Suicide prevention/Interview with Dr Kaka Kalina, Clinical and health psychologist

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Extract from the article: Every 10 September is World Suicide Prevention Day. The aim is to show that suicide can be prevented. Suicide is a real public health problem. In Togo, according to data from the Ministry of Security and Civil Protection, 46 cases of suicide were rec

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 "Suicide is far from being a solution. Man is capable of rising to any challenge, of finding a solution to life's difficulties’.

Every 10 September is World Suicide Prevention Day. The aim is to show that suicide can be prevented. Suicide is a real public health problem. In Togo, according to data from the Ministry of Security and Civil Protection, 46 cases of suicide were recorded between June and December 2021, most of them in the Maritime region (20) and the Savanes region (14). In 2019, a WHO report ranked Togo as the ^8th African country with the highest suicide rate. In this interview, Dr Kaka Kalina , clinical and health psychologist and lecturer at the University of Lomé, sheds light on this real public health problem.

Santé-Education: What is suicide?

Dr Kaka Kalina: Suicide is an act whereby a person voluntarily takes his or her own life. It is also known as ‘self-murder’. A suicide attempt is behaviour aimed at taking one's own life, without succeeding. Suicidal behaviour is a conscious attempt to kill oneself. A suicidal idea or idea of suicide is a thought that one might kill oneself. It is an imaginary construction of death scenarios, without actually carrying out the act.

How can we explain the fact that a person voluntarily decides to end his or her life?

A number of situations can lead a person to consider dying. It may be a feeling of deep despair, profound helplessness, profound sadness or profound guilt.In this case, the person sees death as a release, an ultimate solution.A suicide attempt can also be a cry for help or a way of drawing the attention of others to one's suffering.It can also be a case of emotional blackmail or seeking affection from a third party.

What are the risk factors for suicide?

Analysis of the context of the suicidal gesture is based on three (3) categories of risk factors: psychopathological, biographical or personal and situational.Psychopathological factors relate to a person's state of mind.There are certain disorders that predispose a person to wanting to commit suicide.When the person is depressed, addicted to drugs, schizophrenic, neurotic or anxious.The person's biological risk factors. Biographical or personal risk factors relate to the person's history. These include a history of suicide attempts.Studies show that 30-40% of suicidal people usually attempt suicide again within a year, and 10% die by suicide within 10 years.A family history of suicide deaths is also a risk factor.

Suicide attempts can be triggered by a negative event or a traumatic experience. Examples include rape and other sexual assaults.Loneliness or isolation can also lead to suicide.This is the case for widowed, single, divorced or separated people.Similarly, situations of social and professional disintegration or fragility, such as unemployment, insecure employment or recent retirement, are a risk.Certain pathologies or chronic conditions increase the risk of suicide, especially if they are painful, functionally disabling or considered incurable.

Situational risk factors relate to unfortunate events.Among teenagers, for example, a suicide attempt is never to be seen as a harmless act to be blamed on an ‘adolescent or youth crisis’, but evokes a specific event such as a conflict with parents, problems at school, a malaise, a relationship breakdown or an argument.

What do people think about when they decide to commit suicide?

Suicidal thoughts appear to be a way of putting an end to inexorable suffering, as the person no longer has any hope.These ideas may remain fleeting or become long-lasting or pervasive, culminating in a preliminary act. To try to understand the act of suicide, several levels of psychological analysis are possible, without going into the details of theoretical concepts.

At the level of intentionality, the person wishes to escape from an unbearable situation, to call others to account for their suffering, or to harm others.At the level of the suicidal act itself, it is imposed as a necessity, in the face of the impossibility of containing invasive and destructive anxiety.

What is the suicide situation in Togolese society?

In the absence of epidemiological studies on a national scale, it is difficult to put forward figures. Nevertheless, cases of attempted suicide are reported by clinical and health psychologists working in university hospitals (CHU) and hospitals.

What is suicidal risk behaviour?

High-risk behaviour is behaviour in which the subject takes risks, but without any conscious idea or desire to die.The methods used to commit or attempt suicide are drug intoxication, alcohol, hanging, drowning, using firearms, explosives, fire and burning objects, sharp objects and jumping from a height.

What impact does suicide have on a family?

Death by suicide causes severe stress in the family.Feelings of guilt are always present. It is therefore essential to offer the bereaved psychological care to support them.

What should you do if someone close to you is suicidal?

Current scientific data shows that we need to be very cautious and modest when it comes to primary suicide prevention.We can, however, stress the importance of recognising the warning signs and risk factors and treating them whenever possible. For example, parents or family members need to be made aware of the warning signs that indicate that a family member is suffering and may be in a suicidal crisis.

These warning signs are mainly along the lines of ‘I'm going to kill myself, I won't bother you any more, you'll be left in peace, I'm tired of life, life disgusts me’.

Parents need to be informed about the strategies and means used by suicidal people.They must also be informed about the means, facilities and resources that can be called upon in the event of a suicide attempt. They must also work to create a calm family climate, encourage open communication between family members, be alert to warning signs and any sudden or hidden change in behaviour on the part of one of the family members, and seek professional help and appropriate care.

How can suicide attempts or suicidal behaviour be prevented?

A number of approaches can be considered, depending on the context and the severity of the after-effects.However, as this is a complex issue, it is recommended that families refer the patient to a psychologist or take the patient to hospital for referral to the appropriate services.Mental health services are available in university hospitals and hospitals throughout Togo.

What advice can you give to people whose life challenges lead them to decide to commit suicide?

When you're in difficulty, when you're disgusted with life, you have to open up to a confidant and seek the help of a mental health professional. Suicide is far from being a solution to problems.People are capable of rising to any challenge and finding a solution to life's difficulties.

Interview by Elom AKAKPO