South Africa is rapidly becoming one of the major suicide capitals of the world. New research shows that two South Africans kill themselves every hour, with an additional 20 attempting suicide every 60 minutes.

A recently published survey by the South African National Injury Mortality and Surveillance System showed that about 10% of all non-natural deaths in South Africa are due to suicide, a figure that far exceeds the yearly world average of 16 for every 100 000.

But this is only "the tip of the iceberg", warns Lourens Schlebusch, professor and Head of the Department of Behavioural Medicine at the University of KwaZulu-Natal's Nelson R Mandela School of Medicine.

"At least two fatal suicides occur in South Africa every hour and 20 attempted suicides occur every 60 minutes," he said this week. "We have a severe problem with self-destructive behaviour in this country which needs to be addressed."

His latest findings are contained in a chapter in a co-sponsored book published by the Medical Research Council and the University of South Africa, entitled Crime, Violence and Injury Prevention in South Africa: Developments and Challenges. .

A Durban-based parasuicide (non-fatal) study, under the leadership of Schlebusch, also showed that children and adolescents were the second most at-risk age group, after young adults, and one-third of all-non-fatal suicidal behaviours involved this age group.

Yet despite the disturbing increase in self-destructive behaviour occurring hourly in all race groups, with the exception of the South African Police, there are at present no national suicide prevention programmes.

In the past few weeks alone, a young boy jumped to his death off Howick Falls in KwaZulu-Natal and a Durban medical student was shot dead by her boyfriend, who then fatally shot himself in the head.

And in the past few months several high-profile family suicides have also underlined the escalating suicide rate in the country.

Global figures from the World Health Organisation show that two million people commit suicide worldwide every year, or one death every 40 seconds and one attempt every three seconds. This is a 60% increase in 45 years.

"Historically in South Africa there has been inadequate research done on suicide," said Schlebusch. "It is only now that we are seeing a more accurate picture and that is that , in world terms, our rate is excessively high - and growing."

Schlebusch, whose research over 25 years into the suicide phenomenon has earned him the reputation as one of the world's leading specialists in the field of suicidology, believes that several key factors are driving the upsurge in fatal and non-fatal suicides in South Africa.

These included:-

* Feelings of hopelessness, stigma and fear surrounding HIV/Aids, which in HIV-positive patients increased the suicide behaviour risk by 36 times compared with the general population. A "disturbing" feature is the reported correlation between HIV testing and suicidal behaviour before the results are known;

* Increasing depression among schoolchildren, many of whom are coping with loss through parental bereavement, divorce, family conflict and the increasing threat of sexual abuse. Also included in this category are children under pressure to achieve good results and pass their examinations.

It has been found that more unhappy than happy memories in children can lead to vulnerability to depression and suicidal behaviour. In one child study in the Cape. it was found that 38% of children were mildly depressed and 13% seriously depressed;

* Co-morbid factors, like substance abuse, mood disorders (depression) and schizophrenia;

* Chronic and acute stress within families, inter-personally and in society generally. This could be related to financial problems, unemployment and gender-based violence.

The report also highlighted the World Health Organisation findings that 45% of fatal suicide victims had high levels of alcohol in their blood.

Recent studies show that alcohol is a factor in about one-third of all suicides recorded in South Africa and that in 50% of all unnatural deaths, due to homicide and motor vehicle collisions, high blood alcohol levels were present.

This, said the report, was "astonishing".

Other facts to emerge are that in South Africa suicide is the third major contributor to death, after homicide and unintentional causes, in Asians, blacks and coloureds, and in whites the second leading cause, after unintentional death.

Overall, five times more males than females commit suicide and the average age of people committing suicide is 36.

Main methods used in fatal suicide are hanging, shooting, poisoning, gassing and burning, while other methods include sharp objects, asphyxia, electrocution, drowning and jumping from heights.

Most common choices in non-fatal suicide were overdosing (90%) on pain killers, benzodiazephines (tranquillisers) and anti-depressants and household substances, such as paraffin, insect and rat poison.

"I believe that it is a matter of urgency that we start suicide prevention and awareness programmes," said Schlebusch,
"particularly in schools, where much of this behaviour begins and in family practices, hospitals and clinics where suicidal pointers can often be identified."

Published on the web by Sunday Tribune on May 29, 2004. © Sunday Tribune 2004. All rights reserved.
 

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