KUALA LUMPUR - When Anne (not her real name) drives and sees a truck, she has an almost overwhelming urge to swerve and crash into it. Or when she is smoking on her balcony, she cannot help but think how easy it is for her to jump.
But then she reminds herself of her children.
"They’re the only thing stopping me. Anyway, I can’t be sure if I will die,” she told Bernama.
Currently in her 40s, Anne had attempted suicide twice before. Her first attempt was in her early 20s, a few months after moving back into her parents’ home when she flunked out of university.
Anne, who has been suffering from depression since she was a teenager, said she was inundated with feelings of failure then, on top of feeling sad after a bad breakup with her college boyfriend.
"I remember just wanting the feelings to stop,” she said.
Her second attempt came a few years later, after the end of a long-term relationship.
Now married with children, she regrets the suicide attempts but the suicidal thoughts and ideation never really went away, even with therapy and medication. She has accepted her condition and is trying to move on with her life the best she can, saying the time for any meaningful change has long passed.
But when she dwells on the what-ifs, she finds herself wishing for a little empathy and unconditional support from her parents and others for her younger self, who was terrified, stressed and uncertain about the future.
"(After my first suicide attempt), my therapist asked my father and me to attend a counselling session together. He went (with me) once and that’s it. We never talked about it again,” she said.
REASONS FOR TABOO
Unfortunately, Anne is not the only one to encounter this. Support before, during and after suicide attempts is crucial but activists and mental health experts say too many people, especially among the middle-aged and older generations, feel stigmatised and ashamed about suicide which complicates prevention and recovery.
Suicide is still a taboo topic in society especially in conservative Malaysia. Mental health experts said this was typical in Asian cultures where mental health issues are seen as denoting weakness.
"There is a lot of minimising that happens when it comes to parents ... when you are not able to regulate your emotions, it’s as though you have failed,” said Dr Yang Wai Wai, a clinical child psychologist at Universiti Kebangsaan Malaysia (UKM).
For too long Malaysia has criminalised suicide attempts, punishing the act with one year in jail and/or a fine, instead of treating it as a cry for help. The government decriminalised suicide in June this year.
In Malaysia, there were 981 suicides in 2022 and 1,142 cases in 2021, which was almost twice the 2020 figure of 631, according to the Ministry of Health.
Dr Keith Tye Sue Kiat, a psychologist and counsellor at the National Heart Institute said some families were resistant when he told them their family member had attempted suicide.
"(The families) will actually say (the patient doesn't) have mental health issues and that they are just being weak, they are being lazy and they are not practicing (religion) very much,” he said.
Other than culture, one big stumbling block for suicide prevention is the fact that suicide is often seen as taboo in any religion.
Mental Illness Awareness and Support Association (MIASA) religious adviser Ustaz Mohammed Noor Mohammed Deros told Bernama those who attempt suicide tend to have lost faith and hope.
He said this makes them, especially those who come from religious communities or families, leery of seeking help in fear that they will be judged for losing faith in God.
"People think if you commit suicide, no matter how good you were, it’s all settled, all your good deeds go in the trash,” he said, adding this is not true in Islam.
He cited a hadith as related by Prophet Muhammad’s friend Al Tufayl bin Amr Al Dawsi, which tells the story of a devout Muslim man who became depressed and killed himself by cutting his fingers and bleeding to death.
In the hadith, Al Tufayl saw his friend in a dream, who looked well except his hands were covered in bandages. When asked how Allah treated him, his friend said he was being treated well except for his hands, saying, ‘I was told that we would not repair what you yourself have ruined.’
When Al Tufayl told Prophet Muhammad of his dream, the Prophet said, ‘O Allah, forgive his hands as well.’
Mohammed Noor, who is also a vice president at MIASA, said the hadith showed that in Islam, suicide does not erase one’s good deeds or faith.
He said as such, any counsellor providing mental health assistance and suicide prevention, be they from a religious background or otherwise, should not focus on faith issues. The most important part is restoring hope and saving lives.
"We need to first show there is still goodness in the world. Because when they reach the stage of attempting suicide, they don’t really believe in the goodness of people and ask themselves, ‘Do they mean well? Do they have an agenda?’” he said.
THE AGE GAP
More adolescents are reporting having suicidal thoughts and attempting suicide, according to the National Health and Morbidity Survey 2022. Teens aged 13 to 17 reporting suicidal thoughts came in at 13.1 percent, while 9.5 percent attempted suicide. Girls are more likely to have suicidal thoughts (18.5 percent) and attempted suicide (13.4 percent) than boys.
At the same time, activists said the younger generation are more aware and cognizant of mental health issues and suicide ideation than their parents or grandparents and are thus likely to report such feelings.
Mental health school programmes and better awareness among teachers, where teachers would ask students to inform them if they were feeling overwhelmed or anxious or having trouble emotionally and mentally, also help tremendously.
"Our children talk about it more, whether it is due to the influences of the media, they do talk about it more and they are able to open up and talk to you whereas if you talk to their parents, they are more at a loss and don’t know what to do about it,” said Dr Yang, who is also a senior lecturer at UKM.
She said this is good as younger people are more vulnerable to mental health issues and consequently suicide.
This is because teens are at several transition points where they are developing physically, mentally and emotionally and going through life milestones like national exams and graduation. On top of that, the last few years have been very difficult, particularly for adolescents who missed out on almost three years of crucial socialisation due to pandemic restrictions.
"The period of adolescence itself is when you try to find out your identity. So you put all this together, it is almost impossible for some of them to see what is more for them,” said Dr Yang.
She stressed the importance of pinpointing the warning signs and then listening, giving support and helping people develop appropriate skills or strategies to prevent suicide. And like anything health-related, she said early intervention is best.
"It’s important to recognise (problematic patterns of behaviour) in a young person, to support them or help them in that sense,” she added.
Thinking back, Anne realised she never really developed effective coping skills when life threw her a curveball.
She almost didn’t survive her second attempt at suicide. She had swallowed all the medication she could find in her parents’ house and soon became unconscious.
Her parents did nothing for two days, thinking she was oversleeping due to her depression and left her alone.
She thinks a little kindness would have gone a long way, remembering how desperate she was for kind words then.
"When I was in the hospital after trying to commit suicide, a doctor was doing his rounds. He asked me why I was there. I said I tried to kill myself. He listened and then he patted my arm. I still remember that,” she said.
If you or someone you know is feeling depressed, anxious or suicidal, there are trained professionals who are available to help. Call these numbers:
BEFRIENDERS KL
03 7927 2929 (24/7)
CPRC KKM HOTLINE (COVID-19)
03 7723 9300
TALIAN KASIH
15999 (24/7)
019 261 5999
MERCY MALAYSIA
03 2276 2116
ALL WOMEN’S ACTION SOCIETY (AWAM)
016 237 4221
MALAYSIAN MENTAL HEALTH ASSOCIATION
03 2780 6803
THRIVE WELL
018 900 3247
MENTARI PUTRAJAYA
03 8881 1232
LIFE LINE ASSOCIATE MALAYSIA
03 4265 7995
BUDDY BEAR
1-800-18-2327
MENTARI SELAYANG
03-6127 0946
POLICE
03 2266 2222 or 999
FIRE AND RESCUE DEPARTMENT
03 8892 7600 or 999
AMBULANCE SERVICE
03 2143 8122 or 999
MIASA
1-800 18 0066
03 9765 6088 - BERNAMA