GILGIT: A host of factors, including sociocultural stigma, communication gap between parents and children, academic pressure, lack of employment opportunities and limited access to professional psychological help are resulting in an increase in suicide cases in Gilgit-Baltistan, a new report has said.

According to the report titled “Prevention of Suicides in Gilgit Baltistan: An Integrated Multisectoral Strategy and Roadmap for Implementation,” from January 2005 to June 2022, 573 suicidal deaths were reported in GB.

However, the number of cases have drastically increased in 2022 with 65 cases being reported in the first seven months, more than double, as compared to 2021, the report said, quoting government’s data.

Of these, 79 per cent of deceased were in the age bracket of 15 to 39 years, while more than half of all deaths were in males (54pc).

Report identifies lack of jobs and academic pressure among leading causes; number of cases in 2022 twice that in 2021

The most number of incidents occurred in Ghizer district, (64.9pc), followed by Gilgit (10.7pc), Skardu (8pc) and Hunza (7.5pc), the report said. Out of the 556 cases — for which data on marital status was available — 54pc were single while among married, 47pc were males and 53pc females. According to the data, depression was the leading cause of suicides, with mental health issues and domestic issues being the other reported reasons.

However, in the absence of a robust data collection mechanism, these numbers might under-represent the true extent of the cases, the report said, adding that families also hide such cases for the fear of stigma, and refusal of the religious leaders to offer a proper burial.

An all-round systemic failure

The report has highlighted several challenges at community, as well as administrative level which hamper the development of a comprehensive policy to deal with the cases of suicide.

“There is a near absence of mental health care infrastructure in the public sector in GB from the community to higher levels,” the report stated adding that the current health care system was incapable to respond to cases of suicide.

“Psychiatrists often have to fight for beds in the medical ward, as this is not considered a high priority by health administrators. No nursing or other supportive staff in inpatient areas are trained in offering in-patient care to patients presenting with acute psychiatric illnesses that require admission.”

The report pointed out that there was no system to collect data of suicide or self-harm while no psychiatric evaluation, risk assessment of follow up were being done.

In terms of community-level challenges, the report added that high degree of stigma associated with mental health, lack of communication between parents and children, academic pressure and limited avenues to express feelings were some factors that were resulting in higher suicides.

“The tension between the traditional and the modern values in respect of the parents and their children, unhealthful competitiveness and comparison between families for academic achievement among the youth, existence of traditional domestic differences sometimes leading to acts of violence, limited opportunities for employment among educated youth in GB, and abuse of social media [...] were some of the key sociocultural and economic issues highlighted during these meetings and interviews,” the report added.

Lack of employment opportunities, complex governance structure and lack of training of government officials were highlighted as key governance challenges. One of the key contributing factors in strengthening the taboo around suicides was the irresponsible media coverage of the issue, the report said.

Recommendations

Calling it a complex problem, the report said multi-pronged short- and long-term strategies were needed for the prevention of suicides in GB.

“These strategies are based on a five-pillar framework that includes — policy and governance, early identification and response, build awareness and hope, introducing continuum of care, and learning more about the problem.”

To strengthen governance and regulation, the report recommended coordination among police, health and educations sectors; capacity building of government institutions and decriminalisation of suicide.

It added that a mechanism to “improve coordination and information sharing” among law enforcement and health officials was needed in the event of an act of suicide.

While calling for more resources for the public health sector, the report also urged the GB government to ask the federal government to “decriminalise suicide and suicidal attempts” to help reduce stigma in the community.

Guidelines should be developed to promote ethical journalism and improve reporting of suicides, the report recommended, adding that a surveillance system should be established across all GB districts for data collection, processing and analysis in the event of a suicide.

While stressing the need for an intervention at community level, the report called for an “innovative technological solution” to provide community-based mental health services through frontline healthcare workers.

This approach will have five segments: training, screening, counselling, referral and tracking and monitoring. The researchers should be trained in identifying mental health issues and also in basic psychoeducation and counselling, it added.

“In the case that teachers identify students in distress, teachers could be trained in engaging parents in understanding the issue faced by the student. Teachers could educate parents about mental ill-health and help connect the family to care option”

The report also proposed the GB government to incorporate “life-skills building and hope building curriculum” into middle, high, and higher secondary schools.

Published in Dawn, November 14th, 2022