On World Suicide Prevention Day: Because Emotional Self-Expression Is Not Part Of Bhutanese Culture

Kamana Khadka, MPH

  

“Golden Gate Bridge board Oks $76 million for suicide barriers,” read the headline in SFGate.

Despite the controversies regarding $76 million investment in creating 20 feet steel-cable suicide net, I would like to congratulate Mr. Roger Grimes who started the campaign for suicide barrier at the Golden Gate Bridge.  It was reported that he regularly walked on the bridge with a sign reading, "Please care: support a suicide barrier" in addition to attending several meetings.  While I do hope that placing the barrier will prove to reduce suicide rate and bring peace to family members of 1600 individuals who jumped to death from the bridge; I cannot help but begin to imagine the ethnicities (often minorities) of individuals who will be involved in labor intensive and risky (perhaps hanging off the bridge in the thin air while placing the suicide barrier) jobs during actual implementation of the project.  I would also like to point the fact that according to Centers for Disease Control and Prevention (CDC), in 2010, the most common methods of suicide were firearms (50.6%), suffocation (including hangings)  (24.8%), and poisoning (17.3%). Sarcasm apart, I certainly do hope that this million dollars project will be successful in raising increased awareness about suicide in general including minority communities such as the Bhutanese in U.S.

Suicide is among the top 10 causes of death in America.  According to CDC the reported suicide in 2011 (most recent year for which data are available) was 39,518. The numbers drastically changed for U.S. post Bhutanese refugee resettlement.  The global suicide rate is 16 per 100,000.  For general population, U.S. rate is 12.4 whereas its 20.3 for Bhutanese. 

"If you treat them, what are you treating them towards? If you treat them to sit in a chair all day and do nothing, what’s the treatment?"

–      Ken Thompson, Squirrel Hill Health Center

I not only work closely with the Bhutanese community in Arizona, but having been born in Nepal, I share a common language and culture with them.  And because we speak Nepali (common language), often times I pitch in as a Qualified Nepali Interpreter (one who received training to become an interpreter).  My personal opinion is that, yes, it is a mental health situation, but working through trauma, depression, and post-traumatic syndrome disorder with the Bhutanese is not the only concern here.  It is very important that we find something to engage them here in the U.S. as they start their new lives.  It is wrong that 45 minutes counseling session, often with an untrained Nepali interpreter (who omits and adds to what is being said in the room leading to inaccurate interpretation) is the only solution for a Bhutanese man who once the breadwinner and role model for his family (in Bhutan and Nepal), cannot find a job in U.S. to provide for his family and is dependent on his English speaking child for simple conversations with the outside world.  We leave him hollow, helpless, and depressed outside the session, outside the hospital, and outside the home visit.

 “Most suicide decedents were generally unemployed men who were not providers of their family; the most common post-migration difficulties faced by the victims were language barriers, worries about family back home, and difficulty maintaining cultural and religious traditions,”

– Centers for Disease Control and Prevention