On average, 73 suicide deaths occur in a year in Bhutan, which works out to about seven in a month

Blueprint: Rapid economic development is fast turning Bhutan into a paradoxical society. The proverbial country of gross national happiness is today also a country with staggeringly high suicide rate.

A total of 361 suicide deaths occurred between 2009 and 2013, average of 73 suicide deaths in a year or roughly seven in a month.

A study has found that suicide death ranks among the top six leading causes of deaths after alcoholic liver disease, other circulatory diseases, cancers, respiratory diseases, and transport deaths. Suicide deaths outnumber the combined deaths due to tuberculosis, malaria and HIV.

The pattern is all the more worrying. Suicide deaths occur among the most productive age groups – 87 percent of death occurred between the age groups of 15 and 40 years. Although the global suicide rate has decreased, it has remained steady in Bhutan. In fact, the rate increased significantly in 2012 and 2013.

Male-to-female ratio of suicide death in Bhutan is found to be two men to each woman, which is slightly higher than the average ratio of 1.5 men to each woman in low- and middle-income countries. Most suicide death (88 percent) has occurred in rural areas, 66 percent among married people. About 42 percent of suicide deaths occurred among uneducated people, and 58 percent among low-income people.

Among other reasons in Bhutan, economic factors, relationship problems, domestic violence, and emotional abuse are among the leading risk factors for suicide deaths. It has been found that fast pace of country’s development and societal transition are posing major stress on the society – economic and livelihood opportunities, academic competition for excellence in schools, and job stresses, among others.

As Bhutan observed World Suicide Prevention Day yesterday, stakeholders gathered at the conference hall of Tarayana Foundation to initiate the implementation of action plan for National Suicide Prevention (NSP) in the country that the Cabinet approved on May 12.

According to the blueprint, suicide prevention requires a combination of universal, selective, and indicated strategies to address the risks. Universal strategies target the entire population. Selective strategies are appropriate for subgroups that may be at increased risk for suicidal behaviours. Indicated strategies are designed for individuals identified as having a high risk for suicidal behaviours.

However, social stigma continues to remain the major barrier in prevention efforts across the world due to which vulnerable people and their friends, families and individuals do not access seek counselling and postvention support services.

(Dr) Gampo Dorji, Dy. Chief Programme Officer with Department of Public Health, said that despite the lack of national suicide prevention strategic plan there is a strong political commitment to establish effective suicide prevention programmes in the country. Stakeholders are engaged in addressing risk factors like alcohol addiction, drugs and substance use, and violence prevention at various levels.

Said (Dr) Gampo Dorji: “Realistic action plans can initiate a swift national suicide prevention response. Our aim is to reduce suicide rate by 10 percent in three years.”

Dr Dorji Wangchuk, health secretary, said that suicide death is multifactorial and there is a need to have a holistic, multisectorial approach to address the issue. “Bringing suicide rate down to 10 percent by 2018 is a tall order, but we can do it with persistent effort.”

Jigme Wangchuk