Affriming Spaces, Breadth of Knowledge, Confidentiality and Digital Security; The ABCD Of Online Counselling
MARPS in Uganda initiated the Online Trauma, Identity, Sexuality & Suicide Support Services-OTISSSS an online platform providing fifteen sessions per person and we first targeted beneficiaries who had HIV and those who contemplated suicide. We operate at:
We have also gone a step further to provide a second option at:
With these two options, we are able to handle the traffic as it comes our way.
Suicide as well as the fact that all our beneficiaries cited a common experience that counselling options are affected by the cultural-social-economical contexts, are issues that prompted us to start the online platforms. The WHO estimates that globally there are at least 20 suicide attempts for every success, meaning that there are least 20m and rising. In a study done in Oxford UK, 864 people that attempted suicide (and survived) were asked to rate, on a scale of 1 to 30, how intent they were on killing themselves (where 30 was totally intent, and 1 was hardly at all). Two thirds of people that try to kill themselves are not that intent on succeeding. Maybe there's a part of them that wanted to end it, and a part didn't, and due to some event that tipped them over the edge, they tried to commit suicide. Suicide is a major problem. We are living in a society where more and more people are considering suicide. Second, note that anyone thinking of trying to kill themselves is much more likely to screw it up than succeeding. The odds globally are at least 20 to 1 against, and in the US quite possibly 33 to 1 against or higher. And many of those unsuccessful attempts end up with people having nasty short or long term health implications. And third, many people who actually try and commit suicide say after the event they weren't that intent on doing it. Many people attempt suicide on impulse, and then end up living with serious health implications. This is why we came up with these tools to target people who wanted to have someone to talk to. For more on suicide support, one can read these resources:
http://lostallhope.com/suicide-statistics; https://crisiscentre.bc.ca/volunteer/administration/; http://www.webmd.com/depression/guide/depression-recognizing-signs-of-suicide#1; https://www.cdc.gov/violenceprevention/suicide/index.html; https://www.academia.edu/5929748/RESEARCH_PAPER_ON_SUICIDE; research paper.essayempire.com/topics/argumentative-research-paper-topics/suicide-prevention/.
According to the British Columbia’s Crisis center website, those at risk for suicide do not necessarily want to die, but do want help in reducing the pain they are experiencing so that they can go on to lead productive, fulfilling lives (https://crisiscentre.bc.ca/volunteer/administration/).
According to Letmin Jose Gangte (2013), when we talk about suicide, we need to break it down to ascertain a cause and effect relation. There are definitions and types of suicide.
The Oxford English Dictionary defines Suicide as an act of taking one’s own life; one who dies
by his own hands, self-murder.
1. Suicide is the process of purposely ending one's own life. Emile Durkheim defines suicide as follows:
“…the term suicide is applied to all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result.”
2. The great nineteenth century French sociologist Emile Durkheim, in his book, Le Suicide (1897) illustrates the types of suicide. He discusses four different kinds of suicide: Egoistic suicide, Altruistic suicide, Anomic suicide and Fatalistic suicide.
1. Egoistic Suicide:
Egoistic Suicide according to Durkheim, is caused by lack of social integration of society in the religious sphere, domestic, and the political sphere. The more weakened the groups to which one belongs, the less one depends on them, the more one consequently depends only oneself and recognize no other rules of conduct that are founded on his private interests. The individual ego asserts itself to the excess in the face of the social ego and at its expense; it may be called egoistic the type of suicide springing from excessive individualism.
2. Altruistic Suicide:
Altruistic Suicide is characterized by a sense of being overwhelmed by a group's goals and beliefs. It occurs in societies with high integration, where individual needs are seen as less important than the society's needs as a whole. If excessive individuation leads to suicide, insufficient individuation has the same effects. When a man has become detached from society, he encounters less resistance to suicide in himself, and he does so likewise when social integration is too strong. Bartholin, in his book reports that Danish warriors considered it a disgrace to die in bed of old age or sickness, and killed themselves to escape this humiliation. The Goths likewise believed that those who die a natural death are destined to languish forever in caverns full of venomous creatures. So old men would throw themselves from the high pinnacle called ‘The Rock of the Forefathers’ and accordingly they assigned a delightful abode to those who committed suicide.
3. Anomic suicide:
This type of suicide is due to certain breakdown of social equilibrium, such as bankruptcy or after winning a lottery. In other words, anomic suicide takes place in a situation which has cropped up suddenly. It reflects an individual's moral confusion and lack of social direction, which is related to dramatic social and economic upheaval. It is the product of moral deregulation and a lack of definition of legitimate aspirations through a restraining social ethic, which could impose meaning and order on the individual conscience.
4. Fatalistic suicide:
Fatalistic suicide is the opposite of anomic suicide. It happens when a person is excessively regulated, when their futures are pitilessly blocked and passions violently choked by oppressive discipline. It occurs in overly oppressive societies, causing people to prefer to die than to carry on living within their society. A good example would be that some people prefer to die than live in a prison with constant abuse and excessive regulation that prohibits them from pursuing their desires. This type of suicide is due to overregulation in society.
We know that depression carries a high risk of suicide. Anybody who expresses suicidal thoughts or intentions should be taken very seriously. So, we hoped that by providing these platforms beneficiaries will not hesitate to call our suicide platform immediately.
According to the WebMD site, men take their lives nearly four times the rate of women. Risk factors for suicide vary by age, gender, and ethnic group. And risk factors often occur in combinations. Over 90% of people who die by suicide have clinical depression or another diagnosable mental disorder. Many times, people who die by suicide have an alcohol or substance abuse problem. Often they have that problem in combination with other mental disorders. Adverse or traumatic life events in combination with other risk factors, such as clinical depression, may lead to suicide. But suicide and suicidal behavior are never normal responses to stress.
Other risk factors for suicide include:
• One or more prior suicide attempts
• Family history of mental disorder or substance abuse
• Family history of suicide
• Family violence
• Physical or sexual abuse
• Keeping firearms in the home
• Chronic physical illness, including chronic pain
• Exposure to the suicidal behavior of others
There are warning signs that someone may be thinking about or planning to commit suicide include:
• Always talking or thinking about death
• Clinical depression -- deep sadness, loss of interest, trouble sleeping and eating -- that gets worse
• Having a "death wish," tempting fate by taking risks that could lead to death, such as driving fast or running red lights
• Losing interest in things one used to care about
• Making comments about being hopeless, helpless, or worthless
• Putting affairs in order, tying up loose ends, changing a will
• Saying things like "it would be better if I wasn't here" or "I want out"
• Sudden, unexpected switch from being very sad to being very calm or appearing to be happy
• Talking about suicide or killing one's self
• Visiting or calling people to say goodbye
Be especially concerned if a person is exhibiting any of these warning signs and has attempted suicide in the past. According to the American Foundation for Suicide Prevention between 20% and 50% of people who commit suicide have had a previous attempt.
When all members have gone through the fifteen sessions, they are then asked to join our Whatsapp Group at +1415-707-9564. We have a total online membership of 7,700 members at all our different platforms as of 2016 from almost all countries in Africa. We also encourage formation of viable physical groups among members who stay in areas not for from each other. This helps to build both the virtual and reality groups. It also enables people to process group dynamism well. Our groups have reached a naming and performing point. We did rely on peer-to-peer respondent recruiting methods at first and this helped us build our numbers easily. The participants we work with come from countries with unprecedented levels of backlash against many forms of organizing. Digital security is therefore an imperative for us. We have developed thematic topics on a matrix and we call these cues. We use cues to help keep all of us focused on given topics. We explore topics as counselling cues and also as discussion points at out group meetings. We encourage debate, we encourage spontaneity and we have mentors who guide members and give the last word.
We have discovered that it is possible to allay fears, build trust, improve on one another's self-worth, integrate and implement best practices all the while when one has just used say, USD 1 per month! We have learnt that most people need to be given time for behavioral changes to take place. When we had just started many members liked to add sexually explicit memes to our conversation files. We didn't stop them but we did not encourage it. So, we kept bringing the ground rules and also encouraging participation by all. We also chose to separate members into smaller groups of 50-200 and assign five mentors. We hope this assures participation, attention and the right emotional space in which members can grow mentally and physically. Our approach addresses all aspects of members lives and examines how their understanding of topics impacts their well-being, their roles in relating with one another and in their communities. The themes we chose are day to day themes and we are sure they are integrated within activists’ sense of wholesome security.
Online balkanization is a new venture in socialization and we hope that as people can access smart phones, it will be another form of collectivism or cooperation which will empower individuals in skills such as: intercultural communication, self-worth development, interpersonal and intrapersonal relation skills. Our members can now contribute confidently to our common work. We have seen members whom we at first used to prod, turn out to take initiative to start discussions about a wider range of themes and be there when winding up. We encourage individual initiative as long as it is in line with the themes we share at the beginning of the every session which lasts 24 hours. Since 2014, we have covered 1,825 topics ranging from negotiated sex agreements to income generating activities. We have averted 190 suicide attempts so far.