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‘Could I have prevented it?’: When the ripple effect of a suicide extends beyond the

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IMPACT ON WIDER COMMUNITY 

Suicide is the leading cause of death for those aged 10 to 29 in Singapore, according to the Samaritans of Singapore. 

Since the early 1970s, suicide researchers have asserted that six people are greatly affected by each suicide – a statistic based on the average size of an immediate family.

But a new study in the US has found that each suicide affects up to 135 people, said Dr Jared Ng, chief of the emergency and crisis care department at the Institute of Mental Health (IMH). 

The higher figure represents all the people who knew the deceased, according to the 2018 study by researchers from the University of Kentucky. The study highlighted the importance of supporting a broader group of people to reduce harm from suicide.  

“Usually what we do when we encounter (a suicide) is that we might draw Circles of Vulnerability. The centre, where the deceased is, is where we think they’re most affected,” explained Dr Ng, referring to a research model that identifies vulnerable groups who are most at risk of “suicide contagion”.

“Students and classmates, especially for youth suicides, are important. Teachers, or even school principals, friends, acquaintances, distant relatives … all these people will certainly be affected in some way or another.”

In the wake of a suicide, survivors can be saddled with a debilitating amount of guilt, which can quickly turn into depression if left untreated, said IMH’s doctors.

“They are quite upset about it, especially if they have … just seen the person before. I have heard from virtually everybody who talks to us that they wish they had done more. And they have really done a lot, but there is still that guilt,” said Dr Mythily Subramaniam, assistant chairman of the medical board (research) at IMH.

This guilt can take years to overcome, she added. Her colleague interviewed a person who lost someone to suicide and still carried the feeling of guilt many years later.  

Dr Mythily is part of a team of IMH researchers seeking next-of-kin and close friends of those who died by suicide for a study titled Seeking Answers: A Psychological Autopsy of Exploring and Analysing Risk Factors in Singapore.



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