Suicidal death bothers me a lot, as it would any sensitive individual. We usually do not comprehend the reason for someone to end their life. We can see the diseases like cancer, high blood pressure, diabetes. Still, since we can not see stress, anxiety, and depression, it is understandably hard to conceptualize mental health challenges. It is challenging to understand suicidal ideation and behaviour symptoms as they usually overlap with other psychiatric comorbidities, such as depression and other mental health illnesses.  

Psychology research has proved that there are generally three factors that predispose someone to suicidal ideation or suicidal behavior. These factors are genetic, biological, and environmental factors.  

Genetic factors are passed to us from our families and ancestors. Intergenerational transmission of suicidal behaviour is well researched and suggests that suicide often runs in families. Genetic liability to mental illnesses and impulsive aggression may also determine their susceptibility to suicide and suicidal behaviour. The researchers believe that the specific gene that plays a role in suicidal ideation controls serotonin’s production and activity, affecting the hormonal balance required for mental health well-being.  

Biological factors include inefficient hormonal regulation or a chemical imbalance in our body; for example, the researchers have found a low level of serotonin metabolite in cerebral spinal fluid in the brain of persons who have attempted suicide. Serotonin is the essential hormone that stabilizes our mood, feelings, and happiness. It enables our brain cells to communicate with each other and helps with sleep, eating, and digestion. Therefore, low serotonin levels can cause mood disorders such as depression, lack of sleep, low appetite, and inadequate digestion.  

 

Environmental factors are critical in mental health, as they usually trigger genetic and biological deficiencies we already have in our bodies. What are environmental factors? The family’s environment, childhood trauma, prolonged stress, harassment, relationship problems, unemployment, hopelessness, rejection, financial crisis, loss of self, social status loss, alcohol, and substance abuse, impulsive behaviour and aggression, parental psychopathology, lack of support, discord, poor socioeconomic situation (malnutrition) and lack of sunlight, etc. Impulsive aggression contributes more to suicide and suicidal behaviour in younger individuals. These factors may serve as the trigger for suicidal feelings, which can be moderated to the most extent. 

 

So, how do we deal with this pandemic in the most effective way possible? What is our responsibility as a society, community, family, and mental health professionals? Most importantly, we need to understand that suicidal ideation and behaviour are mental illnesses like other physical ailments and need proper care, treatment, and support. People do not just snap out of their mental health issues and challenges. It is a long process and requires patience and consistency in dealing with individuals experiencing suicidal ideation, their families, and friends.  The most effective way to help is to form a therapeutic alliance between the person experiencing suicidal ideation, their family (support system), and the care provider for a holistic approach to the client and their families’ overall health and wellness. It is imperative to understand that suicidal ideation or suicidal behaviour is not the patient’s fault, and neither is their family’s, and they both need understanding and support.  

In many cultures, mental health is considered taboo and is associated with a colossal stigma related to stereotyping, judgemental attitude, name-calling, and labeling. To comprehend the issue and the solution, mental health issues must be seen with a unique cultural lens. The first-generation immigrants to western countries have brought their own cultural and religious beliefs and understanding of mental health and illness, integrating mind, body, and spirit. Therefore, one must be ready to view their mental health disorders, symptoms, and solutions with a culturally sensitive approach or a different general view. For example, research has shown that depression and being trapped in an unhappy situation are among the top three perceived causes of suicide. There has been a marked increase in completed suicides among South-Asian youth. Parents raise Punjabi Sikh adolescent first-generation Canadians emigrated from India with a strong sense of family values and collective lifestyle, including extended family members, resulting in a displaced hierarchy or power dynamics within the family. Also, various traditional healing remedies are likely to be attempted before consulting medical professionals, especially in mental illness resulting in delayed treatment. Despite a high number of attempted and completed suicides, it is believed that South-Asian children are underrepresented in mental health clinics. Although the reasons for underrepresentation are unclear; possible explanations may include a lower rate of mental health issues, cultural and religious home remedies, tendency to resolve the problems within the family rather than seeking help from outside, limited understanding of mental health issues and their symptoms, little knowledge of resources and stigma associated with it.  

The only and the most effective way to reduce or eliminate this stigma is by normalizing the discussions around mental health in our families and educating ourselves about mental health issues and well-being. We need to educate ourselves about the issue, its etiology, contributory factors, and sign and symptoms. We also need to educate ourselves on detecting these signs in someone and then an appropriate and supportive way to help them. We can create a natural, compassionate environment for those facing mental health challenges and their families so they can feel heard and seen and not ridiculed, judged, and labeled. As a society, we are responsible for providing a sustainable environment for our loved ones and ourselves for thriving holistic health.  

Mental health professionals must understand Sikh beliefs (religious beliefs) about suicide and suicidal-related behaviour, cultural elements, family system, and power dynamics. The suicidal behaviour may be best understood within a multidimensional model that acknowledges the biopsychosocial and spiritual factors affecting any individual.  

I believe suicide is more of a social issue than a personal one. Somehow, we should take responsibility for its happening and prevention by getting meaningfully involved as a society. Every life is worth fighting for… 

Mann Kaur Bajwa 
BScN, RN, MA, PsyD (candidate).  
Canadian Certified Counsellor