First, it was fashion designer Kate Spade. Then celebrity chef Anthony Bourdain. In only three days, the world recently lost two notable names whose deaths had one thing in common: apparent suicide.
High-profile celebrity suicides like those of Spade and Bourdain are not unprecedented. Just last year, American musician and Linkin Park lead vocalist Chester Bennington ended his own life by hanging. In 2010, renowned fashion designer Alexander McQueen killed himself by similar means after reportedly taking a mixture of cocaine, tranquillisers and sleeping pills. Among the most shocking cases was comedian Robin Williams, who committed suicide in 2014.
Thailand also has seen suicidal deaths among famous names in the past. In 2002, singer Amarin "Jo" Luangboriboon of rock band Pause was found dead from a single gunshot wound to his right temple. The following year, Bundit "Tar" Dejkunchorn of boy band Dr Kids also ended his life, by hanging himself while in a depression.
Suicides among celebrities, especially the most recent cases of Spade and Bourdain, highlight an ongoing troubling situation of mental-health issues globally, said psychiatrist and suicide prevention expert Asst Prof Dr Prakarn Thomyangkoon of the Psychiatric Association of Thailand.
"Of course, when we see celebrities kill themselves, it reflects the fact that their lives and their worlds are actually not as complete as we imagine. People of wealth and fame may still feel short of something inside. But apart from that, what we must not overlook is the issue of mental illness. A large number of people who commit suicide have depression or problems of drug abuse."
There are endless cases that can be mentioned here in support of Dr Prakarn's statement. After Spade's suicide, her husband Andy Spade revealed that his wife had long suffered from depression and anxiety. Bourdain was also reported to have fallen prey to depression. Talinda Bennington, widow of the late Linkin Park frontman, spoke out after her husband's death about his battle with depression. And despite his award-winning roles in various films, Robin Williams had been known to have suffered from depression throughout much of his adult life.
Despite years of campaigning, suicide is still a worrying public-health issue. The World Health Organization (WHO) listed suicide as the second-highest cause of death among people aged between 15 and 29. The WHO also reported more than 800,000 people committing suicide annually around the world. In the United States, around 45,000 people took their own lives in 2016, an alarming rise of nearly 30% since 1999, according to statistics from the US Centers for Disease Control and Prevention (CDC).
Now back to Thailand. According to Dr Prakarn, Thailand saw around 6.3-6.4 people successfully committing suicide per 100,000 in 2017, an equivalent to approximately 4,000 a year. The number is relatively low when compared to the global suicide rate of around 10 people per 100,000. Setting aside these success cases, Dr Prakarn revealed that an estimated 20,000-30,000 cases were found in 2017 to be failed suicide attempts, which could lead to physical disabilities and other complications.
What's more worrying is that 50-80% of successful suicides have depression to blame.
"We say mental illness has become more acceptable in society. But the truth is that visiting a psychiatrist is still a stigma, especially among patients. Like high blood pressure or diabetes, some mental diseases require lifelong medication and doctor consultation. And it's a problem here because no one wants to be looked at as a mental patient forever. This is especially the case for celebrities, whose public image is something they hold on to," said Dr Prakarn, also president of the Suicide Prevention Club of Thailand.
High-profile celebrity suicides can also lead to copycat suicides, added the psychiatrist, citing data collected after Robin Williams killed himself in 2017. It was found that following his death, the number of suicides among males aged from 30-44 years old increased by almost 13%. Shockingly, 32% of those cases were reported to have copied Williams' suicide technique.
"Here, the media should be urged to publish as little detail of suicide technique as possible to prevent suicide from being contagious," he added.
There's still some good news, though. Mental-health support programmes or campaigns both from the state and private sectors have been found to alleviate suicide problems.
"Take Japan, for example," explained Dr Prakarn. "They set up a public campaign to provide counselling for those suffering sleeping difficulties. Though this was a very broad movement, it did reach out to those with mental-health issues and suicide possibility. Many years ago, Japan saw around 23-24 people out of 100,000 committing suicide. After the campaign, the number plunged to only 18."
Thailand has set its suicide-prevention target to lower the number of cases to below six per 100,000. And to reach the goal, several initiatives have been put in place. The National Centre for Suicide Prevention under the Ministry of Public Health's Department of Mental Health is at the forefront in suicide prevention. Last year, they released an app called Sabaijai, which serves as a platform to provide advice and assessment in association with suicide. Developed by Khon Kaen Rajanagarindra Psychiatric Hospital, the app is available in Thai both on the App Store and Google Play.
The Psychiatric Association of Thailand also organises activities every year in September to raise understanding and public awareness regarding suicide prevention. Suicide prevention hotlines like 1323 of the Mental Health Department and 02-713-6793 of the Samaritans Thailand, an association to provide telephone counselling, are also available as part of the much-needed aids.
But while support is there to be accessed, patients as well as those around them must bear in mind that mental-health issues, especially depression, are likely to lead to suicide if left unattended. Therefore, the stigma that comes with the diseases as well as psychiatric visits should be erased once and for all.
"A lot of studies and research have revealed that mental illnesses are not just emotional conditions. They are the result of interrupted neurotransmitters or the abnormality in the brain. To put it simply, mental-health illnesses are sicknesses. And they therefore need to be treated."
