Bhutan is heading down the wrong path on mental health and suicide: UNICEF Representative

Bhutan has recorded more than 4,200 cases related to mental and behavioral disorders in 2017 and 6,858 cases in 2020. Depression Incidence in Bhutan per 10,000 population has risen from 6.0 in 2017 to 10.4 in 2019.

Suicide ranks among the top six leading causes of deaths. There was a total of 361 suicide deaths in the past five years from 2009 to 2013. This means on an average there are 73 suicide cases per year or  six suicide deaths in a month.

This increased to a total of 283 suicides deaths in 2018 to 2020.

UNICEF Representative, Dr Will Parks said, on an average 94 suicide death cases now occurs per year or 8 suicide deaths per month. This indicates that every 90 hours, Bhutan is at risk of losing a life to suicide.

“The data confirms, we are heading down the wrong path. There is a new international momentum, but we need to break the silence. There are proven interventions that can promote mental health and resilience from pre-birth to supporting those over 60 years, but these need investment and coordination,” said UNICEF Representative.

Despite case increases, over the last five years, the annual budget allocation to mental health has remained under Nu 3.5 million (less than USD 50,000).

UNICEF, UNDP, WHO, UNFPA and UNODC are the agencies that are coming together to support RGoB’s mental health responses.  There is support to parents, front liners, community, schools, primary health care and referral services to help break the silence, improve coordination and investment.

Dr Damber K Nirola, Psychiatrist in JDWNRH said in Bhutan, suicide deaths rank among the top six leading causes of deaths after alcoholic liver disease, other circulatory diseases, cancers, respiratory diseases, and transport deaths.

Suicide occurs among the most productive age groups; 87% of deaths occurred within the age group of 15‐40 years. Although the global suicide rate has seen a drop, suicide rates in Bhutan have remained steady and rather increased particularly in the recent years.

There’s no single reason why someone may try to take their own life, but certain factors can increase the risk. Someone may be more likely to attempt suicide if they have a mental health disorder.

About 90 per cent of people who commit suicide have a mental illness at the time of their death. Depression is the top risk factor, but there are various other mental health disorders that can contribute to suicide, including bipolar disorder and schizophrenia.

In Bhutan, some of the major contributing social factors identified were lack of job opportunities, broken families, and a high rate of domestic violence. Alcohol and substance use were also found to be contributing factors for suicide according to a study on reported suicide cases in Bhutan published by Ministry of Health in 2014.

According to Bhutan Health Journal, there is an increasing trend of attempted suicide in Bhutan. Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) recorded 72 clinical records of attempted suicide patients from January 2014 to September 2018.

The result showed a higher rate of attempted suicide in females (56.9 %) and highest in the age range between 21 and 30 years. The percentage of patients from the western region of the country was higher (48.6%).

Pre-existing mental health disorders, mostly depressive disorder, was the major underlying cause of attempted suicide (55.5%). The predominant method used for attempted suicide was self-poisoning on medication (76.3%) with the common medicine being Paracetamol.

To prevent attempted suicide and eventual suicide, there is a need to strengthen early detection of depressive illnesses and regulate the accessibility of over-the-counter drugs like Paracetamol.

Meanwhile, RENEW has provided 162,080 different kinds of services to its clients over the years. YDF has 8,000 Youth Volunteers in Action across the country, the network also helped with the efforts to help address the issues of mental health/addiction during the pandemic.

Chithuen Phendhey Association (CPA) has helped on average 200 clients a year struggling with addiction and some persons with mental health issues.

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