Suicide Prevention

The world has changed by leaps and bounds in the last decades. We see Pakistani society reeling under a host of tremors as a result of changing income pattern, new professions, new values and priorities and unfettered interaction with other cultures.

Karam And Friends Foundation is formed by a group of concerned citizens who have come together since 2014 to design a programme of intervention and support for youth. We are bound by one common objective, i.e. to stem the growing incidence of suicide particularly amongst youth and young adults. Even with understated reporting, Pakistan would rank amongst the nations in the world reporting the highest number of suicide cases.

Since today’s social structure shows an alarming increase in family dysfunction, personal distress, maladjustment, depression and suicide, we felt an urgent need first to get ourselves trained to help the distressed and extend a helping hand to society.

Screening

There is little data on the effects of screening the general population on the ultimate rate of suicide.As there is a high rate of people who test positive via these tools that are not at risk of suicide, there are concerns that screening may significantly increase mental health care resource utilization.Assessing those at high risk however is recommended.Asking about suicidality does not appear to increase the risk.

Mental illness

In those with mental health problems a number of treatments may reduce the risk of suicide. Those who are actively suicidal may be admitted to psychiatric care either voluntarily or involuntarily.Possessions that may be used to harm oneself are typically removed. Some clinicians get patients to sign suicide prevention contracts where they agree to not harm themselves if released.Evidence however does not support a significant effect from this practice. If a person is at low risk, outpatient mental health treatment may be arranged.Short-term hospitalization has not been found to be more effective than community care for improving outcomes in those with borderline personality disorder who are chronically suicidal.

There is tentative evidence that psychotherapy, specifically, dialectical behaviour therapy reduces suicidality in adolescents as well as in those with borderline personality disorder. It may also be useful in decreasing suicide attempts in adults at high risk. Evidence however has not found a decrease in completed suicides.

There is controversy around the benefit-versus-harm of antidepressants.In young persons, the newer antidepressants such as SSRIs appear to increase the risk of suicidality from 25 per 1000 to 40 per 1000. In older persons however they might decrease the risk. Lithium appears effective at lowering the risk in those with bipolar disorder and unipolar depression to nearly the same levels as the general population.Clozapine may decrease the thoughts of suicide in some people with schizophrenia.

HOw to Prevent 

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