to know the individual’s condition
Understanding that suicide is something that should be talked about
Show that you care by talking to them
Encourage to seek professional help (Can offer to accompany during the appointment)
Don’t leave them alone when you think he or she is in immediate danger, seek help from emergency services eg: Crisis Hotline
Make sure he or she does not have access to any means of self-harm (Eg: Scissors, knives)
Prevention is always better than cure. And most importantly, suicide can be prevented. Research found that coping skills, religious belief and responsibility to family are some of the protective factors in suicide among Malaysians (Amitage et al., 2015). Similarly, the Centers for Disease Control and Prevention (CDC, 2021) has identified some protective factors of suicide including coping and problem-solving skills, cultural and religious beliefs that discourage suicide, connections to friends, family, and community support, supportive relationships with care providers, availability of physical and mental health care.
Where to Seek HELP!
Hotline numbers: 03-7627 2929(24 hours)
Talian Kasih (Crisis Helpline)
Malaysia Mental Health Association (MMHA)
Hotline: 03-2780 6803
Life Line Association Malaysia
Reference & Resources
Armitage, C. J., Panagioti, M., Abdul Rahim, W., Rowe, R., & O’Connor, R. C. (2015). Completed suicides and self-harm in Malaysia: a systematic review. General Hospital Psychiatry, 37(2), 153–165. doi:10.1016/j.genhosppsych.2014.12.002
American Foundation for Suicide Prevention. (n.d.). Risk factors, protective factors and warning signs. https://afsp.org/risk-factors-protective-factors-and-warning-signs
American Psychological Association (APA). (2019, November). Suicide Warning Signs. https://www.apa.org/topics/suicide/signs
Cheah, Y. K., Azahadi, M., Phang, S. N., & Abdul Manaf, N. H. (2018). Sociodemographic, lifestyle and health determinants of suicidal behaviour in Malaysia. Psychiatry Research, 261, 319–324. doi:10.1016/j.psychres.2017.12.086
Centers for Disease Control and Prevention (CDC). (2021, May 13). Suicide Prevention: Risk and Protective Factors. https://www.cdc.gov/suicide/factors/index.html
World Health Organization (WHO). (2021, June 17). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide
Sharalyn. (2021, July 1 ). PDRM: 468 Suicide Cases Recorded In M’sia From January To May 2021, Majority In Selangor. World of Buzz. https://worldofbuzz.com/pdrm-468-suicide-cases-recorded-in-msia-from-january-to-may-2021-majority-in-selangor/