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Let’s turn T&T towards mental well-being and care

By Dr Margaret Nakhid-Chatoor
Co-Chair (International Association for
Suicide Prevention/PAHO Conference 2024)

May was Mental Health Awareness Month. Daily, we have become very much aware of the many senseless deaths of persons, including the deaths of very young children, that have created a heavy grief blanketing our country now.

Parents have lost their children to gun violence; children have lost fathers and mothers to murder; and there are numerous unreported cases of domestic violence and abuse that continue unabated in some homes.

Mental illnesses such as depression, anxiety disorders and paranoia are on the rise, due to these and other factors such as crime, poverty, and social isolation affecting family life, decreasing job performance, and increasing sick leave and bereavement leave in workspaces.

There is yet another heaviness that is not spoken about, except in hushed tones or in quiet circles. Suicide. For many parents and caregivers, the prospect of losing a young son or daughter to suicide is an unspeakable fear.

Every week, there are parents and relatives who are traumatised by loved ones—both young and old—who have chosen to end their lives. They continue to wonder why they missed the red flags persons may talk about such as ‘feeling empty, hopeless, having no reason to live, extremely sad, anxious, agitated, or in some cases anger and rage’—unbearable emotional or physical pain that were cries for help.

More and more, young persons are speaking of a hopelessness that surrounds them, like a heavy cloak that they want to take off but cannot—this hopelessness clings to them, interrupting their lives and plunging them into darkness, while worried relatives and friends look on with concern and despair, not knowing what to say again, or how to help their loved one.


Slavery and suicide

Suicide and hopelessness are not new to Caribbean territories. During slavery, men and women killed themselves for several different reasons. Many were unable to cope with the long and traumatic Transatlantic journey, which regularly involved beatings, murder and rape and hoped that death would take them back home to Africa.

Dying by suicide was also an act of rebellion and the crews of slave ships were always anxious to prevent enslaved people from killing themselves because each person who managed to take their own life reduced the voyage’s profits.

Enslaved Africans leapt overboard to drown, jumping into the sea together, holding hands or embracing until the end. This tactic was not as easy as it might seem since many slave ships had to put up netting to stop persons from jumping overboard.

As seen above, suicide happens when trauma exists, in whatever form and circumstance. Different circumstances can trigger emotional distress and suicidality in young people, such as parental divorce or separation, the loss of a loved one, school examinations, relationship issues and experiences of bullying and abuse.

Presently, Guyana tops the list of the highest rates of suicide in the region, with Suriname second, and Trinidad and Tobago, which was in third place, falling back to fifth in the region, with Cuba third and Haiti in fourth position.

In 2019, suicide was the fourth leading cause of death in children and young adults 15–29 years old. In 2024, suicide has moved to second place within this vulnerable group of youths globally and regionally, and the figures continue to rise.

Why are we failing as a society, to protect persons at risk? Can we surround them with netting, or place them in a bubble until the hopelessness ends? What can be done?

Suicide is complicated and tragic, but it is often preventable. Knowing the warning signs for suicide and how to get help can save lives.

Firstly, the stigma that still surrounds mental illness is a significant factor that must be addressed as many persons hesitate to speak out about their struggles, even to trusted relatives and friends. They should be able to do this in safe and supportive spaces where they will not be judged. More stress relief centres should be considered.

Secondly, there is the need for Caribbean territories to reform their mental health policies and practices. Already, young activists led by United Global Mental Health, have come together to draft initiatives towards decriminalising suicide in Trinidad and Tobago.

Guyana has led the way in this, and the Suicide Prevention Bill 2022 not only repealed the law that made suicide a criminal offence but replaced it with a national suicide prevention plan.

Today, Guyana is in the process of establishing suicide prevention centres throughout the country and rolling out public programmes to reduce suicide attempts and reduce the stigma which prevents persons from seeking needed help.

Parliamentarians, policy makers and stakeholders in mental health care in Trinidad and Tobago, take note of the advances being made to address mental illness in this neighbouring country!

Let us turn around our country once more in the direction of mental well-being and care. Let us increase mental health support for persons at a high risk for suicide, and provide training for primary healthcare providers so that they are better able to identify and report signs of mental illnesses such as depression and chronic anxiety disorders.

Let those beautiful Trinity hills that surround us be symbols of HOPE, instead of hopelessness for our people affected by mental illness.