1. Suicide-Prevention
Occupational Health
By
 Dr.Ashok laddha
 Occupational Health
Physician
 MBBS, PGDC ,PGDD,
PGDEM, AFIH ,ACLS,BLS
 Diploma in Workplace
Health and safety. MBA-HA

2. Definition
 the action of killing oneself intentionally.
 Latin word -------suicidium------"to kill oneself"

3. History-India
 The story of suicide is probably as old as that of man
himself. Through the ages, suicide has variously been
glorified, romanticized, bemoaned, and even
condemned. Be it the tragic Greek heroes Aegeus,
Lycurgus, Cato, Socrates, Zeno, Domesthenes or
Seneca; or the Roman figures Brutus, Cassius, Mark
Anthony or the Egyptian princess, Cleopatra; or
Samson, Saul, Abimelech and Achitophel of the Old
Testament; or the suicide bombers in the present
world, the universality of suicide transcends religion
and culture

4. History-India
 An understanding of suicide in the Indian context calls for an
appreciation of the literary, religious, and cultural ethos of the
subcontinent because tradition has rarely permeated the lives of
people for as long as it has in India. Ancient Indian texts contain
stories of valor in which suicide as a means to avoid shame and
disgrace was glorified. Suicide has been mentioned in the great
epics of Ramayana and Mahabharata. When Lord Sri Ram died,
there was an epidemic of suicide in his kingdom, Ayodhya. The
sage Dadhichi sacrificed his life so that the Gods may use his
bones in the war against the demons. The Bhagavad Gita
condemns suicide for selfish reasons and posits that such a death
cannot have “shraddha’, the all-important last rites. Brahmanical
view had held that those who attempt suicide should fast for a
stipulated period. Upanishads, the Holy Scriptures, condemn
suicide and state that ‘he who takes his own life will enter the
sunless areas covered by impenetrable darkness after death’.

5. History-India
 However, the Vedas permit suicide for religious
reasons and consider that the best sacrifice was that of
one's own life. Suicide by starvation, also known as
‘sallekhana’, was linked to the attainment of ‘moksha’
(liberation from the cycle of life and death), and is still
practiced to this day. Sati, where a woman immolated
herself on the pyre of her husband rather than live the
life of a widow and Jahuar (Johar), in which Rajput
women killed themselves to avoid humiliation at the
hands of the invading Muslim armies, were practiced
until as recently as the early half of the 20th century;
stray cases continue to be reported*

6. Epidemiology
 Approximately 0.5% to 1.8% of people die by suicide
globally
 2nd leading cause of death
 Mortality rate ---of 11.8 per 100,000 persons per year
 Rates of suicide have increased by 70% from the 1960s
to 2014
 Increase of suicidal is primarily in developing country
 For every suicide that results in death there are
between 10 and 40 attempted suicides

7. Epidemiology-India
 3rd leading cause of death among young and Adolescents
 Rates per 100,000 -------India 23.2
 The countries with the greatest absolute numbers of
suicides are China and India accounting for over half the
total
 male ratio in the rate of suicide is higher
 Mental disorders (particularly depression and alcohol use
disorders) are a major risk factor for suicide in Europe and
North America; however, in Asian countries impulsiveness
plays an important role. Suicide is complex with
psychological, social, biological, cultural and
environmental factors involved.

8. Statistics About College Depression
 second leading cause of death in college students ages 20-24.
 Teens diagnosed with depression are five times more likely to
attempt suicide than adults.
 Over two-thirds of young people do not talk about or seek help
for mental health problems.
 64 percent of Indian college students reported feeling symptoms
of depression.
 differences in opinion, persistent pecking, high expectations and
lack of inter-connectivity may be the major reasons for teens
opting for the extreme step.
 Depression is the No 1 occupational disease of the 21st century
says WHO

9. causes
 The pressure to do well in school-----pressure is not from
teachers but from parents too
 Not getting admission in college of their choice
 academic pressure
 Lack of social support
 Depression
 Family background ------chaotic family environment
 difficulty in a romantic relationship
 students in India are unaware of how to deal with stress
and it's ill-effects
 Impusiveness

10. Other causes
 Financial crunch
 Lack of opportunity to talk and vent out frustrations
with parents
 Fear of being put down and ridiculed by them, and
lack of family support
 Parental disharmony
 Constant comparison to other siblings who are doing
well

11. Challenges and obstacles
 the prevention of suicide has not been adequately
addressed due to basically a lack of awareness of suicide as
a major problem and the taboo in many societies to discuss
openly about it.
 In fact, only a few countries have included prevention of
suicide among their priorities.
 Reliability of suicide certification and reporting is an issue
in great need of improvement.
 It is clear that suicide prevention requires intervention also
from outside the health sector and calls for an innovative,
comprehensive multi-sectoral approach, including both
health and non-health sectors, e.g. education, labour,
police, justice, religion, law, politics, the media.

12. Symptoms
 Drastic changes in mood or behavior.
 Extreme and unusual anger.
 Sudden withdrawal from society.
 Complete apathy towards others or things that might have concerned the person earlier.
 Changes in eating or sleeping habits.
 Illnesses that occur without cause and which cannot be explained.
 Extreme loss of energy and fatigue.
 Changes in social habits – either over-socializing or backing off from all socializing.
 Inappropriate behavior.
 Loss of pleasure in simple things.
 Loss of interest in life.
 Risk-taking.
 Extreme depression, accompanied by deep sadness and a lot of crying.
 Preoccupation with death. Talk of suicide, even in jest. Sudden abuse of alcohol or drugs.

13. Risk Factors
 There are some people who are more at risk of committing suicide than
others. These categories of people are as follows:
 Males are more at risk of suicide than females.
 Those younger than 19 years of age and those older than 45 years of age.
 People who are clinically depressed.
 Anyone who has earlier attempted to commit suicide, especially if the
suicide plan was organized.
 People who are divorced, separated or widowed. This could also apply
to people who have been in a very close relationship which was broken.
 People who have received any kind of mental health service.
 People with little or no support socially.
 Those who abuse drugs or alcohol.
 Those who have lost the ability to think rationally
 People with chronic medical illnesses.

14. Strategies
 Promote awareness that suicide is a public health problem that is preventable
 Develop broad-based support for suicide prevention
 Develop and implement strategies to reduce the stigma associated with being a
consumer of mental health, substance abuse and suicide prevention services
 Develop and implement community-based suicide prevention programs
 Promote efforts to reduce access to lethal means and methods of self-harm
 Implement training for recognition of at-risk behavior and delivery of effective
treatment
 Develop and promote effective clinical and professional practices
 Increase access to and community linkages with mental health and substance
abuse services
 Improve reporting and portrayals of suicidal behavior, mental illness and
substance abuse in the entertainment and news media
 Promote and support research on suicide and suicide prevention
 Improve and expand surveillance systems

15. Specific strategies
 Selection and training of volunteer citizen groups offering confidential
referral services.
 Promoting mental resilience through optimism and connectedness.
 Education about suicide, including risk factors, warning signs and the
availability of help.
 Increasing the proficiency of health and welfare services at responding
to people in need. This includes better training for health professionals
and employing crisis counseling organization.
 Reducing domestic violence and substance abuse are long-term
strategies to reduce many mental health problems.
 Reducing access to convenient means of suicide (e.g. toxic substances,
handguns). Reducing the quantity of dosages supplied in packages of
non-prescription medicines e.g. aspirin. Interventions targeted at high
risk groups.

16. Suicide prevention
 Suicide prevention is an umbrella term for the collective efforts
of local citizen organizations, mental health practitioners and
related professionals to reduce the incidence of suicide.
 Beyond just direct interevention to stop an impending suicide,
methods also involve
 a) treating the psychological and psychophysiological symptoms
of depression,
 b) improving the coping strategies of persons who would
otherwise seriously consider suicide,
 c) reducing the prevalence of conditions believed to constitute
risk factors for suicide, and
 d) giving people hope for a better life after current problems are
resolved.

17. Suicide Prevention and Intervention
 Implement a school/college-based prevention
program
 Implement a gate keeping program.
 Create a comprehensive school/college crisis plan.
 Be prepared to engage in postvention.

18. Suicide Prevention and Intervention
 Each school / district have a plan for how it will handle
emotional and behavioral distress, including suicidal
thinking, behavior, and threats of violence.
 The attached draft, model Plan will help districts and
schools develop their own plans to respond quickly
and effectively in a crisis.
 Understands dimensions and indicators of health
(emotional, physical, intellectual, and social).
 Appropriately responding to a tragedy that may put
students at risk is an essential part of any crisis or
suicide prevention plan.

19. Multi-sectoral Partnership
 Media
 Parents
 Teachers
 Social worker
 Ngo
 Government
 Health Professionals
 Use of Alternative medicine
 Local community centers
 Spiritual and religious leaders.Police etc

20. Why MULTI-SECTORAL COLLABORATION
 increased access to resources.
 more efficient use of resources.
 enhancement of accountability.
 development of innovations.
 broadened awareness.
 lasting relationships.
 sustainable development of activities.
 broad sharing of responsibility for different activities;
 stronger ownership.
 use of strengths of different partners.
 sharing of knowledge and technology.
 better balanced design of projects.

21. Simple techniques for stress management
 Morning walk
 Surya Namaskar
 8 hrs sleep
 Improve inter-personal relationship
 Reading—authentic books
 Yoga
 Meditation
 Aerobics
 Positive Thinking

22. Suggestion
 Preservation of culture
 Introduction of change in gradual manner
 Employment generation
 Population control
 Decrease study burden
 Change of education pattern
 Lastly----Get connected with each other to get rid of
with target in mind--------zero suicide in coming years