Singapore needs a national suicide prevention strategy to better tackle the issue of suicides here, said Nominated Member of Parliament (NMP) Anthea Ong.

In an adjournment motion in Parliament on Wednesday (Mar. 25), Ong pointed out that there were 1,204 suicides in Singapore per year, on average, between 2017 and 2019. The rate of suicide also increased from 7.74 per 100,000 residents in 2017 to 8.36 in 2018.

Figures likely to be underreporting actual situation

Ong expressed her concern that these numbers are likely to be an underestimation of the real situation in Singapore, given that the Attorney-General's Chambers classifies a death as a suicide only when there is clear evidence of suicidal intent and self-harm.

"From my interactions with suicide-bereaved parents, the cause of death is sometimes categorised as ‘fall from a high place’ or ‘unnatural death’ – and also labelled as such on the requests of family. In addition, we must also not forget that for every suicide and attempted suicide we know, there are many more people struggling with self harm and suicide ideation that we have little data on."

Further, while these numbers may not seem high by international standards, Ong felt Singapore is "still not doing enough" because the number of deaths by suicides in Singapore has remained relatively unchanged from the 1980s (9.5 suicides per 100,000 residents) till now (8.3 suicides per 100,000 residents).

Having a national suicide prevention strategy, therefore, will help Singapore bring down the suicide rate, she argued.

"According to (the) WHO, such a strategy is important as it indicates a government’s clear commitment to prioritising and tackling suicide, while making resources available for necessary interventions."

Suicide is "not a selfish choice" & cannot be blamed on the individual

Ong also noted a few previous positions the government and other MPs took on discussing suicide, such as in schools, expressing her concern that this position may disagree with that held by experts.

With respect to talking about suicide in schools, for instance, Ong noted that it was previously said that bringing up suicide numbers in schools may heighten the risk of suicide in vulnerable youth, but pointed out that youth already consume a lot of media online about mental health and suicide.

She said that anecdotally, students are often already in the know about their peers' mental health and suicidal thinking, hence backfiring on any school's attempts to keep student suicides under wraps.

"The expert consensus is that to have a chance at preventing suicide, we must talk about suicide responsibly."

Turning to the decriminalisation of attempted suicide and how various individuals said in Parliament that it may incentivise suicide, as well as previous concerns raised about allowing people to claim from MediSave and MediShield Life, Ong argued that these views "perpetuate the stigma by shrouding suicide in exclusion".

"Experts indicate that incentives for help-seeking are helpful in combating stigma , allowing those who are struggling to feel more comfortable in seeking support."

Ong additionally argued that the mentality of suicide being a selfish act should be relooked.

"My cousin, who has attempted suicides several times, often shares that he feels that he’s a burden to his family, including me, even as he acknowledged that he knows how much we love him. Studies have shown that people who attempt to take or took their own lives commonly feel that their lives hamper others, viewing their decisions as relieving their loved ones... This is the reality of suicides, and those who succumb can hardly be labelled as selfish."

Things S'pore govt can do to lead & coordinate efforts to prevent suicide

Ong made a few suggestions for immediate actions the government can take to act more decisively against suicide:

1) Expand funding for SOS

Not just for them to operate our national suicide helpline, Ong said, but also to ensure they are able to do timely follow-ups with callers who need more support.

Increasing resources for mental healthcare services can also help address wait time and patient load challenges.

2) Start tracking hospital admissions that arise from attempted suicides

This can better help coordinate the continuity of care for folks who are picked up by the healthcare system when they attempt suicide.

Ong also noted that the collection of data from suicide attempts is no longer required under the criminal code since suicide was decriminalised at the start of this year.

However, she added, the lack of such data limits Singapore's ability to developed "informed strategies", calling for coordinated data collection and surveillance into suicides and attempted suicides across government agencies and community partners.

3. Provide post-suicide intervention support & create protocols for suicide for students

Moving on to teenage suicides, Ong pointed out that suicide is now the leading cause of death for those aged 10 to 29.

This calls for post suicide intervention support, she said, because families, friends, and students in schools will have to grapple with trauma and grief when a student commits suicide.

Ong then called on the Ministry of Education to lay out its suicide protocols clearly so that it can help parents and students confront the increasing suicides among teenagers.

Tackling suicide as a community

Ong also suggested various ways that the community can come together to tackle suicide.

People need to be better educated about the waning signs of suicide and this can be done through public education programmes in schools, workplaces, and communities.

With suitable suicide-first responder training, key "gatekeepers" like the police, teachers, grassroots leaders can intervene in suicide attempts.

Community support groups like SOS, Please Stay, and Caring for Life also play a part in bringing together the community in tackling suicide.

As good as these measures are, they are not effective without a national strategy, said Ong:

"Without a national strategy for these efforts to align to, we risk having a fragmented and sub-optimal approach to supporting survivors and bereaved parents."

Working towards Zero-Suicide Singapore

Ong then concluded with a call to the government to initiate a ​National Suicide Prevention Strategy with a vision towards a ​Zero-Suicide Singapore.

"We must stand firm in the belief that suicides are preventable and commit to the efforts in making that possible," she said.

"When it comes to loss of lives — human lives​, nothing short of zero has ever been good enough for us."

Top images via Pexels and screengrab from YouTube.