Sains Malaysiana 42(3)(2013): 399–402

 

Half a Century of Suicide Studies - a Plea for New Directions in Research and Prevention

(Kajian Bunuh Diri Selama Separuh Abad- Seruan ke Arah Halatuju Baru dalam Penyelidikan dan Pencegahan)

 

T. Maniam* & L. F. Chan

Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia

Jalan Yaakob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia

 

Received: 22 July 2012/Accepted: 31 July 2012

 

ABSTRACT

Suicide studies in Malaysia tend to be repetitive. Data from hospital studies, small scale community surveys and national epidemiological studies over nearly 50 years have consistently shown that there are real ethnic differences in terms of suicides and attempted suicides in this country, though some of these differences appear to be narrowing somewhat. Malays have shown significantly lower rates of suicidal ideas, attempts and completed suicides. Indians, on the other hand, figure prominently at the other end with high rates in all the above parameters. The reasons for these are also necessarily complex. Experience elsewhere from studies of the Indian diaspora have elucidated a number of explanations, which include the effects of poverty, acculturation, alcoholism, the lack of a strong religious protective factor as well as increased rates of mental ill-health. Efforts to contain this public health problem have been somewhat patchy. This has largely depended on efforts by non-government organizations such as the Befrienders whereas the public response lags behind in providing the financial and other resources necessary for a comprehensive national program. This paper shall review the relevant literature and suggest new areas for research as well as steps to provide a fresh impetus to suicide prevention in Malaysia.

 

Keywords: Ethnicity; Malaysia; risk factors; suicide; suicide prevention

 

ABSTRACT

Suicide studies in Malaysia tend to be repetitive. Data from hospital studies, small scale community surveys and national epidemiological studies over nearly 50 years have consistently shown that there are real ethnic differences in terms of suicides and attempted suicides in this country, though some of these differences appear to be narrowing somewhat. Malays have shown significantly lower rates of suicidal ideas, attempts and completed suicides. Indians, on the other hand, figure prominently at the other end with high rates in all the above parameters. The reasons for these are also necessarily complex. Experience elsewhere from studies of the Indian diaspora have elucidated a number of explanations, which include the effects of poverty, acculturation, alcoholism, the lack of a strong religious protective factor as well as increased rates of mental ill-health. Efforts to contain this public health problem have been somewhat patchy. This has largely depended on efforts by non-government organizations such as the Befrienders whereas the public response lags behind in providing the financial and other resources necessary for a comprehensive national program. This paper reviews the relevant literature and suggest new areas for research as well as steps to provide a fresh impetus to suicide prevention in Malaysia.

 

Keywords: Ethnicity; Malaysia; risk factors; suicide; suicide prevention

 

ABSTRAK

Kajian mengenai masalah bunuh diri di Malaysia sering mengulangi topik yang sama. Data daripada kajian hospital, kaji selidik komuniti skala kecil dan kebangsaan, kajian epidemiologi selama hampir 50 tahun di Malaysia telah secara tekal menunjukkan bahawa terdapat perbezaan etnik yang nyata daripada segi kejadian bunuh diri dan cubaan bunuh diri di negara ini, walaupun jurang perbezaan ini adalah agak rapat sekarang. Kaum Melayu telah menunjukkan kadar yang jauh lebih rendah daripada segi pemikiran untuk bunuh diri, cuba membunuh diri dan bunuh diri. Kaum India pula menunjukkan kadar yang tinggi dalam semua parameter di atas. Sebab-sebab untuk penemuan ini adalah kompleks. Pengalaman di tempat lain daripada kajian diaspora India telah memberi beberapa penjelasan, termasuk kesan kemiskinan, pembudayaan, alkoholisme, kekurangan faktor pelindung agama yang kukuh serta peningkatan kadar masalah kesihatan mental dan sebagainya. Usaha untuk membendung masalah kesihatan awam ini agak kurang dengan sebahagian besarnya bergantung kepada usaha oleh badan bukan kerajaan (NGO) seperti Befrienders manakala sambutan rasmi seolah-olah kekurangan daya untuk menyediakan sumber kewangan dan lain-lain yang perlu bagi program kebangsaan. Kertas ini menyelidik kajian yang berkaitan dan mencadangkan topik yang perlu dikaji dan juga langkah-langkah untuk memberi dorongan baru kepada pencegahan bunuh diri di Malaysia.

 

Kata kunci: Bunuh diri; faktor risiko; keturunan; Malaysia; pencegahan bunuh diri

 

REFERENCES

Amarasingham, R.D. & Lee, H. 1969. A review of poisoning cases examined by the Department of Chemistry, Malaysia from 1963 to 1967. Med. J. Malaya 23(3): 220-227.

Aishvarya, S., Maniam, T., Hatta Sidi & Oei, T.P.S. 2013.  Suicide ideation and intent in Malaysia: A review of the literature (in preparation).

Azhar, M.Z. 1991. Profile of in-patient suicides in two hospitals in Malaysia. Med. J. Malaysia 46: 171-176.

Bollen, K.A. & Phillips, D.P. 1982. Imitative suicides: A national study of the effects of television news stories. American Sociol. Review 47: 802-809.

Chan, L.F., Maniam, T. & Shamsul, A. 2011. Suicide attempts among depressed inpatients with depressive disorder in a Malaysian sample: Psychosocial and clinical risk factors. Crisis - The Journal of Crisis Intervention and Suicide Prevention 32(5): 283-287.

Hayati, A.N., Salina, A.A., Abdullah, A.A., Eusni, R.T. & Mansar, A.H. 2004. The pattern of completed suicides seen in Kuala Lumpur General Hospital 1999. Medical Journal of Malaysia 59: 190-198.

Hayati, A.N., Abdullah, A.A. & Sham, M.M. 2008. National Suicide Registry Malaysia: Preliminary Report July to December 2007. Kuala Lumpur: Public Health Institute.; pp. 11.

Maniam, T. 1988. Suicide and parasuicide at a hill resort in Malaysia. British J. Psychiatry 153: 222-225.

Maniam, T. 1994. Changing patterns of suicides in Cameron Highlands. Malaysian J. Psychiatry 2: 48-58.

Maniam, T. 1995. Suicide and undetermined violent deaths in Malaysia, 1966 - 1990: Evidence for the misclassification of suicide statistics. Asia-Pacific Journal of Public Health 8: 181-185.

Maniam, T. 2003. Why Malaysian Indians have high suicide rates? In Suicide Prevention: Meeting the Challenge Together, edited by Laksmi Vijayakumar. Chennai: Orient Longman Limited.

Maniam, T., Lim, C.H., Kadir, A.B., Abqariah, Y., Nurashikin, I., Salina, A.A., Sarfraz, M.H., Toh, C.L., Fauziah, M., Faudzi, A.Y. & Karuthan, C. 2011. Does religious affiliation protect against suicidal ideation? Results of an epidemiological survey. Chinese Journal of Mental Health 25: 9 (Supplement) S177-178.

Ministry of Health Malaysia. 2005. Malaysia’s Health Report: Suicide Prevention in Malaysia. Putrajaya.

Ministry of Health Malaysia. 2009. National Suicide Registry Malaysia (NSRM) Annual Report for 2008. Kuala Lumpur.

Morris, P. & Maniam, T. 2001. Ethnicity and suicidal behavior in Malaysia: A review of the literature. Transcultural Psychiatry 38(1): 51-61.

Orr, J.W. & Tin, N.P. 1985. Parasuicides in Kuala Lumpur: A descriptive study. Singapore Medical Journal 26: 161-170.

Yeoh, O.H. 1981. Attempted suicides in Penang: Preliminary observations. Medical Journal Malaysia 36(6): 56-60.

 

*Corresponding author; email: tmaniam@yahoo.com

 

 

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