Presented by : National Association for Suicide Prevention and Research ( NASPAR )

1. World Suicide Prevention Day 10th September 2013 “ Stigma : A Major Barrier to Suicide Prevention ” Presented by :National Association for Suicide Prevention and Research (NASPAR)

2. To increase awareness for enhanced understanding of the damaging effects of suicide. To implement programs in an effort to prevent suicide in our society. To provide services to help survivors deal with their loss. To conduct advocacy for strengthening and supportive environment to address the issue of Suicide prevention and its essential services To influence policy authorities to consider the issue of suicide in their plans and policies. Objective

3. “An act with a fatal outcome that is deliberately initiated and performed by the person himself or herself in the knowledge of expectation of its fatal outcome” (WHO 1993) Introduction: Suicide

4. Every year, almost 1 million people die from suicide In the last 45 years, suicide rates have increased by 60 % in some countries. Suicide is among top 20 leading causes of death for all ages. Suicide ranks among top 3rd leading causes of death among those aged 15-44 years. (Source: WHO) Global Suicide Scenario

5. Suicide ranks among top 2nd leading causes of death among those aged 10-24 years. 30% of all suicide worldwide occurs in Asia. 1 death every 40 seconds. On average, almost 3000 people commit suicide daily. ( Source: WHO ) Global Scenario contd..

6. 3, 536 suicidal incidents were recorded in Fiscal Year 2069/070 31,503 suicide incidents were recorded in Fiscal Year 2059/060 to 2069/070 Source: Nepal Police & Kantipur news: National Scenario

7. Detail Suicide incidents were recorded in Fiscal Year 2059/060 to 2069/070

8. Types of Suicide Figure of Nepal from last 10 yrs Source: Nepal Police

9. Distribution of Suicides by Gender Source: Nepal Police

10. Mentally disorders Youth and Adolescence Divorced, Single or Living alone Late Life Police and Military Personnel Member of broken Family Sexual Abuse Family History of Suicide MARP for HIV, PLHIV etc. High Risk Group for Suicide

11. Poverty, Unemployment Poor relationship with family Domestic violence Poor or lack of social support Recent stressful life event: loss of beloved , Loneliness, Illness, unsuccessful in exam, Sexual misuse etc Social Risk factor of Suicide

12. Childhood Trauma esp. sexual and physical abuse Substance abuse Influence of media or films Stigma and Discrimination Political Instability Displacement of family due to migration etc Social Risk Factor of Suicide contd.

13. A pre-existing mood disorders (depression, anxiety, or mania) A current psychiatric disorders such as schizophrenia Substance dependency Discomfort with sexuality and gender Psychological Risk Factors

14. Violent Methods: e.g. hanging, burning, use of sharp instruments, drowning, electrocuted etc. Common Classification of Suicide Methods in Nepal

15. Common Classification of Suicide Methods in Nepal 2. Non-violent Methods: e.g. poisoning, drug overdose, suffocation etc. 3. Passive Methods: e.g. patient choosing to die by refusing to accept treatment

16. Problem Statement • According to the WHO and the latest Burden of Disease Estimation, suicide is a major public health problem in high-income countries and is an emerging problem in low and middle-income countries. • Suicide is one of the leading causes of death in the world, especially among young people • A large proportion of people who die by suicide suffer from mental illness.

17. Problem Statement • Recent estimates of WHO suggest that the disease burden caused by mental illnesses will account for 25% of the total disease burden in the world in the next two decades, making it the most important category of ill-health (more important than cancer or heart diseases.) • A significant number of those with mental illnesses who die by suicide do not contact health or social services near the time of their death. In many instances, there are insufficient services available to assist those in need at times of crisis.

18. Problem Statement • Negative attitudes about individuals with mental illnesses and/or suicidal ideation or impulses (prejudice) is common in many communities • Many health professionals who feel uncomfortable dealing with persons struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes towards such patients. This can result in a failure to provide optimal care and support for persons in crisis.

19. Issue of Suicide has not been adequately addressed by the Government, Non-Government and Civil Society. Lack of awareness of suicide as a major psycho-social public health problem. Existing taboos towards Suicide to discuss openly Problem Statement

20. Responsibility of the Government Develop national policy frameworks for national suicide prevention strategies. Incentive for suicide research. Suicide prevention requires intervention Local Level Policy statements and research outcomes need to be translated into preventive programs and activities in the community. Gaps needing fulfillment in Suicide Prevention Sector in Nepal.

21. Gaps needing fulfillment in Suicide Prevention Sector in Nepal. • Comprehensive multi-sectoral approach, including both health and non-health sectors, e.g. education, labour, police, justice, religion, law, politics, the media • Research is needed to improve understanding of the circumstances and contributory factors of these tragic events, to guide interventions

22. Services for Suicide Prevention Activities such as: Massive awareness and sensitization programmes Hot-line services and Crisis Management. Advocacy for prevention of suicidal behavior. Provision of adequate treatment and follow-up for people who attempted suicide. Gaps needing fulfillment in Suicide Prevention Sector in Nepal.

23. Sensitization of family members to create enabling environment for suicide victims Early treatment and care for Mental disorder patients. Reduce stigma “A Major Barrier to Suicide Prevention”. Gaps needing fulfillment in Suicide Prevention Sector in Nepal.

24. Activities of NASPAR in the issue of Suicide Prevention and Care World Suicide Prevention Day , 10th September 2011

25. Participants of Suicide Prevention Day 2011

26. World Suicide Prevention Day 10th September 2010

27. World Suicide Prevention Day 2010Press meet, 7th September 2010

28. Hotline Services:4232296

29. National Association for Suicide Prevention and Research (NASPAR) GPO Box: 19907 Anamnagar, Kathmandu Tel: 4232296, Fax : 4252473 Email: nasparnepal@gmail.com Thank You !