INTRODUCTION:

Often the burden of debt can become too much and it's thought the only option is to commit suicide. It's important that people are aware there are other options and that people can seek help and become debt free. Suicide is a decision many people contemplate because they have a debt problem, however there are solutions and caring people ready to support individuals like counselors, psychotherapist & psychologist.

Difficulty in making hire purchase or mail order repayments and paying off credit card debt, in addition to housing related debt (rent and mortgage arrears), was strongly associated with suicidal thoughts (H Meltzer etal, 2011). The aim of this case study begins with perplexity and seeks out cases under debt and offers illumination. This case study understands some phenomena of interest owing to debts and attempted suicide. Counseling session was ministered for the suicide attempted clients. The remarkable case history and the counseling sessions were jotted in this paper.

Case Study 1:

Client borrowed sum of Rs. 10 lakhs from his friends. He has LIC insurance for Rs. 25 lakhs, which can be claimed only after his death. He decided to die so that LIC amount could claim his debt. Client wrote a farewell letter and mixed insecticide poison with alcohol (Brandy) and consumed it. No significant threatening intended suicidal behavior. Immediately he called his brother in law over through phone reporting the consumption of alcohol with poison and got admitted in hospital. No significant history of pre and extra marital relationship. He is an alcoholic and smoker for the past 10 years (Regular). Initially he started to smoke and consume alcohol (Social drinking) with peer group.

Probing revealed that he had attempted suicide for the third time. First attempt was made before marriage. Second attempt, before 20 years and got admitted for 5 days. Methods used for all 3 attempts were poison.

Trustworthy relationship was created with the client. Self disclosure, restating & focusing techniques were adopted throughout the counseling session. Beck’s Suicidal intent scale depicted medium suicidal risk with total score 17. Based on the score obtained, client suggested for No suicide contract. Alternatives were explored for repaying his debit. Guilt feelings were accepted in non judgmental way. Personal strengths, self esteem & burn out were revealed throughout the session. Client was voluntarily willing to quit smoking and alcohol. Hope & optimism were installed within the client’s cognitive framework. Consecutively No suicide contract (Mutual) was obtained. Next review was suggested.

In review session free association technique was used to ventilate the deeper feelings of the client. His eye contact was reluctant at times. Silence and active listening were used as the therapeutic tool and found to be effective throughout the session. Functionally he is willing to smoke at least while passing stools early morning. Client’s mental short cut revealed that loss in share market business should be repaid by seeking the social support network system (Friends). Written No Suicide Contract was reviewed by both counselor and the client. Client was reassured. Next review suggested through telephone.

Case Study 2:

Client ingested Valium 10 mg tablets 14 in number pertaining to business loss and debt. Thenceforth client had induced vomiting. Suicidal ideations and verbal cues present since two years. Family history of suicide was validated and portrayed committed suicide (uncle). Significant history of multiple substances uses correspondingly alcohol, nicotine and pan masala antecedently for 2-3 months.

Client exhibited resistance, redundant discrepancies of information, profoundly defensive and concealed behavior throughout the counselling session. Questioning technique was used and pertinent solutions were explored by the client. Reality discerns were figured out. Family coping strategies were operated between the spouses. Client further recommended for the Detox treatment. Next review was not suggested.

Case Study 3

Client, her husband and two children attempted suicide owing to debt, borrowed huge amount for weaving and applied for loan. They mixed poison with rice flour made it doughnut and consumed. While eating doughnut client felt bitter taste, irritable throat and subsequently fainted.

In course of initial assessment counselor faced resistance. Hogan grief reaction checklist was adopted to assess the grief response. Client admitted acceptance of grief. Ventilation, silence and catharsis techniques were used for intuitive grief intervention (emotion focused) and further dream analysis were interpreted. Client was reassured. Next review was not suggested.

CONCLUSION:

Those in debt were twice as likely to think about suicide after controlling for sociodemographic, economic, social and lifestyle factors. Feelings of hopelessness partially mediated the relationship between debt and suicidal ideation. The number of debts, source of the debt and reasons for debt are key correlates of suicidal ideation (H Meltzer etal, 2011).

REFERENCES:

1. Zalsman G, Hawton K, Wasserman D, van Heeringen K, Arensman E, Sarchiapone M, et al. (July 2016). "Suicide prevention strategies revisited: 10-year systematic review". The Lancet. Psychiatry. 3 (7): 646–59.

2. Connor RC, Platt S, Gordon J, eds. (1 June 2011). International Handbook of Suicide Prevention: Research, Policy and Practice. John Wiley and Sons. p. 34.

3. Suicide Fact sheet N°398". WHO. April 2016. Archived from the original on 4 March 2016. Retrieved 3 March 2016.

4. White T (2010). Working with suicidal individuals : a guide to providing understanding, assessment and support. London: Jessica Kingsley Publishers. p. 12

5. Shrivastava A, Kimbrell M, Lester D (2012). Suicide from a global perspective : psychosocial approaches. New York: Nova Science Publishers. pp. 115–18.

6. H Meltzer etal. Personal debt and suicidal ideation. Psychol Med 2011 Apr;41(4):771-8.

Received on 31.07.2020 Modified on 25.08.2020

Asian J. Nursing Education and Research. 2020; 10(4):457-458.

DOI: 10.5958/2349-2996.2020.00097.X