Suicide Prevention and Awareness Month Q&A with Dr. Frida Kameti

  1. Why do people attempt suicide?

The most common reason is that someone is depressed. When one is depressed, their thinking becomes irrational and so someone will have negative, and often exaggerated, beliefs about themselves, others and their future. There’s a sense of impending doom and feeling worthless, and so suicidal thoughts start to take hold of the person.

Suffering from a painful illness might drive a person to attempt suicide with the reasoning that it is better to die than to continue feeling immense pain on a daily basis, especially if their treatment is expensive and their families are struggling to finance it.

Individuals who have psychosis experience hallucinations. They might hear voices instructing them to end their lives. Such is the case with individuals with schizophrenia. Medication has been found to help in such instances in order to manage the psychosis.

Alcohol and substance abuse can lead one to attempt suicide when the individual is intoxicated. Once sober, the individual might feel regret, fear or shame because when sober, they might not feel the strong desire to end their lives. Exploring any underlying emotional issues is helpful in such a case.

2. What biological factors increase risk for suicide?

An existing mental health condition is usually found in about 90% of individuals who attempt or complete suicide. Suicidal behaviour is commonly linked to pre-existing conditions like schizophrenia, bipolar disorder and substance abuse disorders.

Genes also play a role in suicide risk. Family members with mental health conditions are likely to pass it on to different members in future generations. However, the risk for suicide in members of those future generations increases if in addition to a mental health condition, there was impulsive aggression that was passed on. This combination of inheriting a mental health condition as well as the temperament of impulsive aggression means that the individual might lack the internal resources to control their feelings and therefore more likely to complete suicide.

3. Can the risk for suicide be inherited?

Yes. Mental health conditions like bipolar disorder, major depression, schizophrenia, alcoholism and substance abuse, and some personality disorders like antisocial personality disorder, which run in families, increase the risk for suicidal behavior.

4. What are the most common methods of suicide?

  • Use of a firearm 
  • Suffocation
  • By hanging
  • Fasting/dehydration
  • Drowning
  • Poisoning-overdose
  • Self-harming; cutting or piercing self
  • Fall; jumping off a tall building or a bridge, jumping on to oncoming traffic

5. Why do people attempt suicide when they appear to feel better?

It seems like a contradiction, but signs of happiness and calmness after a suicide attempt can be a red flag. This is because the individual has likely made peace with the decision to end their life, planned when and how to do it, which gives them a sense of relief and excitement since it seems to them that their problems will soon be over.

6. What are the warning signs of suicide?

  • The individual talking about completing suicide.
  • The individual attempting suicide and not succeeding.
  • The individual talking about life being meaningless, asking questions like, “What’s the point?”
  • Withdrawal from individuals and anger outbursts when approached. 
  • Giving away personal belongings and mending relationships.
  • Sudden happiness and calmness after struggling with depression and previous suicidal attempts for a long time. The keyword is ‘sudden’, because it might mean an individual has decided to end their lives in the near future and is planning towards it.

7. What should you do if someone tells you they are thinking about suicide?

Stay calm throughout the conversation. Take slow deep breaths if possible.

Listen without judging and let them know you’re there whenever they need to talk.

Reassure them that they can feel better by seeking professional help.

Help them connect to a professional. As a show of support, you can accompany them to their sessions and wait for them.

Talk to a professional about your feelings so that you can learn how to manage feelings of fear, confusion or sadness. The professional can also help you know how to respond to the individual speaking to you about suicide.

8. If a person seems troubled, is it safe to ask if they are thinking about hurting themselves? Can asking increase the danger of suicide?

It is safe and even necessary to be direct and ask if they are thinking of committing suicide. Research shows that asking directly will not encourage them to harm themselves. On the contrary, it can help them talk about what they’re going through. This is a difficult conversation to have, so be gentle with your words. One can ask, “Does it get to a point where you feel like harming yourself or ending your life?” as opposed to “Don’t tell me you’re thinking of killing yourself!”

9. On that note, what do you do if the answer is yes?

Stay calm as you continue to listen. Show them that you care for them by listening without judgment.

Affirm them for their openness to talk about such a heavy issue and for trusting someone with that information.

Encourage them to see their desire to commit suicide as an indication that it’s time to talk to a profession about their mental health.

10. Do people attempt suicide to prove something or to get sympathy?

In some cases, yes. However, it is important to take suicide attempts seriously, even if it is done to get sympathy. This is because the more the individual attempts suicide, the higher the chances that they one day will succeed.

It’s also important to involve a mental health professional so as to help the individual find healthier ways of expressing their needs.

11. Does alcohol and other drug abuse increase the risk for suicide?

Yes. Individuals who are dependent on alcohol and other drugs tend to have other underlying issues like depression, financial and social problems. This increases the chances of them committing suicide.

Individuals dependent on alcohol and drugs tend to be impulsive and engage in high risk behaviours that lead to self-harm.

12. Why do men complete suicide more often than women do?

Men tend to use more violent methods of suicide than women. While women usually use less violent methods like overdosing on medication or drugs, men usually use firearms, hanging or asphyxiation, which are more likely to succeed.

Men tend to avoid seeking help, leading to a build-up in emotional turmoil and therefore completing suicide while women are more likely to seek help when they struggle with suicidal thoughts.

Women may be more likely to consider others, such as their children, partners, parents or friends and therefore they have less incentive to commit suicide.

13. Who is at highest risk for suicide in Kenya?

It is likely individuals living with an undiagnosed mental health condition and have no professional help, lack nurturing social relationships and are economically disadvantaged.

14. I, or some I care about, lost a loved one to suicide. How do I/they go about grieving process?

It is important to be gentle with yourself. You will likely have strong feelings of guilt, anger, despair, sadness or shame. It is important to feel those feelings and heal from them, rather than live your whole life blaming yourself and becoming overwhelmed by the feelings of guilt and shame.

Find healthy ways of coping such as being connected to family and friends, expressing your emotions through painting, exercises, crying, journaling, talking to friends.

Find a support group of individuals who have lost loved ones by suicide.

Talk to a professional and express your thoughts and feelings that are interfering with your day-to-day life.

Find a way to honour the person, which can also be a way for you to get closure about their death. This can be by participating in an activity they enjoyed doing, supporting mental health organizations, creating awareness about mental health, writing a letter to them expressing how you feel since they died; or supporting a cause they liked.

15. Suicide is largely a taboo topic in our society. How do you sensitise older people (especially parents) and other ignorant people about suicide?

Sensitization is largely done through educating people about an issue. For instance, spreading awareness about HIV/AIDS around Africa has led to individuals living longer, seeking medical help, being able to work, are more integrated in society as opposed to being segregated and are now able to have long, fulfilling lives. Similarly, speaking about mental health conditions in an attempt to educate can help parents and the older generation understands mental health and its real impact on people. This sensitization needs to be done in an approachable way as opposed to judging them for ignoring mental health issues. Also, it needs to be spoken in a language they can understand and in a comfortable, non-threatening environment.

It’s also important to involve religious leaders, teachers and local leaders like chiefs in these efforts to sensitize parents and the older generation.

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Dr. Frida Kameti, PhD clinical psychologist & associate professor, Africa Mental Health Research and Training Foundation (AMHRTF). She is a versatile performance driven professional clinical psychologist with over 12 years of experience from the USA, South America & Kenya. She has experience in counselling individuals of various ethnic and socio-economic backgrounds, including children, adolescents and adults. Frida’s experience has been focused on providing counselling services in private practice, community agencies, managed behavioural health care organizations, hospitals, employee assistance programs and substance abuse treatment centres.

Her vast experience spans from specialized training in the assessment, diagnosis, formulation and psychological treatment of mental health, behavioural and emotional disorders across the lifespan, neuropsychology, developing models for understanding trauma and related mental health concerns to implementing appropriate interventions that are grounded on eco – systemic and multicultural-social justice counselling frameworks. Frida is a sought out clinician for her accomplishments in domestic violence, couple’s, family, health, addiction counselling, human trafficking assessments, trauma systems therapy, crisis intervention and treatment analysis and planning.

AMHRFF website:  www.africamentalhealthfoundation.org

Telephone No: 020 2651360/0797 526576

Twitter: amhf_kenya

Facebook: AfricaMentalHealthFoundation

Instagram: #africamentalhealthfoundation

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