Breaking the taboo

Clinical psychologist Dr Nicholas Briffa told MaltaToday last Sunday that an important preventive factor for teen suicide is education and discussion to prevent suicide. He’s right. Unfortunately, discussing suicide is a taboo in Malta, as is discussing depression and self-harm among young people. Depression, mental health problems, self-harm and suicide are regarded with a sort of stigma in our society. 

Our language is loaded with stigma when referring to people with mental health problems – using words like mignun, jekk jarawh barra jigbruh, spissjat, mohhu hafif, imtektek. Only a handful of local, well known personalities have spoken about their own experience of depression and mental health problems.

Former Parliamentary Secretary Mario Galea was one of them. During his time as parliamentary secretary, Mr Galea suffered from depression himself. Later on, he suffered a relapse. Despite pressure from some quarters to keep it a secret, the former parliamentary secretary spoke openly about his mental health problem.

I interviewed Mario on Iswed fuq l-Abjad earlier on this year. Following the interview, I met a woman whose son – a young man in his late twenties, suffering from depression – who emphasized the need for leading politicians and well known personalities to come forward and speak openly about mental health problems as, according to this woman, they are best suited to help break the taboo. Mental health problems do not affect only the individual concerned but also family members – and they need help and support too. 

Although depression does not necessarily lead to suicidal thoughts or suicide itself, severe depression can lead to suicide. According to statistics from the World Health Organisation (WHO) 800,000 people commit suicide each year and it is the second leading cause of death among people aged between 15 and 29 (The Malta Independent, February 2, 2015). There is little if any discussion on suicide on our local media. 

I recall a leading psychiatrist telling me how, following a TV programme on which he was invited to talk about the various options and help at hand for people with suicidal thoughts, he received a phone call from a man who had already bought a gun to kill himself but decided otherwise and sought help, encouraged by what the psychiatrist said on TV. That was one life saved.

Parents need to be informed and able to detect teen suicidal behaviour that experts say often include: evidence of substance abuse, thoughts of dying and desire to leave this life, dramatic mood swings and changes in normal habits – such as eating, sleeping and lost interest in schoolwork. Of course, these patterns are not necessarily indications of suicidal thoughts, however there can be a pattern which, unchecked, might lead to serious consequences. 

Self-harm too is on the increase, especially among young women. Going through local media reports on the matter, hospital sees three self-harm cases a day. Back then, leading psychiatrist Anton Grech – the psychiatry chairman at Mt Carmel Hospital – called for better education and awareness about depression, which he described as a common cause for self-harm – Times of Malta, May 28, 2014. Unfortunately, not much has been done since then in terms of awareness and education. 

According to the report published by MaltaToday last Sunday, more girls aged between 15 and 19 die from self-harm than from road accidents or disease. The head of the crisis team at Mater Dei hospital, Dr Mark Xuereb, told MaltaToday that self-harm among teenage girls in Malta was becoming increasingly common. 

Self-harm and suicide attempts are two distinct matters – although there is often confusion between the two, due to lack of awareness and information. Self-harm, which according to reports is higher among women and young girls, is often an attempt to relieve emotional distress and does not necessarily mean that the young girl is suicidal.  However, if unchecked things might complicate themselves further.

There are countless sites encouraging self-harm. Those seeking self-harm as a means of relieving emotional distress often find ‘comfort’ and a sense of belonging by visiting these sites, knowing that there are people who are similar to them. Young people going through emotional distress visit these sites and some of them compete on who can cut the deepest.  

With the rise of cyber bullying, the pressure exerted on young people to ‘succeed’ and do well at school, and increasing social expectations, apart from peer pressure, teenagers are having to grow in an increasingly difficult world. Stress management courses need to be an essential part of the school curricula, starting from a young age.  

The government needs to pull up its socks on this worrying trend of self-harm, mental health problems and suicide by launching a nationwide prevention strategy at schools, workplaces and on the media – especially on social media. 

The lack of proper awareness and education in schools and within families manifested itself in the past days, albeit on a totally different subject, but which goes to show the lack of proper education. Instead of providing children with a rational explanation to the ‘Charlie Charlie’ pencils challenge – gravity and friction, many schools went into panic mode.

On Iswed fuq l-Abjad last Wednesday, Fr Elija Vella told me that he had parents taking their children to him for the ‘exorcist’ to pray over them just in case they were possessed by Charlie the Mexican devil after having played the pencil challenge at school.  Students were warned, I am told by a nine year old attending a church school, to report to their teachers if one of their peers dares mention the pencil challenge. 

Society needs to act fast. With self-harm on the rise, the World Health Organisation claiming that, by 2025, mental health problems will be more common than cardiovascular disease or cancer and every 40 seconds someone, somewhere in the world commits suicide, people, especially the young and their families, need to be equipped on how to deal with emotional distress and where to seek help. Education and awareness truly save lives.