Despite progress in implementation of the three-year action plan for suicide prevention in Bhutan, the number of suicide incidences in the country has not decreased.

National Suicide Prevention Programme (NSPP) plans to come up with a five-year action plan.

Deputy chief programme officer with NSPP, Yeshi Wangdi, said that going by the implementation of the action plan, there was a good progress.

Yeshi Wangdi said the programme is yet to tally the progress of the reports submitted by the stakeholders.

Except for a few activities related to the development of human resources among some of the stakeholders, there is progress of 100 percent in the implementation of the activities, he added. However, progress in the activities related to the development of human resources are yet to make commendable progress due to limited financial resources.

With more than a month for the three-year action plan for suicide prevention in Bhutan to end in June, the NSPP is in the process of reviewing the plan.

Yeshi Wangdi said the programme is reviewing the action plan activity-wise because it is a multi-stakeholder approach. “There are many relevant agencies implementing the plan.”

The action plan includes having strong suicide surveillance system.

“As far as I am concerned, no suicide incidence is left unreported and this could be a reason for the increased number,” he said.

The number of suicide incidence in the country increased to 106 last year from 92 in 2016.

Drafting the next action plan will look into whether the increase is because the action plan is not working in reducing the suicide incidence in the country.

“However, we will look at challenges and issues facing stakeholders before we come up with the next plan,” Yeshi Wangdi said.

Gasa and Lhuentse did not have any suicide incidence in 2016, but the two dzongkhags reported one and two cases respectively last year.

Among the dzongkhags, Chukha with 15 suicide cases last year was the highest, followed by 12 cases each in Thimphu and Samtse. Mongar and Samdrupjongkhar reported 10 and nine cases respectively.

Yeshi Wangdi said the programme is also in the process of analysing why certain dzongkhags have high suicide incidences. “Until we have a final report, we won’t be able to tell why Chukha had the highest number of suicide incidences last year.”

The final report is expected to be ready by July this year.

He emphasised that it is difficult to say the actual reason that led a person to take his or her own life. “Even after the analyses, we will only be able to give the factors associated with the suicide incidence.”

According to the suicide incidence reporting system, most of the victims killed themselves because of mental illness or depression, followed by domestic violence and relationship issues. Last year, it was reported that a total of 15 people killed themselves because of mental illness.

“However, these are not underlined analytical causes of suicides,” he said.

A psychiatrist with the referral hospital in Thimphu, Dr Damber Kumar Nirola, said that the most common mental illness is depression. Other mental illnesses such as bipolar disorder, schizophrenia, alcoholism, substance abuse and other chronic mental disorders may also lead to suicide.

He said there is a compelling evidence indicating that adequate prevention and treatment of depression, and alcohol and substance abuse can reduce suicide rates, as well as follow-up contact with those who have attempted suicide.

Health officials said that those who attempted suicide but failed are most vulnerable; if they do not receive proper counselling, they are likely to attempt again.

Nine killed themselves because of relationship issues and domestic violence, according to the incidence reporting system.

Dr Yeshi Wangdi said that from the health part, there are counselling and treatment if the issues are related to mental illness. “But when it comes to relationship issues there is only so much the health sector can do.”

Of the total reported suicide cases last year, the highest (27) was among persons between ages of 21 and 30 years. About 23 cases were among adolescents between 11 – 20 years, and 21 between 31 – 40 years.

Health officials said that religious talks have more impact, as religious figures could convince people to have a positive attitude towards life.

Dr Nirola said strategies involving restriction of access to common methods of suicide such as firearms or toxic substances like pesticides have proved to be effective in reducing suicide rates. However, he added that there was a need to adopt multi-sectoral approaches involving many levels of intervention and activities.

Dechen Tshomo