KARACHI, July 5: The suicide rate has gone up considerably over the years primarily because of social and economic pressures.

Psychiatrists point out that no government agency has tried to keep a data-bank containing the particulars of all those people who either attempt to commit suicide or succeed in doing so.

“The fact that suicide is still unlawful in the country makes people conceal the identity of those who fail to kill themselves,” they say.

They add that ‘alienation’ and ‘insecurity’ are major factors leading to suicide behaviour. “The psychological analysis has convincingly proved the ‘appeal character’ or ‘desperate call for help’ behaviour preceding the attempt.”

According to senior psychiatrist Dr S. Haroon Ahmed, who is president of the Pakistan Association for Mental Health, those who commit suicide fall broadly in two categories.

“The first group is that of those young people who, in most cases, commit suicide in order to make an emotional statement or in reaction to something. The success rate is low among these young people. The second group commit what is called consummate suicide. They could be successful, even rich, but they think that life is not worth living. They, therefore, decide to put an end to their lives. They could also suffer from hallucinations.”

He added that the second group always dropped hints about their intentions, “because they are actually crying for help that nobody heeds”.

Talking about the second group of those who commit suicide, senior psychiatrist Dr Zaki Hassan said they thought about committing suicide for a long time. “They also suffer from depression. Their ages range between 20s and 30s to 80s. They may also want to commit suicide to put an end to an illness they have been suffering from long.”

He said that the cases of attempted suicide — which was referred to as parasuicide in technical parlance — were higher among women than men. “In the UK, where records are kept faithfully, the suicide rate is eight per 100,000 people. The number of those who use suicide to signal resentment or annoyance is 10 to 15 times higher.”

Dr Haroon said: “The data for suicide and attempted suicide in Karachi was collected from official sources and published by some psychiatrists in 1981. The data was compared with a similar study conducted 15 years back by Dr Ashraf. The temporal constancy of under-reporting in Karachi was substantiated in spite of changing social situation.

However, the mode of attempting suicide changed radically. In 1964 frequently used methods were copper sulphate (neela thotha), dhatura, and Kerosene oil. In the modern times, they are DDT, sleeping pills, etc. Jumping into the sea or from building dropped from 22 per cent to four per cent while sharp instrument and violent methods used, increased from 24 per cent to 59 per cent.”

Dr Haroon said: “The annual rate calculated for suicide was 0.7 and for parasuicide 0.82 per 100,000 in the first study and in the second study they dropped to 0.11 for suicide while parasuicide remained 0.72 per 100,000 population. The fall has been ascribed to better emergency care and the emergency centres accepting the plea of ‘accidental overdose’ more frequently.”

He added that the data in a country where suicide was not only a sin but still a crime was less likely to be accurate. ”However, all the ingredients in our society especially in Sindh point to increasing alienation of people and the decreasing security perceptions in everyday life. It is of special concern because the self-destructive desire is cutting across very religious barrier of suicide.”

When asked what psychiatrist did when a patient told them that he was contemplating suicide, Dr Zaki Hassan said that psychiatrists alarmed the family members of the patient. “The psychiatrists also prescribe anti-depressant medication which takes some time to take effect.