THE YOUTH SUICIDE PREVENTION IN KAZAKHSTAN
Background
In 2011, I just came back from the USA, the suicide rate among teen girls Kazakhstan was higher than ever. In September 2011, I traveled to 3 cities to see three high school children after they committed suicide. In May 2012, we organized a press conference «UNT and suicide». We were disappointed that only a few journalists accepted our invitation. However, next afternoon we received a lot of calls from different departments, including Ministry of Education. It was a big attack: “Who let you open such discussion”, “Where did get your statistics” and so on… So, we found out that the newspaper called “Комсомольская правда” and K+ TV gave a short info about our press conference. We were frightened, if to say honestly. In half a year, D. Nazarbayeva voiced her deputy request to the Minister of Education and Science of Kazakhstan, where she linked UNT and suicide. Our team breathed lightly as if it was our victory.
Recognizing the growing problem the Government of Kazakhstan has taken a major step in implementing suicide prevention program. The Government acknowledged UNICEF’s technical expertise, and in December, 2015 launched a phased suicide prevention activities specifically targeting children and adolescent to be conducted as part of the National Action Plan for 2015-2020 on strengthening family relations, moral-ethical and spiritual values with support of UNICEF. Psychological and social counseling center, including psychiatrists and sociologists was created at Astana Health Department.
Our team and input
According to our observation almost every patient had suicidal thoughts, about half of them had suicidal intention and attempts. That is why we decided to work intensively in suicide prevention field.
We organized 2 schools (180-200 people) and 4 seminars per year (300 people), weekly 1 supervision group and 5 small groups, and many individual sessions. We published different posts, handouts on depression and suicide topic.
Our team at Psychoanalytic Association have been working on the topic of self-harm and suicide for 7 years and have been witnessing wide range of suicidal behaviors and ideations. All data were obtained through consultations of seminars’, schools’ and supervision groups’ participants (in total, ? people). The findings were that almost every patient had suicidal thoughts; about half of them had suicidal intention and attempts.
Moreover based on our observation and secondary data collection we have found several main reasons of youth suicide:
It is well known that the era in which a person was born influences the formation of his/her life views, habits and psychological traits. You remember the Chinese proverb: live in an era of change.
The soviet people had relatively healthy personalities. A very opposite mood was observed during the Perestroika and the following crisis: increased amount of depressed and suicidal people, many cases of aggressive and self-harming behavior because of unclear ideological, cultural values and uncertainty in the future. Interestingly, in Sanskrit “freedom” means “uncertainty”, “no freedom” means “certainty”. It is not difficult to imagine what kind of children could be born from depressed and anxious parents. Unfortunately, our youth has transgenerational depression trend, which is a direct way to suicide.
2) Significant part of the young generation has divorced parents and they have been divorced in their turn (45% of couples were divorced in 2017). They experience negative effects: a feeling of going round in circles, risk taking, low self-esteem, depressive elements, and associated pathologies (alcoholism, poly toxicomania, sex addiction, etc.). Shame, disgust and guilt are often present in these subjects. The loss of belief in the positive effects of a relationship, the loss of hope in others, progressively make one become sad and empty. So, it is a transgenerationally traumatized generation.
3) The young generation lives without a belief. The Soviet people had relatively clear values because of the confidence in the future, in Soviet ideology. Some of our beliefs are vital: a belief in the natural functioning of one’s own body, in the continuity of the self, in the reality of the outside world, in the consciousness of others. Without that it will be difficult to fully live one’s own life. To believe, one must be able to place one’s trust not only in others but also in oneself.
4) ‘Unlimited pleasure is a must!’ is the slogan of the new societal Super-ego. The modern society in which we live is slowly but surely conditioning women and men – children or adults – to a world where whatever we desire must be available for immediate acquisition. The ‘unlimited’ consumer products are in offer. In this context, young generation is an infant who would like to get everything right now and immediately.
We observed reactions of intense depression when the object or situation has not been satisfied. The subject then feels empty and will have a tendency to identify himself with trash.
5) Love and sex are separated. Splitting is an essential defensive mechanism used by youngsters. They give to sex objects the same status as to any other products. Sexual excitement is increasingly distanced from the loving feelings associated with a relationship. As Freud reminds us, to love other people, one must first be able to love oneself.
Love implies both an encounter and sharing. Loving someone else has the particular power of being able to tear a person away from a regressive position of narcissistic omnipotence. Loving, thus, implies accepting – by the other – something of one’s own deficiencies. But that other can never fully satisfy these deficiencies. As soon as there is any frustration, one must either deal with this ‘other’, to be replaced by a new one or kill oneself in order to punish that other.
6) Youth is under many forms of addiction. Addiction has become a source of suffering. It is often the sense of loss of meaning that forces recognition of the dependency. Our youth’s weak ego is easily exposed to an overflow of emotions, breakdowns and states of distress.
7) Youth spends a lot of time on the smartphones. The screens (television, internet, telephone, etc.) have replaced books and notebooks. One can question the important role of the Internet as a new education tool, its effects on the psychic apparatus in its capacity to imagine or fantasize, i.e. be creative. The danger is that external images come little by little to replace fantasies (produced from within). The subject, thus, goes from an active role (implied in fantasmatic production or in the imagination) to passive mode in thinking, in living.
Girls use social media more often, giving them additional opportunities to feel excluded and lonely when they see their friends or classmates getting together without them, while they anxiously await the affirmation of comments and likes. Social media gives middle- and high-school girls a platform to carry out the style of aggression they favor, bullying and excluding other girls.
Statistics.
According to the data collected in 2016, suicide is the 4th leading cause of death in Kazakhstan.
As UNICEF pointed out (Annual Report 2014), only 20% of Kazakhstani people knew about the existence of Kazakhstan’s suicide problem. It can be concluded that there is no great attention to this problem from both side: community and government.
The more time individuals spend looking at screens, the more likely they are to report symptoms of depression. Their risk of depression increases by 27 percent, while those who play sports, go to religious services or even do homework cut their risk significantly.
Teens who spend 3 hours a day or more on electronic devices are 35 percent more likely to have a risk factor for suicide, such as making a suicide plan. One piece of data indicates children’ growing isolation. Since 2007, the homicide rate among teens has declined, but the suicide rate has increased. As teens have started spending less time together, they have become less likely to kill one another and more likely to kill themselves.
Background
In 2011, I just came back from the USA, the suicide rate among teen girls Kazakhstan was higher than ever. In September 2011, I traveled to 3 cities to see three high school children after they committed suicide. In May 2012, we organized a press conference «UNT and suicide». We were disappointed that only a few journalists accepted our invitation. However, next afternoon we received a lot of calls from different departments, including Ministry of Education. It was a big attack: “Who let you open such discussion”, “Where did get your statistics” and so on… So, we found out that the newspaper called “Комсомольская правда” and K+ TV gave a short info about our press conference. We were frightened, if to say honestly. In half a year, D. Nazarbayeva voiced her deputy request to the Minister of Education and Science of Kazakhstan, where she linked UNT and suicide. Our team breathed lightly as if it was our victory.
Recognizing the growing problem the Government of Kazakhstan has taken a major step in implementing suicide prevention program. The Government acknowledged UNICEF’s technical expertise, and in December, 2015 launched a phased suicide prevention activities specifically targeting children and adolescent to be conducted as part of the National Action Plan for 2015-2020 on strengthening family relations, moral-ethical and spiritual values with support of UNICEF. Psychological and social counseling center, including psychiatrists and sociologists was created at Astana Health Department.
Our team and input
According to our observation almost every patient had suicidal thoughts, about half of them had suicidal intention and attempts. That is why we decided to work intensively in suicide prevention field.
We organized 2 schools (180-200 people) and 4 seminars per year (300 people), weekly 1 supervision group and 5 small groups, and many individual sessions. We published different posts, handouts on depression and suicide topic.
Our team at Psychoanalytic Association have been working on the topic of self-harm and suicide for 7 years and have been witnessing wide range of suicidal behaviors and ideations. All data were obtained through consultations of seminars’, schools’ and supervision groups’ participants (in total, ? people). The findings were that almost every patient had suicidal thoughts; about half of them had suicidal intention and attempts.
Moreover based on our observation and secondary data collection we have found several main reasons of youth suicide:
- Mental health. Death by suicide represents the most severe outcome of a mental illness. Self inflicted injury is common in the course of major depression, schizophrenia, and personality disorders (Tanney, 1992; Henriksson et al., 1993; Isometsa et al., 1994; Lesage et al., 1994). In a variable percentage of cases suicide also occurs in medical illnesses with a chronic decourse which lead to invalidity, such as Hungtington’s disease, Parkinson’s disease, disseminated sclerosis and epilepsy (Buzan & Weissberg, 1992; Stenger & Stenager, 1992). For more than a decade Suicide is a symptom and sign of serious depression. Depression is a treatable disorder, but often the treatment takes time, energy and effort on the part of the person who's feeling depressed. Sometimes, as a person who is depressed feels the energizing effects of an antidepressant medication, they will still feel depressed, but have more energy. It is during this time in treatment that many people turn to suicide and suicidal acts. Sadly, Depression is one of the most common and most serious mental health problems facing people today.
It is well known that the era in which a person was born influences the formation of his/her life views, habits and psychological traits. You remember the Chinese proverb: live in an era of change.
The soviet people had relatively healthy personalities. A very opposite mood was observed during the Perestroika and the following crisis: increased amount of depressed and suicidal people, many cases of aggressive and self-harming behavior because of unclear ideological, cultural values and uncertainty in the future. Interestingly, in Sanskrit “freedom” means “uncertainty”, “no freedom” means “certainty”. It is not difficult to imagine what kind of children could be born from depressed and anxious parents. Unfortunately, our youth has transgenerational depression trend, which is a direct way to suicide.
2) Significant part of the young generation has divorced parents and they have been divorced in their turn (45% of couples were divorced in 2017). They experience negative effects: a feeling of going round in circles, risk taking, low self-esteem, depressive elements, and associated pathologies (alcoholism, poly toxicomania, sex addiction, etc.). Shame, disgust and guilt are often present in these subjects. The loss of belief in the positive effects of a relationship, the loss of hope in others, progressively make one become sad and empty. So, it is a transgenerationally traumatized generation.
3) The young generation lives without a belief. The Soviet people had relatively clear values because of the confidence in the future, in Soviet ideology. Some of our beliefs are vital: a belief in the natural functioning of one’s own body, in the continuity of the self, in the reality of the outside world, in the consciousness of others. Without that it will be difficult to fully live one’s own life. To believe, one must be able to place one’s trust not only in others but also in oneself.
4) ‘Unlimited pleasure is a must!’ is the slogan of the new societal Super-ego. The modern society in which we live is slowly but surely conditioning women and men – children or adults – to a world where whatever we desire must be available for immediate acquisition. The ‘unlimited’ consumer products are in offer. In this context, young generation is an infant who would like to get everything right now and immediately.
We observed reactions of intense depression when the object or situation has not been satisfied. The subject then feels empty and will have a tendency to identify himself with trash.
5) Love and sex are separated. Splitting is an essential defensive mechanism used by youngsters. They give to sex objects the same status as to any other products. Sexual excitement is increasingly distanced from the loving feelings associated with a relationship. As Freud reminds us, to love other people, one must first be able to love oneself.
Love implies both an encounter and sharing. Loving someone else has the particular power of being able to tear a person away from a regressive position of narcissistic omnipotence. Loving, thus, implies accepting – by the other – something of one’s own deficiencies. But that other can never fully satisfy these deficiencies. As soon as there is any frustration, one must either deal with this ‘other’, to be replaced by a new one or kill oneself in order to punish that other.
6) Youth is under many forms of addiction. Addiction has become a source of suffering. It is often the sense of loss of meaning that forces recognition of the dependency. Our youth’s weak ego is easily exposed to an overflow of emotions, breakdowns and states of distress.
7) Youth spends a lot of time on the smartphones. The screens (television, internet, telephone, etc.) have replaced books and notebooks. One can question the important role of the Internet as a new education tool, its effects on the psychic apparatus in its capacity to imagine or fantasize, i.e. be creative. The danger is that external images come little by little to replace fantasies (produced from within). The subject, thus, goes from an active role (implied in fantasmatic production or in the imagination) to passive mode in thinking, in living.
Girls use social media more often, giving them additional opportunities to feel excluded and lonely when they see their friends or classmates getting together without them, while they anxiously await the affirmation of comments and likes. Social media gives middle- and high-school girls a platform to carry out the style of aggression they favor, bullying and excluding other girls.
Statistics.
According to the data collected in 2016, suicide is the 4th leading cause of death in Kazakhstan.
As UNICEF pointed out (Annual Report 2014), only 20% of Kazakhstani people knew about the existence of Kazakhstan’s suicide problem. It can be concluded that there is no great attention to this problem from both side: community and government.
The more time individuals spend looking at screens, the more likely they are to report symptoms of depression. Their risk of depression increases by 27 percent, while those who play sports, go to religious services or even do homework cut their risk significantly.
Teens who spend 3 hours a day or more on electronic devices are 35 percent more likely to have a risk factor for suicide, such as making a suicide plan. One piece of data indicates children’ growing isolation. Since 2007, the homicide rate among teens has declined, but the suicide rate has increased. As teens have started spending less time together, they have become less likely to kill one another and more likely to kill themselves.
Conclusion
There is a hope: Suicide is a global phenomenon in all regions of the world. It is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions.
There is a hope: The rate of suicide among adolescents aged 15-to-19 years fell from 17.5 in 2011 to 14.9 in 2016, driven mainly by a decrease in suicide among girls. (WHO, 2017)
There is a hope: Psychological literacy and culture of Gen Y and Z are higher than of previous generations. These generations are not afraid of a psychologist; they somehow know the difference between a psychiatrist, a psychologist and a psychoanalyst.
But there are some barriers that prevent the youth from consulting a psychotherapist:
the denial of the problems, avoiding suffering from depressive symptoms,
going from one therapist to another one as soon as the frustration is felt,
lack of money,
their parents and grandparents still are against the word “psyche” because of soviet heritage of punitive psychiatry.
We have to raise community awareness by improving National Suicide prevention program that includes scientific research, specialist education, psychological trainings, prevention centers, mobile applications, TV and radio shows. We should organize special psychological courses for parents and specialists. They must know that suicides and mental illnesses might go up. The children who spend more than average time on screen activities are more likely to be unhappy. At the generational level when teens and young adults of twenties spend more time on smartphones and less time on in-person social interactions, loneliness is more common. High usage of the Internet without regulation could be contributing to the increase in suicide and mental illnesses among teens today and in the future.
The adults must know that youth uses the mechanism of splitting, idealization and omnipotence. A new person can be strongly idealized: presenting no failings, doted with all possible qualities, they are apprehended as being ‘perfect’. Denial that permits the exclusion of the field of consciousness and facilitates the isolation of those representations or affects that are not in line with keeping with the ideal self-image. Everything that might make the psychic life fragile by its contradictory character is abandoned. A loss, a grieving process, a separation, for example, might provoke in such subjects reactions in which there is no apparent suffering but masked /chronic depression that leads to suicide.
We should organize a National Suicide prevention week is to raise awareness and encourage actions especially in schools and colleges, to open special psychological centers for young people. The youth's inability to be happy in a couple, recurring compulsion, a loss of control, associated with a painful sense of failure request for treatment.
The qualified psychologists will help the young generation to go:
1. From affective insecurity to security;
2. From intolerance of frustration to tolerance;
3. From a tendency to action and to acting out to affect regulation;
4. From the compulsive behavior to self-management;
5. From emotional overflow to self-control;
6. From affective and social isolation to social inclusion;
7. From masked depression to joyfulness.
Literature
http://nosubject.com/Suicide
http://www.apsa.org/content/news-psychoanalytic-perspective-suicide-prevention
https://www.ncbi.nlm.nih.gov/pubmed/914450
https://www.researchgate.net/publication/300128426_Psychoanalytic_theories_of_suicide
http://www.tandfonline.com/doi/abs/10.1300/J032v12n02_02
https://www.researchgate.net/publication/289084107_Narcissistic_vulnerability_to_suicide
http://psyjournal.ru/articles/zigmund-freyd-o-samoubiystve
http://www.svetgeorg.com/stati/dlai/596-suicid-s-pozicii-psihoanaliza-yal-obuhov.html
http://www.healthdata.org/kazakhstan
https://www.unicef.org/about/annualreport/files/Kazakhstan_2015_COAR.pdf
http://worldpopulationreview.com/countries/suicide-rate-by-country/
https://tengrinews.kz/kazakhstan_news/kazahstane-rost-detskogo-suitsida-svyazali-provedeniem-ent-223040/
There is a hope: Suicide is a global phenomenon in all regions of the world. It is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions.
There is a hope: The rate of suicide among adolescents aged 15-to-19 years fell from 17.5 in 2011 to 14.9 in 2016, driven mainly by a decrease in suicide among girls. (WHO, 2017)
There is a hope: Psychological literacy and culture of Gen Y and Z are higher than of previous generations. These generations are not afraid of a psychologist; they somehow know the difference between a psychiatrist, a psychologist and a psychoanalyst.
But there are some barriers that prevent the youth from consulting a psychotherapist:
the denial of the problems, avoiding suffering from depressive symptoms,
going from one therapist to another one as soon as the frustration is felt,
lack of money,
their parents and grandparents still are against the word “psyche” because of soviet heritage of punitive psychiatry.
We have to raise community awareness by improving National Suicide prevention program that includes scientific research, specialist education, psychological trainings, prevention centers, mobile applications, TV and radio shows. We should organize special psychological courses for parents and specialists. They must know that suicides and mental illnesses might go up. The children who spend more than average time on screen activities are more likely to be unhappy. At the generational level when teens and young adults of twenties spend more time on smartphones and less time on in-person social interactions, loneliness is more common. High usage of the Internet without regulation could be contributing to the increase in suicide and mental illnesses among teens today and in the future.
The adults must know that youth uses the mechanism of splitting, idealization and omnipotence. A new person can be strongly idealized: presenting no failings, doted with all possible qualities, they are apprehended as being ‘perfect’. Denial that permits the exclusion of the field of consciousness and facilitates the isolation of those representations or affects that are not in line with keeping with the ideal self-image. Everything that might make the psychic life fragile by its contradictory character is abandoned. A loss, a grieving process, a separation, for example, might provoke in such subjects reactions in which there is no apparent suffering but masked /chronic depression that leads to suicide.
We should organize a National Suicide prevention week is to raise awareness and encourage actions especially in schools and colleges, to open special psychological centers for young people. The youth's inability to be happy in a couple, recurring compulsion, a loss of control, associated with a painful sense of failure request for treatment.
The qualified psychologists will help the young generation to go:
1. From affective insecurity to security;
2. From intolerance of frustration to tolerance;
3. From a tendency to action and to acting out to affect regulation;
4. From the compulsive behavior to self-management;
5. From emotional overflow to self-control;
6. From affective and social isolation to social inclusion;
7. From masked depression to joyfulness.
Literature
http://nosubject.com/Suicide
http://www.apsa.org/content/news-psychoanalytic-perspective-suicide-prevention
https://www.ncbi.nlm.nih.gov/pubmed/914450
https://www.researchgate.net/publication/300128426_Psychoanalytic_theories_of_suicide
http://www.tandfonline.com/doi/abs/10.1300/J032v12n02_02
https://www.researchgate.net/publication/289084107_Narcissistic_vulnerability_to_suicide
http://psyjournal.ru/articles/zigmund-freyd-o-samoubiystve
http://www.svetgeorg.com/stati/dlai/596-suicid-s-pozicii-psihoanaliza-yal-obuhov.html
http://www.healthdata.org/kazakhstan
https://www.unicef.org/about/annualreport/files/Kazakhstan_2015_COAR.pdf
http://worldpopulationreview.com/countries/suicide-rate-by-country/
https://tengrinews.kz/kazakhstan_news/kazahstane-rost-detskogo-suitsida-svyazali-provedeniem-ent-223040/
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Email: psychoanalyst.ast@gmail.com
Mamyr-4, 200-B, Auezov district, Almaty 050036/A10E7Y0