Editor’s Note: September 10, is the World Suicide Prevention Day. Twitter and #MentalHealthPH organized a special #UsapTayo (Let’s Talk) session together with different organizations and government agencies in Asia to increase awareness on suicide and suicide prevention, and to remind everybody that there are alternative to suicide and that suicide can be prevented through different means.
Researchers: Angelica Jane Evangelista, Azie Marie Libanan, and Alvin Joseph Mapoy
Writers: Azie Marie Libanan and Alvin Joseph Mapoy
Editors: K Ballesteros (English), Richardson Mojica (Filipino)
Filipino Translation by: Tobey Calayo
Creatives: Krystle Labio and Jia Moral
Tweetchat Moderators: Eula Mei Labordo and Angelica Jane Evangelista
Spaces Moderators: K Ballesteros and Alvin Joseph Mapoy
Documentation: Alvin Joseph Mapoy
Mental health advocacy has always been the heart and soul of #MentalHealthPH. Since 2016, the organization has increased awareness about people’s struggles with mental ill-health, empowered members to support themselves and others, and collaborated with various sectors towards sustainable solutions.
One of its social media campaigns, #UsapTayo, seeks to educate and zero the suicide cases and stigma against mental health. The teams involved in the different campaigns also continuously go back to their why’s to improve the organization’s goals– to champion and build mentally healthier communities in the Philippines.
This September 10, on World Suicide Prevention Day (#WSPD2021), #MentalHealthPH’s collaborations continue to expand as the organization seeks to understand suicide and suicide prevention policies in Asia. By amplifying collective voices from different institutions, everybody is reminded that we all can be a source of light.
Moving the elephant
So you keep pushing, and a lot of times you feel like you’re pushing against this thing that just never moves, but you keep on doing it, you run around it, you shout, you make noises, and then you push again, and eventually it gets up, it shakes itself off and, lo and behold, it starts moving.
Taken from the Everyday Leadership library, Dr. Ndwapi Ndwapi, shares the Botswana National ARV Program’s efforts to move a sleepy elephant that was the country’s publicly funded AIDS treatment program.
“That’s how it felt in some of the successes we had in the fight against HIV, especially with treatment, I mean, For a long time we debated, and debated, and debated, and debated, and a decision was made to treat only to find that we had a whole list of problems to deal with.”
Much like the many essential health advocacies (elephants) that take years to push forward, mental health, despite being acknowledged as playing a necessary role in achieving global development goals, lacks the ample pushing it still needs. Advocacy on mental health has come a long way.
But is it enough?
People with mental disorders experience severe human rights violations, discrimination, and stigma. Depression is considered one of the leading causes of disability. Suicide remains the second leading cause of death among teenagers and young adults .
“So, this is why I said, you know, it was this elephant that we were trying to wake up and we kept pushing, and pushing, and pushing, and pushing, and at times it would seem like it would go nowhere until finally, it sort of stood up and stretched and walked.”
Be the Light: Suicide Prevention Strategies
Suicide is a serious public health problem . According to the 2021 World Health Organization (WHO) fact sheet on suicide, more than 700,000 people die from suicide every year. Suicide is considered the fourth leading cause of death among teenagers and young adults. Every suicide affects families and communities, with long-lasting effects on people left behind .
Contrary to popular belief, suicide is not exclusive to high-income countries. Seventy-seven percent (77%) of global suicides occur in low-and middle-income countries. Ingestion of pesticides, hanging, and firearms are among the most common methods of suicide globally .
In the Philippines, the National Center for Mental Health (NCMH) hotline has received a total of 26,767 calls from 2019 to 31 August 2021 The highest number of calls recorded was in 2021 with 12,625 calls (as of August 2021). Of the 26,767calls, 29% or 7,691 were suicide-related calls. As of August 2021, 4,138 or 33% of all calls received by the NCMH hotlinewere related to suicide.
Risk Assessment of calls also showed that 1,910 calls assessed were considered high risk in 2021 alone. The highest number of calls by age bracket came from the 18-30-year-olds with 1,709, 4,675, and 7,355 calls in 2019, 2020, and 2021.
Suicide attempts happen impulsively in moments of crisis; dealing with life stresses, financial problems, relationship break-up, chronic pain, and illness may be reasons for suicide attempts . Post-traumatic issues such as disaster, violence, abuse, and a sense of isolation may also contribute to suicidal behavior. Further, minority groups who experience discrimination–such as refugees, migrants, indigenous peoples, the LGBTQIA+ community, and incarcerated individuals–are vulnerable to suicide attempts . However, the most potent risk factor for suicide is a previous suicide attempt . These individuals need to be protected. They need a light to guide them through.
Stigma surrounding mental disorders and suicide has become a barrier for individuals to seek help. Lack of awareness about suicide as a significant public health problem and the taboo associated with suicide has prevented individuals from openly discussing it. Suicide prevention is not a priority among countries; only 38 countries established a national suicide prevention strategy .
Suicide prevention starts with community awareness and breaking the stigma against suicide. For every successful suicide, there are many more people who attempt suicide. A prior suicide attempt is the most critical risk factor for suicide in the general population . However, suicides are preventable with evidence-based, timely, and low-cost interventions. A multisectoral suicide prevention strategy is needed for national responses to be effective .
Measures including LIVE LIFE, WHO’s approach in suicide prevention recommends effective evidence-based interventions. Limiting access to the means of suicide can significantly decrease suicide attempts at the individual level. Fostering socio-economic life skills among adolescents, and interacting with media for responsible suicide reporting helps suicide prevention at the community level. Identification, assessment, management, and follow-up of anyone who is affected by suicidal behaviors are adopted by mental health practitioners to prevent suicide .
These evidence-based but straightforward interventions can help prevent suicide. However, factors such as situational analysis, multisectoral collaboration, awareness-raising, capacity building, financing, surveillance, monitoring and evaluation at the systems level must be vigorously implemented by various government and non-government organizations .
Suicide prevention requires coordination and collaboration among different sectors of society, including organizations working in health, education, labor, business, justice, law, politics, and in media. Comprehensive and integrated systems approaches are needed to impact complex issues such as stigma and suicide .
Creating Hope in Asia
September 10 is World Suicide Prevention Day #WSPD2021, and the International Association for Suicide Prevention invites us to Create Hope Through Action : by encouraging understanding, reaching in, and sharing experiences, we want to give people the confidence to take action. To prevent suicide requires us to become a beacon of light to those in pain. You can be the light.
This #WSPD2021, #UsapTayo’s theme is “Creating Hope ASIA.” This session aims to understand suicide and suicide prevention policies in Asia. It seeks to amplify collective voices from different institutions to remind everybody that we all can be a source of light and that suicide can be prevented through various means. The event recognizes the individual actions and contributions of individuals working in suicide prevention.
A particular focus for both the tweet chat and spaces sessions on this day is on suicide prevention, the advocacy around which #MentalHealthPH was created.
This event will happen on Twitter Spaces, a live audio conversation launched by the social media platform. Twitter has always been supportive of mental health advocacies. In 2019, Twitter launched the #ThereIsHelp notification with Samaritans of Thailand and #MentalHealthPH. It is a notification service that provides mental health resources to vulnerable individuals who need help . Joining the conversation will be the following organizations and their representatives:
- Befriender KL: Representative Kenny Lim is a trained volunteer with The Befrienders Kuala Lumpur and currently serves as its Executive Director. He has experience in providing emotional support via telephone, e-mail, and face-to-face to those in distress, feeling depressed, or suicidal. In addition, Kenny is a member of the training team, helping train and supervise new volunteers. He frequently gives talks and runs workshops with various groups on active listening and suicide prevention.
- Into the Light Indonesia: Into the Light Indonesia Suicide Prevention Community for Advocacy, Research and Education (ITL-SP-CARE) is a youth-based community established in 2013 for developing evidence and human rights-based suicide prevention and mental health promotion among Indonesian youths and other high-risk groups. Their work is largely centered on three working groups: suicide news guidelines, university students suicide prevention, and suicide loss survivor. Due to its impact, the national government has awarded the community for its efforts. Into the Light Indonesia is acknowledged as one of the leading Indonesian mental health communities on an international level. Their representative, Benny Prawira Siauw, is a social health psychology researcher in Indonesia. He has been working in suicide prevention and mental health promotion for youth and marginalized communities in Indonesia since 2013. Throughout his career, he has been a lived experience advisor in various global organizations. He is currently the Southeast Asia Regional Lead in the Global Mental Health Peer Network and advisor of Into the Light Indonesia. Besides doing research, education, and advocacy in suicide prevention and the global mental health field, he is also a certified mindfulness teacher. He is currently in training to be a mindful self-compassion teacher and compassionate mind facilitator. He is particularly interested in utilizing meditation & compassion for improving individual well-being and social change. He has been awarded and nominated for several awards; he was elected Asoka Special Relationship for the global social changemakers Ashoka in 2021.
- Samaritan of Thailand: Representative, Trakarn Chensy, has been with the Samaritans of Thailand since 1997. He has served four terms as the organization’s Director and is currently on his second term as its Chairman.
- Samaritan of HK: Representative, Karman, has been with The Samaritans Hong Kong since 2012. She is an experienced volunteer and has served in various posts throughout the years, from volunteer training to leadership roles. She has been Chief Executive since 2019. With a psychology and counseling background, Karman’s career expands over several industries, including market research and trading. Karman is a registered counselor and an accredited mediator in Hong Kong. Passionate about people, she is dedicated to supporting volunteers in meeting the challenges of suicide prevention and is a firm believer that it is equally important to care for the service users, as well as the volunteers.
- Samaritans of Singapore (SOS): Gasper Tan is the Chief Executive of Samaritans of Singapore (SOS). Since the pandemic, he represented SOS as a member of NCSS led Beyond COVID-19 Taskforce. Before SOS, Gasper had been in the corporate sector for more than 30 years, taking up various leadership positions and managing a portfolio of dynamic businesses and start-ups in the Asia Pacific region. He also served on the Board for multiple companies, and his passion for giving back to society allowed him to lead NGO projects and, eventually, SOS.
- National Center for Mental Health (Philippines): The NCMH Crisis Hotline aims to address the mental health needs of Filipinos as it assists on a 24-hour, 7-day-a-week basis for free to individuals with mental health concerns, especially to those in crisis and at risk of suicide. The Crisis Hotline is manned by Crisis Hotline Responders trained in identifying and handling different mental health issues and concerns through telephone services.
The NCMH Crisis Hotline Suicide Prevention Strategy embodies the LIVE LIFE approach of the WHO, which aims to provide a comprehensive package of suicide prevention interventions. Early Identification is a core intervention in preventing suicide. The 24/7 Crisis Hotline meets this objective of providing rapid crisis identification, assessment, and management of distressed Filipinos who are at risk of committing suicide.
Since its creation in May 2019, it has received more than 7,000 calls (as of June 2020) from different parts of the country and abroad and has attended to the various concerns of individuals in the community. It provides much-needed help for those at risk of committing suicide and serves as a portal to other agencies and mental health professionals. It continuously collaborates and creates linkages with other government agencies and professional organizations to improve the referral of callers to mental health professionals in the country.
- Department of Mental Health Thailand: The department is under the Ministry of Public Health, which initiated many strategic plans to increase human resources and provide a better quality of mental health care in both general and psychiatric hospitals.
As we navigate through these difficult times, let us remember to pause and TAKE TIME.
The International Association for Suicide Prevention reminds us that taking time to reach out to someone in your community– a family member, a friend, a colleague, or even a stranger – could change the course of someone’s life .
TAKE TIME to notice what is going on with you, your family, friends, and colleagues. By stepping closer and reaching in, we can be aware of those around us who need help .
TAKE TIME to reach out and start a conversation if you notice something is different. We can encourage those with suicidal thoughts to reach out  by stepping closer and reaching in.
TAKE TIME to find out what help is available for both you and others. By stepping closer and reaching in, we can support those in need by sitting in their pain .
As we say in our tweetchats and twitter spaces—-Always remember, #MayKaramayKa (you are not alone), kasama mo kami (we are here with you). Kaya, tara #UsapTayo! (Let’s talk!).
See you every 10th, 20th, and 30th of every month, and together let’s ZERO the suicide cases and stigma against mental health!
- How do you create hope in your life circles? (Theme: Taking Action)
- What mental health services do you think the government and non-government organizations should provide or continue to provide? (Theme: Moving elephants)
- What can you say to people who may be suffering at the moment? Share a message of light and hope. (Theme: Being a source of light)
 Everyday Leadership: When Moving an Elephant. University of Washington Global Health E-Learning. Retrieved from: https://www.youtube.com/watch?v=01cVdu3_bdM&t=6s
 International Association for Suicide Prevention, Retrieved from: https://www.iasp.info/wspd2021/
 International Association for Suicide Prevention. Resources. Retrieved from: https://www.iasp.info/wspd2021/resources/
 Mental Health (2021). World Health Organization. Retrieved from: https://www.who.int/health-topics/mental-health#tab=tab_1
 Suicide (2021).WHO Fact Sheet. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/suicide
 Ampolpittayanant, M. (2019). Working together to prevent self-harm and suicide. Retrieved from: https://blog.twitter.com/en_sea/topics/company/2019/Working-together-to-prevent-self-harm-and-suicide