Education and treatment key to preventing suicide

A recent spate of suicides in the United Arab Emirates has brought the issue to the forefront of residents’ minds, as incidents involving both UAE nationals and expatriates in recent weeks have proven that many communities are affected. In one high-profile case, police found Indian expatriate Dubai resident Sreesha Nambiar, 29, in a bathroom of her family’s apartment in Bur Dubai with slit wrists. Her daughter, Avantika, had been suffocated and her husband hanged himself shortly after the 6-year-old had been killed, according to police reports.
A police official, Khalid Ismail, said: “We are treating this as a suicide, and at this initial stage there are no criminal suspicions because of the father’s note.” The case has been referred to Public Prosecution, and the mother will face charges of attempted suicide. She could face murder charges if she is found to have suffocated her daughter. Although decriminalized in many parts of the world, suicide remains a crime in many Arab states. The manner in which UAE law deals with suicide, both considered and attempted, perpetuates the problem. The crime is punishable by a short prison sentence, a Dh5,000 fine, or both.
Meanwhile, doctors who seek to treat patients who have threatened or attempted suicide must inform the authorities or face prosecution for, in essence, aiding and abetting the victim. And in doing so they breach doctor-patient confidentiality. Anecdotes of people considering suicide being turned away by medical professionals for fear of punishment are becoming more and more common, and doctors and other medical professionals who have long criticized the fact that discussions about suicide and its causes are discouraged, increasing calls for greater safeguards and support for mental health patients.

 According to statistics cited in the International Journal of Social Psychiatry, in 2011, seven times as many foreigners committed suicide in the UAE than did UAE citizens. Of those, three-quarters were Indian nationals. According to figures released by the Indian consulate published in The National, about 100 Indian expatriates committed suicide in the UAE in 2011. Statistics show suicides are increasingly prevalent among professional married men, debunking the lower-class single laborer stereotype as the main population affected by the issue.

The article reiterated a call from 2000 for “public education on risk factors for suicide (i.e. depression, substance abuse, previous suicide attempt) and about where to obtain help in suicidal crisis (i.e. hotlines).” According to Dr. Yousef Abou Allaban, the medical director of the American Center for Psychiatry and Neurology in Abu Dhabi, the Middle East is “way behind in addressing such a sensitive issue.” He said the lack of resources and awareness available to both mental health professionals and victims leads to unnecessary loss of life that could be saved through greater education within the community and wider availability of treatment. Dr. Justin Thomas, an assistant professor of psychology at Zayed University, explained that in raising awareness of suicide, there is a danger of encouraging copycats.

However, what does need to be understood is “what to look for, in terms of depression, in your child or your spouse” and other risk factors associated with suicide. Experts stress, however, that raising awareness about depression and conditions that could potentially lead to suicide is not a solution in and of itself. According to Dr. Thomas, raising awareness “raises dissatisfaction and anxiety.” It is only through the two-pronged approach of raising awareness and having mechanisms in place “to deal with the potential demand that awareness could create and focusing on healthy psychologies” that suicide can be prevented. He said there needs to be greater “awareness about what you can do to stay psychologically healthy,” and an effort to promote resilience and emotional intelligence to provide people with coping mechanisms to deal with stress, depression, anxiety and other such conditions. 

 According to mental health professionals, the issue of suicide must be dealt with through a joint effort of the government, religious community, and the media; each sector must educate and inform the population, joining forces to promote a greater understanding of the issue and its causes and effects. One such method is “mindfulness”, currently being tested in schools in Australia, Canada and the UK. Dr. Thomas said that the 4-week course helps children understand that “negative moods and emotions do pass” and teaches them “to be able to relate in a less destructive way to negative emotion” and develop the skills they need to deal with difficult periods in life. Using this approach avoids the negative discussion surrounding suicide and its associated risk factors. According to Thomas, mindfulness training has cut the relapse rate for depression by 50 percent. There is still much to be done for mental health concerns and its myriad effects, including suicide, for the issues to be effectively tackled in the United Arab Emirates. The growing number of students seeking education and training in psychiatry and clinical psychology in the country is a positive barometer of the wider audience seeking to make a difference in this field. Ultimately, a psychologically healthier workforce will contribute to wealth creation and productivity in the country.