Before we decide what public health measures need to be
adopted, we must also know what are the findings of relatively recent researchers. In an important W.H.O. Study, Bertolate
(1993) established a clear-cut connection between suicide and mental disorders. He found that out of a total of 6003 suicides,
98% (5866) had a psychiatric disorder. While affective disorder (i.e. Depression and Mania) was found in 24%, 22% showed Neurotic
and Personality Disorders, 16% had substance abuse (alcohol and/or drugs), 10% had schizophrenia and 21% had other mental
disorders. Only in 2% cases no psychiatric diagnosis could be made.
This study effectively proved what psychiatrists all around
the globe who handled suicidal patients knew all along. That there was a strong case for a connection between psychiatric
disorders and suicide. And the centuries of theological and moral debate over whether a person had the right to end his life
or not, or whether it was a sin or not, was not really based on an awareness of the ground realities, for it applied to a
few isolated cases. The legal position of considering suicide as a crime against the State had also missed the mark. They
were all well intentioned but poorly informed attempts at suicide prevention. This W.H.O. study, and earlier and subsequent
ones, prove that mental health professionals have an important role to play in the prevention and management of suicide. The
very fact a diagnosis can be made implies some methods of treatment, prevention and rehabilitation can be applied.*
But we must not forget that if mental health workers have
an significant role to play, so have a number of others. Society itself has the notorious ability to generate and perpetuate
various expressions of deviance and social disintegration. A recent example of social disintegration and its role in suicide
increase has been witnessed in the Baltic States, especially Lithuania, following the collapse of the former Soviet Union.
It reported the world’s highest suicide rate i.e. 50 per lakh population, according to a relatively recent research
report (Haghighat, 1997).
We also know that suicides are more common in the urban slums, lodging homes and in people staying alone where
social isolation is prominent. Moreover, measures to tackle poverty and unemployment are dependent on governmental initiative.
Reducing social isolation, preventing social disintegration and treating mental disorders is the three prongedn attack that
must be the crux of any public health programme to reduce suicide, of course with suitable governmental effort mentioned earlier.
Thus, Befriending programmes for the socially isolated, change that does not lead to fragmentation of the social psyche and
ethos for the society at large, and efficient and affordable mental health care for the psychiatric patient, is the need of
the hour. All these must synergize for any public health programme planned to combat suicide.
Mens Sana Monographs [MSM]: A Mens Sana Research Foundation Publication