- A collaborative initiative by Sri Lanka Sumithrayo and Colombo Taprobane
As part of an initiative by Colombo Taprobane Round Table 3, in collaboration with Sri Lanka Sumithrayo, a discussion was hosted virtually on the topic of mental health and awareness. The discussion, featuring Kilinochchi District General Hospital Senior Medical Officer Dr. M. Jeyarasa, concentrated on the topic of suicide amongst youth and their mental health.
Beginning the webinar, Dr. Jeyarasa stated that youths under the age of 30 are more susceptible to suicidal ideations. He stated that from 1997-2019, there was a clear decline in suicide rates in Sri Lanka. According to epidemiological studies, the national suicide rate is about 14 per 100,000 from 2016-2019.
However, he also observed that from the findings of his hospital, it was evident that there are significant variations in different areas of the country. “Kilinochchi, a distinct in the Northern Province that was affected by war and such, still has a high suicide rate when compared to other parts of the country,” he stated, adding that there are no recent studies in suicide in Kilinochchi to share exact statistics, but the last study showed that annual suicide rates are over 30 per 100,000, while the national rate is less than 20.
He also added that this is why studies on suicide and deliberate self-harm, not just in Kilinochchi but in most districts, are crucial for implementing suicide prevention methods.
Speaking about the clinical audit in hospital data conducted in the Northern District, Dr. Jeyarasa explained that the study conducted was an institutional-based descriptive study. The period of study was from January 2019 to June 2021, where data was collected from the records of the District General Hospital in Kilinochchi while population data was obtained from the divisional secretariat.
The results of this study, according to Dr. Jeyarasa, showed that there were a 121 recorded suicides during the period of the study and that the annual suicide rate of the district was 34 per 100,00 – a large figure when compared to the national rates.
He further observed that a significant increase in the number of suicides were seen in the first six months of 2020, which was when the Covid-19 outbreak affected the district the most. Especially during the period of lockdown in 2021, there were 16 suicides, which seem to have been caused by a lapse in mental and financial health.
Regarding regional risk factors, Dr. Jeyarasa stated that from his observations of both the national context and specifically in the Northern District, most people who died by suicide had experienced early childhood traumatic incidents and there was a clear presence of post traumatic stress disorder (PTSD).
He also observed that there was a high prevalence of gender-based violence and marriages out of the legal system and a heavy risk factor was the lack of support systems for victims of gender-based violence. Other reasons and risk factors that were seen are the cultural restrictions towards relationships as well as the high prevalence of illegal substances and the abuse of such.
When recommending a solution to reduce the suicide rates in the country, Dr. Jeyarasa stated that first and foremost, it is important to conduct psychological autospies for the suicides to identify high-risk factors. After which, he stated that it is necessary to empower community health staff for early detection of psychiatric conditions and do the needed referrals as well.
“It is very important to conduct health education programmes for the general public to increase awareness on common causative factors and vulnerable groups such a victims of war, widows, orphans, unemployed citizens, and children and elders with no support should be provided with special care,” he said.
He also highlighted the need to improve the healthcare facilities around Sri Lanka, especially in the Northern District, where they are almost non-existent. “For this to happen, the formation of a task group at district level to formulate, co-ordinate, implement, monitor, and re-evaluate prevention programmes and research is a necessary expenditure,” Dr. Jeyarasa concluded.