Joshua Seemu­n­gal

Se­nior Mul­ti­me­dia Jour­nal­ist

Joshua.Seemu­n­gal@guardian.co.tt

There has been a 25 per cent in­crease in sui­cides in T&T over the last eight years, ac­cord­ing to da­ta from the Min­istry of Health.

Be­tween 2016 and 2019, 371 peo­ple took their lives, an av­er­age of 93 sui­cides per year. Com­par­a­tive­ly, be­tween 2020 and 2023, 478 peo­ple died by sui­cide—an av­er­age of 120 per year.

Four out of five sui­cide vic­tims in T&T are men, which is high­er than the glob­al av­er­age of a male be­ing twice as like­ly to die by sui­cide.

Men have ac­count­ed for 83 per cent of self-in­flict­ed deaths in this coun­try since 2020. How­ev­er, da­ta about the most com­mon mo­tives is not avail­able.

Ac­cord­ing to psy­chi­a­trist and for­mer in­de­pen­dent sen­a­tor Dr Var­ma Deyals­ingh, the World Health Or­ga­ni­za­tion (WHO) is­sued a warn­ing al­most ten years ago that de­pres­sion would be one of the main caus­es of mor­bid­i­ty by 2020.

“COVID-19 ex­ac­er­bat­ed those fig­ures be­cause when it came on the scene, there were a lot of psy­cho­log­i­cal prob­lems that al­so came—the iso­la­tion, the death of rel­a­tives, un­em­ploy­ment, the whole sce­nario where peo­ple ques­tioned the mean­ing of life. COVID act­ed as a fu­el and an ac­cel­er­ant.

“Those fig­ures, even though it is star­tling, we were see­ing where suc­ces­sive gen­er­a­tions were hav­ing an in­crease in de­pres­sion and sui­cide at­tempts,” he said.

More men suc­ceed in the act of sui­cide than women, Dr Deyals­ingh added.

This was be­cause men tend not to seek help as of­ten as women for de­pres­sion, while men al­so use more lethal means to at­tempt sui­cide.

“There is da­ta that shows that men and women han­dle de­pres­sion dif­fer­ent­ly. So while a woman may reach out—she may talk to her friends and fam­i­ly—a man may in­ter­nalise. While a woman may de­cide that I need to seek help, a man may think it is be­yond me—I’m a man. I’m sup­posed to be strong. I’m not sup­posed to cry. So, it’s sort of en­grained cul­tur­al­ly,” the psy­chi­a­trist said.

“Be­cause of this, we have al­so seen that men may rather go and abuse al­co­hol, or go to bars. They will go to seek out al­co­hol to numb their feel­ings, rather than go and do oth­er healthy ac­tiv­i­ties. This is why there’s a chal­lenge to reach out to men. It’s a chal­lenge to tell them, hey, it’s OK to cry. It’s OK to come in to speak to a pro­fes­sion­al. It’s OK to speak to oth­ers.”

Deyals­ingh said when men do come to his prac­tice, it is usu­al­ly with the prompt­ing of a loved one. Ac­cord­ing to da­ta, around 60 per cent of males who suf­fer from de­pres­sion do not seek pro­fes­sion­al treat­ment, he said.

Signs of a de­pressed male, he said, in­clude ag­gres­sion, so­cial with­draw­al, in­creased drink­ing, and in­creased ir­ri­tabil­i­ty.

Most cas­es among peo­ple in their 30s, 60s and over

* The age group with the most sui­cides is the 30 to 39-year-old age group, which ac­count­ed for 20 per cent of all sui­cides. This age group was close­ly fol­lowed by the 60 and over group, which ac­count­ed for 19 per cent.

* Vic­tims in their 50s ac­count­ed for 17 per cent; 40s–19 per cent; 30s–20 per cent; and 20s–14 per cent.

* Thir­ty-one ado­les­cents and teenagers took their own lives, with eight of them un­der the age of 15 years old.

Sui­cide trig­gers

Dr Deyals­ingh iden­ti­fied some things that tend to lead to sui­cide.

“It’s a few things, like one, you may have a guy un­em­ployed. Pover­ty could fu­el men­tal ill­ness and de­pres­sion. Once you have that de­pres­sion, you can­not mind your­self or your fam­i­ly.

“Two, re­la­tion­ship is­sues with your lover, your wife, your con­sort. Things are go­ing bad. You find that you are start­ing to take things on. If you are be­ing cheat­ed on, you know Trinidad, we have ta­ban­ca as we say. If you are be­ing cheat­ed on and you can­not han­dle it.

“Re­la­tion­ships with fam­i­ly mem­bers. So let’s say you and a fam­i­ly mem­ber have a land dis­pute, or you have el­der­ly par­ents and your sib­ling doesn’t come and take care of them. All of these things bring up this sort of anger.

“Or even if you’re a vic­tim of crime, you know you have post-trau­mat­ic stress dis­or­der—anx­i­ety, de­pres­sion com­ing in,” he said.

Oth­er ex­am­ples, the psy­chi­a­trist said, are changes in the work­place that could lead to over­think­ing and a lack of sleep, re­sult­ing in de­pres­sion.

Sub­stance abuse and med­ical con­di­tions are oth­er com­mon fac­tors.

Men and boys are left out–Fee­les

Pres­i­dent of the Fa­ther’s As­so­ci­a­tion of Trinidad and To­ba­go Rhon­dall Fee­les us­es his voice con­sis­tent­ly to speak out on is­sues af­fect­ing men. Fee­les said the 83 per cent sta­tis­tic was dis­heart­en­ing but not sur­pris­ing. He be­lieves that with the high de­mands placed on men in so­ci­ety, they are not get­ting the nec­es­sary out­lets to vent.

“Over a decade ago, I said that men are over­whelmed and have a lot to say. Men haven’t said any­thing be­fore, be­cause we didn’t give them the av­enue or so­cial spaces to do so. We didn’t give them the phys­i­cal space to do that. And even though there were spaces that were cre­at­ed, those spaces didn’t house per­son­nel that would lis­ten to men gen­uine­ly. So many men shirk go­ing to those kinds of in­sti­tu­tions,” Fee­les said.

“It’s an amal­ga­ma­tion of sev­er­al things. I would say in a nut­shell, it’s a feel­ing of hope­less­ness, cause I mean there are so­cial norms or so­cial stereo­types, and there are the fail­ings of the jus­tice sys­tem and the so­cial wel­fare sys­tem. For some rea­son, men are seen as sec­ondary cit­i­zens. Men are left out.”

Ac­cord­ing to Fee­les, so­ci­ety seems to be un­both­ered by the in­creased stress­es fac­ing men, leav­ing them to drown in their is­sues. He said an ur­gent change of mind­set is need­ed.

“We can’t aban­don a whole gen­er­a­tion of men and boys. Don’t do sta­tis­tics and re­search on men and boys, and then not ex­pect them to be trau­ma­tised and hope­less, be­cause we have no so­lu­tions. We have not stud­ied or re­searched so­lu­tions to al­le­vi­ate the stress­es that may af­fect men di­rect­ly.

“Even be­fore leg­isla­tive change, so­cial per­cep­tions need to change. There needs to be calls from the very podi­ums that have told men to stand up—the very same podi­ums that told men to do so much. These very same lead­ers of po­lit­i­cal par­ties, pas­tors, priests, and pun­dits that have called and made de­c­la­ra­tions that meant so much need to now iden­ti­fy, ac­knowl­edge, and con­fess that we have aban­doned men and boys in a sig­nif­i­cant man­ner,” he added.

‘27 psy­chi­atric clin­ics in the coun­try’

How­ev­er, Dr Deyals­ingh said the State was do­ing its part by pro­vid­ing clin­ics.

“The State has pro­vid­ed us with clin­ics. There are about 27 psy­chi­atric clin­ics all over the coun­try. The State is do­ing its part.

“Where we’ve been miss­ing is go­ing out in­to the com­mu­ni­ty and get­ting the el­der­ly per­sons. Where we may des­tig­ma­tise men­tal health where peo­ple could say they will come in,” he said.

Deyals­ingh added, “A du­ty of psy­chi­a­trists, psy­chol­o­gists, and even ther­a­pists is that when you see those pa­tients, you look to see their sui­cide risks, and al­so give them a safe­ty plan.”

With 50-year-olds and over ac­count­ing for 36 per cent of all self-in­flict­ed deaths, Dr Deyals­ingh not­ed that the el­der­ly sui­cide rate is in­creas­ing be­cause the coun­try has an age­ing pop­u­la­tion.

“We would al­so have de­men­tia in­creas­ing, lev­els of iso­la­tion in­creas­ing, lev­els of med­ical co-ex­ist­ing prob­lems in­creas­ing. For ex­am­ple, If I’m an el­der­ly male and I have a prostate prob­lem and I have a catheter for three years, wait­ing for surgery, that will put me in a state where I’m los­ing my in­de­pen­dence.

“The el­der­ly pop­u­la­tion needs that spe­cial sort of care, where we go out and seek them and try and get their med­ical con­di­tions han­dled as quick­ly as pos­si­ble, and to en­gage them …

“For in­stance, we have found that if you’re an el­der­ly fe­male and your hus­band died, and the chil­dren moved out, you have what you call empti­ness syn­drome, where these women could stay and get de­pressed. The men who get de­pressed, how­ev­er, may de­cide sui­cide is the way out,” he said.

Dr Deyals­ingh said it was im­por­tant to of­fer the el­der­ly sup­port be­cause their sup­port units will be de­creas­ing through the deaths of friends and rel­a­tives.

“This is why some­times we need to have pro­grammes from the Min­istry of So­cial De­vel­op­ment and Fam­i­ly Ser­vices where you could now look at peo­ple in the area who are alone or iso­lat­ed and pro­vide some kind of sup­port. Some­times in our clin­ics, we see peo­ple com­ing in who don’t need med­i­cine, what they need is so­cial en­gage­ment.

“I would say come in, and there would be an­oth­er pa­tient, and I would in­tro­duce them, so when they come to the clin­ic, they feel hap­py. We try to co­in­cide clin­ic dates, so they could sit down there and chat about old times,” he said.

What to do, how to get help

Glob­al­ly, more than 700,000 peo­ple die every year from sui­cide. It is the fourth lead­ing cause of death among 15 to 29-year-olds.

The Min­istry of Health ad­vised any­one think­ing about sui­cide to talk and ex­press their feel­ings hon­est­ly with some­one they trust, seek ap­pro­pri­ate help soon, de­vel­op a safe­ty plan, and let oth­ers know how they can sup­port and prac­tise new cop­ing tech­niques to main­tain a pos­i­tive lifestyle.

In 2023, the Min­istry of So­cial De­vel­op­ment and Fam­i­ly Ser­vices launched a sui­cide hot­line, 800-COPE.