Papali’i Tiumalu Caroline Paul-Ah Chong
Executive Director Fa’ataua le Ola/Samoa Lifeline
World Health Organisation (WHO) documented research on suicide, states, “Suicide is a major public health problem, with far-reaching social, emotional and economic consequences.
There are approximately one million suicides a year worldwide, and it is estimated that around six people are affected by each death; the world suicide average is 1 out of every 10,000.”
In Samoa, the expected rate of suicide is 20 per year. If the recorded stats, on any given year, are below 20, Samoa is relatively well off, albeit there should still be reason for concern. However, if a rate higher than 20 is recorded, it should generate major concern and an immediate response within our society to do something about the problem.
Suicide is never the result of a single factor or event. It should never be considered as a means of coping with personal problems. It should never be regarded or dealt with in a simplistic way. Society, religious beliefs, culture, family, mental illness, depression, and the specific struggles of individuals, adults and adolescents alike, are factors that can have a diverse effect on this grave issue of suicide. Media reporting also plays a major role and can compound the issue by creating an adverse effect on society.
WHO further states: “The factors contributing to suicide and its prevention are multiple and complex and not fully understood, but there is evidence that the media plays a significant role. On the one hand, vulnerable individuals may be influenced to engage in imitative behaviours by reports of suicide. On the other hand, responsible reporting may serve to educate the public about suicide, and may encourage those at risk of suicide to seek help.”
In the late 1970s, suicide rates soared and by 1981, Samoa was rated 3rd highest in the world and 1st in the Pacific. For the next 10 years (1980 to 1990) annual suicide figures peaked at 49, or 34 per 100,000 persons.
The youth suicide rate was of particular concern. Women under 25 had the highest rate of 70 per 100,000 persons. Men under 25 were second in the world, at the rate of 64 per 100,000 persons. This contrasted with the suicide totals of less than 10 in the early 1970s. Between 1990 and 2000 suicide rates continued to fluctuate between 30 and 40.
In February 2000, the Minister for Health Misa Telefoni and a group of concerned citizens formed a committee to address the issue of suicide. In May 2002, Faataua Le Ola (FLO) was birthed and an Ex Council was set up to drive the organisation.
It became registered as an Incorporated Society in October 2002. In November of the same year, FLO became affiliated to Lifeline International and Samoa Lifeline came to fruition.
Between 2002 and 2004 FLO was in its infancy years and the Ex Council focused on defining its vision, mission and goals, and establishing the organization and its operations.
From 2005 to 2010 there was a marked reduction in completed suicide cases in Samoa, evident in annual statistics shown as follows:
2005 – 10 / 2006 – 15 / 2007 – 13 / 2008 – 9 / 2009 – 4 / 2010 – 11.
2011 – 2012 FLO discontinued its work due to operational difficulties.
2013 – Operations resumed but no data was recorded.
2014 – 5 / 2015 – 23 / 2016 (Jan to June) - 11
The rate of suicide in Samoa has decreased markedly since it peaked in 1980.
However, public awareness, or lack thereof, points to a need for resources for suicide prevention.
Faataua Le Ola has many suicide prevention programmes in place, but there are still unanswered questions pertaining to these programmes: How effective are these programmes? What are the strengths of these resources? What are some difficulties these programmes are experiencing?
Since Faataua Le Ola opened its doors in 2002, suicide prevention programmes have grown from strength to strength and yet the incidence of suicide has continued to fluctuate from year to year, without a clear pattern as to why this is happening.
Faataua Le Ola is about suicide awareness and prevention and social issues which could lead one to contemplate the unthinkable. We are all about saving lives! FLO’s logo depicts the words: “Tino/Body – Mafaufau/Mind – Agaga/Spirit” which is the essence of and the 3 components that drive a human being. These are the areas that FLO works with in trying to help people in distress, thereby counselling them away from taking measures which could harm them.
FLO looks at all possible areas of conflict within an individual’s life - relationships, parenting, depression, incest, gender based violence, bullying in schools, cyber bulling, violence between schools and many other social issues which could lead a person to contemplate suicide.
FLO conducts its Suicide Awareness & Prevention Outreach Programmes and Workshops in schools, church communities, village communities in both Upolu and Savaii.
These educational programmes are run every month at different venues in an effort to deliver FLO’s message of “valuing one’s life” and encouraging people who are troubled to seek help instead of believing that suicide is the only solution to their problems.
The youth and parents are especially targeted to attend these awareness programmes in the hope that FLO’s message of valuing one’s life is received in a positive and constructive manner.
FLO also conducts counsellor training workshops which are open to the public. The goal is to train and recruit interested people from all walks of life in Samoa, to be certified with basic counselling skills.
As certified counsellors, they are able to work within their own communities to counsel people needing help and providing them with coping strategies when faced with stressful situations.
FLO offers a face to face counselling service at its office premises located at the ground floor of the John Williams building, Tamaligi. Its doors are open from 8am to 5pm Monday to Saturday.
FLO also offers a 24 hour/7 days a week toll free phone counselling service, Samoa Lifeline 800-5433. Other services include “post vention” (counselling) visits to families of victims of attempted and completed suicides.
FLO has documented that the majority of suicide cases derive from family conflicts.
In Samoan society, family connections and one’s identity is of utmost importance and the severing of this connection and communication with family members is a significant risk factor for suicide. FLO’s suicide prevention programmes focuses on strengthening one’s family connections, communication and relationships. In the past several years, attempted and completed suicide stats document the highest incidences amongst the youth.
FLO is paying special attention to the issue of youth suicide and seeking to find reasons behind this dilemma, thereby ascertaining possible solutions to this grave problem.
Higher standard of education, intergenerational conflicts between parents and children, and globalization could more than likely be contributing factors. The family institution is being shaped and reshaped in a rapidly and ever changing world.
Over the past 20 years this has undoubtedly created huge gaps within the Samoan family unit, and the youth especially are being challenged as they experience conflicts between their cultural upbringing and the western/modern mode of thinking.
FLO addresses these issues and looks at ways to resolve these problems through its outreach programmes and family counselling sessions.
Counselling techniques and training, the role of Christianity, the role of the family, mental illness and suicide, and many other social issues have the potential to affect the future of suicide prevention in Samoa.
Conflicting religious beliefs can play an integral part in this issue of suicide and whilst religion may be a useful tool in suicide prevention, conflicting beliefs and / or total reliance on religious practices may override the core issues that need to be addressed. Unaddressed depression is one of the main factors contributing to suicide attempts in Samoa.
As documented, around 60% of FLO’s clients seek help because they are depressed and more than half admit to having suicidal thoughts. Often, the stigma surrounding depression and the issue of suicide prevents people from seeking help and support in times of need.
Depression is a debilitating illness, a chemical imbalance in one’s brain, which can cause one to be incapable of doing ordinary everyday activities.
It is nothing to be ashamed of and it should not be treated lightly. It can be and should be treated with medication, therapy and counselling. This generates positive results which render an individual to immerse him or herself back into society.
Education is a major factor in addressing and resolving the stigma surrounding depression and suicide.
If people understood that depression is an illness, that there is help available for those experiencing stress and difficulties in life, that one should value one’s life and suicide should never be an option, then FLO’s services, offered free of charge, may be sought after and utilized more than it currently is.
Suicide data collected by FLO, in collaboration with the Ministry of Health and the Ministry of Police, over the past years from 2002 to date, may under represent the actual rate of suicide, due to the cultural and legal issues surrounding suicide in Samoa.
To further compound the issue, there have been discrepancies in suicide data records (attempted and completed).
Cultural issues surrounding suicide e.g. religious implications, the stigma surrounding suicide, can cause families and/or officials to under report suicide and issue the cause of death as something else other than suicide.
Faataua Le Ola, the Ministry of Police and the Ministry of Health each have their own data collecting scheme.
FLO and the two ministries are taking steps towards working collectively in the areas of suicide reporting and data collection and in partnership in an effort to stamp out the scourge of suicide from our society.
FLO would like to see the following measures implemented and realized in the near future as a means of achieving its goal of a suicide free Samoa:
*A reporting system set up to monitor suicidal behavior in Samoa.
*Conduct research on suicidal behavior in Samoa by exploring the trend of suicide and establishing risk and protective factors.
*Explore the impact of family, culture and religion on suicide.
*Research the relationship between depression, mental disorders and suicide.
*Coordinate culturally responsive suicide prevention measures to reduce suicidal behavior, especially amongst the youth in Samoa.
*Implement Media Training Workshops for responsible reporting of suicide.
*Training for professional personnel (e.g. psychiatrist, psychologist, social worker) to be made available in Samoa through its learning institutes, or through offered scholarships.