Dr Ming-Been Lee is an international expert on suicide prevention. He is professor of psychiatry and social medicine at the National Taiwan University College of Medicine. He was the 30th president of CMAAO (Confederation of Medical Associations in Asia and Oceania) before he handed over his role to Dr Vinay Aggarwal on September 12 at an event held in New Delhi.
Dr Lee’s major research areas are clinical psychiatry, medical psychology, medical ethics, health communication, psychosomatic medicine and human behaviour.
In an exclusive interaction with India Medical Times, Dr Lee shared his views:
There is a rising cases of medicos’ suicide in India. What is your view?
I think one of the most pressing reasons is that people are under severe stress, depression, anxiety or substance abuse. There are a growing number of cases in the world and 75 per cent of the cases are centred on the Asian region.
The reasons could be varied — loneliness and alcoholism to depression and economic factors.
The number of suicide attempts among the youth in India and in developed nations is increasing because this is the group that is at the highest risk the world over due to a number of factors, such as youth being more impulsive. Most of the youths today are suffering from an undetected and unidentified psychiatric disorder.
Medical students are under constant pressure of performing and they usually get stressed because of huge load, job anxiety, higher expectations and more pressure to achieve is the concern they always face. Changes in the social structure and lack of interpersonal touch could be one of the contributing factors to increasing vulnerability of the young. A little flexible curriculum could be of great help to them. Not only among the youths, the number of suicides across age groups has also been increasing.
What steps need to be adopted in order to reduce the number of cases?
According to our data, 90 per cent of people suffering from depression not only have behavioural symptoms but also frequently complain of stomach-aches, headaches and back pains. And the suffering patient himself doesn’t know that he is actually suffering from depression. A physician can play an important role in checking for such symptoms. The trouble, depression, anxiety, inferiority complex can be screened by a doctor. So, I think awareness on the part of physicians is very important. Physicians and other primary care providers need to be aware of the signs of suicide and feel comfortable addressing the issue with their patients.
In today’s world, when there is cut-throat competition for jobs and tremendous peer and parental pressure to perform well, often even petty things can affect the youngsters’ psyche. Awareness and healthy competition among students should be promoted.
In Taiwan, we have open awareness and education programmes for public. They are urged to go and see the doctors for any destructive feelings they are going through. In Taiwan, we recognize suicide as a public health problem. We have national suicide prevention centre. All suicide attempt cases require to be reported to the government within 24 hours. So, the promptness needs to be shown on the part of government. Taiwan is the only country to have such a system in place.
No such symptom of suicide should be ignored. People should talk, communicate. Youngsters should socialize and think rationally. But suicide prevention needs a multi-disciplinary approach. It encompasses all kinds of interlinked efforts from home to school, college and office. Anyone could be suffering from stress and similar disorders. We all need some support and care.
What are your initiatives towards this year’s theme of CMAAO on child abuse and neglect?
These days with increasing reports of child abuse, parents and guardians need to take a few elementary precautions and safeguard kids from becoming victims. And if anything unfortunate occurs, it is always better to spot the abuse symptoms at the earliest and put the child at ease. ‘Child Neglect’ is stated to occur when there is failure of a parent/guardian to provide for the development of the child, when a parent/guardian is in a position to do so.
Mostly neglect occurs in one or more areas such as health, education, emotional development, nutrition and shelter. Child maltreatment, sometimes referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect and exploitation that results in actual or potential harm to the child’s health, development or dignity. We need a legal act and interventions on the part of government. In Taiwan we have this kind of law. Of course, laws would not be enough. Something needs to be done at the societal level too.
Patients expect us physicians to provide them with the best-quality care possible. So, CMAAO activities are based on humanitarianism and are intended to contribute to healthcare, health management and health systems for all the people in each region. In addition to this, we believe that our humanitarian activities need to be continued and carried out. We keep the same objective in mind when dealing with the themes of CMAAO, which are carefully chosen and require attention.
Your message to the readers?
I think doctors can play a great role in giving right guidance to the person suffering from depression. In case of child abuse, a paediatrician and a psychiatrist have important role to play. If a doctor comes across unnatural sort of surgery or burns in children they should not hesitate in taking actions. They should report it to the concerned authorities. We doctors can be watchdog too.
Physicians are frequently identified as the individual to whom gatekeepers would refer people at risk for suicide. Physicians, in collaboration with other community leaders, can play an important role in reversing the suicide trend. They can learn to identify patients who are at high risk for suicide and take appropriate actions to reduce those risks and potentially prevent a patient’s death. So, we have to be aware, sensitive and conscious of things happening around us.
by Vidhi Rathee