Trigger Warning! Reading about suicide may trigger uncomfortable feelings, sadness, or pressures. If you or anybody that you know is having a difficult time or thinking about suicide, it is important to seek help immediately. You are not alone, and there is help available.

10 September is celebrated as the World Suicide Prevention Day. This is the Day initiated by the International Association for Suicide Prevention (IASP) and supported by the World Health Organization (WHO). The celebration is meant to increase awareness about the importance of suicide prevention worldwide, and to promote actions to support mental health.

In Indonesia, the number of suicide is 3.4 per 100,000 population. This is lower than the global average (9 per 100,000 population), but nonetheless the importance of awareness raising.

Suicide data reveals that suicide is a serious global problem. The World Health Organisation (WHO) report indicates that suicide leads to a loss of around 700,000 lives, which equals one suicide per 40 seconds worldwide. Suicide is the main cause of deaths amongst people aged between 15 and 29 globally.

Latest data indicates that there are 971 suicides in Indonesia between January and October 2023. This number is well above the number in 2022 (900 cases). The biggest number of suicide happens in Central Java (356 cases), followed by East Java (184 cases), and Bali (94 cases). The most likely location of a suicide is in residential area (741 cases), and the timing is between morning to noon. Data also suggests that there are 585 cases of suicide between January and June 2023.
Generally, suicide is higher in men than in women. Global data indicates that men are three times more likely to commit suicide than women. In Indonesia, the same trend happens, where the number of men committing a suicide is higher than that of women.

A number of risk factors affect the number of suicide, including mental health problems such as depression and anxiety, misuse of drugs, financial problems, and violence and loss.

Data from the Indonesian Health Suvery (Survey Kesehatan Indonesia or SKI) for 2023 shows that the highest prevalence of people with depression is amongst young people aged between15 and 24 years of age, female and with first-level of education or lower, unemployed, still at school, and worker groups that do not require any skills (labourers, drivers, domestic workers, and so on).

The percentage of people aged between 15 and 24 years of age who think about committing a suicide: 61% young people with depression in the last month have thoughts about suicide, and 1.7% young people without depression have thoughts about suicide.

Prevention may done done through campaigns and programs in suicide prevention by focusing on increasing access to mental health services, increasing community awareness, and reducing stigma about mental health.

Suicide amongst Young People and Social Supports to Young People with Depression
Latest data shows that suicide amongst young people in Indonesia is a serious issue. Based on a survey on "Indonesia - National Adolescent Mental Health Survey (I-NAMHS)" by Queensland Centre for Mental Health Research (QCMHR) and Center for Public Mental Health (CPMH) Gadjah Mada University, 1.4% of young people in Indonesia aged between 10 and 17 years old confess that they have the idea to commit a suicide, 0.5% already make plan to commit suicide, and 0.2% have tried to commit a suicide in the last 12 months.

Data from the Indonesian Police also shows an increase in suicide amongst young people. There are 663 suicide in Indonesia between January and July 2023 – an increase of 36.4% from the same period in 2021.

Many factors affect mental health amongst Indonesian young people – physical, emotional and social change experienced during their youth. Depression, anxiety, and other mental health problems are often the main causes of suicide. It is important to increase mental health awareness.

Young people with depression need a variety and complete social supports from their environment, including family, friends, school, and community. These supports are critical in helping them feel understood, accepted and motivated to seek professional help. The following are forms of social supports needed by young people in depression:

1. Supports from family. Family’s emotional supports, particularly parents or guardians, must reflect that they are ready to listen and to understand without judging. This means that they are willing to listen to their feelings, acknowledge their experiences, and offers love and safety.
2. Create safe environment, by creating safe and supportive environmet around the house where the young people feel safe to express their feelings without fear of being judged or blamed.
3. Validate feelings. It is important for families to avoid disparaging someone’s feelings of depression as "only a phase" or "young people’s mood". Conversely, families should acknowledge that what young people feel is real and serious.
4. Encourage young people to get professional help. Families must help young people to access professional help, like a psychologist or counselor, and encourage them to seek help without feeling shameful or guilty.
5. Supports from peers. Peers’ willingness to listen without giving unwanted advice or judgmental advice may help significantly. The presence of a caring friend may make a big difference for a lonely young person.
6. Avoid negative social pressure. Young people are often confronted with pressures to adjust themselves to certain social norms. Supportive peers should avoid attitudes or words that would add pressures or worsen the depression.
7. Promote positive activities. Encourage young people with depression to participate in fun and healthy activities, such as sports, hobbies, or creative activities, to help them feel more connected and involved with their environment.

A Variety of Other Supports for Youth Mental Health
- Supports from schools and communities by accessing counseling services at school. Schools need to provide trained counsellor able to address mental health, and create friendly environment where youth feels safe to talk about their issues.
- Mental Health Awareness Program. Conduct awareness program at schools to reduce stigma, increase understanding about mental health, and build empathy amongst students.
- Supports from teachers and staff. School teachers and staff must be trained to identify signs of depression and provide needed supports. They can also help by giving ample time for youth to finish school assignments or other necessary adjustments.
- Supports from mental health professionals. Easy access to therapy and counseling. Youth must have access to mental health services, such as psychotherapy, conselling, or group therapy. It is important that they feel safe and cosy to talk with competent and experienced mental health professionals.
-Tailored intervention: mental health professionals may offer tailored intervention for youth with special needs, including Cognitive Behavioral Therapy (CBT), family therapy, or therapy based on mindfulness.
- Support groups for community activities. Support groups for youth: attend support group(s) designed specifically for youth suffering from depression, to give a sense of togetherness and understanding. This allows them to share experience and to support each other.
- Participate in social activities and volunteer activities. Social or volunteer activities in communities may help youth feel connected and useful, reduce isolation and loneliness.
- Build self-confidence and mental resilience. Promote activities to develop skills.involved in activities to increase self-confidence, such as sports, arts, music, or other extracurricular activities, to help youth feel positive about themselves.
- Teach stress management techniques. Provide training or workshop on stress management techniques, such as meditation, yoga, or mindfulness, to help youth address negative emotion in a healthy way.
- Promote honesty and openness. Become an example for emotional openness. Adults around youths, incuding family and teachers, must give examples by talking openly about their own mental health or emotional experience, to normalise discussion about their feelings and mental health.
- Provide accessible resources. Education information and materials. Provide books, articles, videos, and other relevant resources relating to depression and mental health that are accessible by youth and people around them.
Youth with depression can feel understood, accepted, and motivated to seek help, with the rights social supports. The supports are critical to help them fell not alone and allow them to take steps towards recovery with confidence.

Is it True that the Health Insurance does not Cover Death and Physical Injuries resulting from Suicide?
Yes, it is true that the health insurance does not cover costs of treatment after suicide (attempt), including death and physical injuries after suicide attempt. This is rticulated in the Presidential Regullation No. 82 Year 2018 on Health Insurance, that states that the Health Insurance does not cover health services that results from attempts to harm oneself or suicide, criminal activities, and accidents resulting from drug and alcohol use.

This means, if someone suffers physical injuries after a suicide attempt or die after a suicide attempt, all treatment, care, or death claim is not covered by the health insurance. This regulation dictates the kinds of services covered by the health insurance based on the principles of social insurance and prevention of misuse of health services.

For mental health services, the health insurance covers consultation, therapy, and medication needed for mental health issues such as depression, as long as this does not relate to suicide.

Assistance Hotline for Mental Health in Indonesia:
1. Ministry of Health - Halo Kemkes.
Telephone: 1500-567.
This service provides information and referral for mental health, including for crisis situation.
2. Yayasan Pulih.
Telephone: (021) 7884-1918
Yayasan Pulih provides psychological supports and counseling to those suffering from emotional pressures or trauma.
3. Online Counseling Service.
A number of organisations such as Into The Light Indonesia and Sehat Jiwa (Health Spirit) provide online counseling services for those who need support
If you need emergency help: do not hesitate to contact family, friends, or health professionals in your area. They can give you assistance and supports you need. Remember. It is okay to ask for help. Many people care and ready to help you face difficult times. (Ast)