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Sumithrayo reflects on 49 years of befriending

Sumithrayo reflects on 49 years of befriending

07 Jun 2023 | By Shailendree Wickrama Adittiya

Sumithrayo Founder Joan de Mel

On 15 June 1974, Joan de Mel established Sumithrayo as Sri Lanka’s first crisis centre, and over the last 49 years, Sumithrayo has made its way to the forefront of suicide prevention, providing confidential emotional support.

Sumithrayo describes its service as befriending, which is the art of actively listening to troubled feelings and helping distressed people explore healthy options which can ultimately lead to empowerment and a positive approach to life’s issues. The organisation bases its values on three beliefs: The importance of having the opportunity to explore difficult feelings, that being listened to in confidence and accepted without prejudice can alleviate despair and suicidal feelings, and that everyone has the right to make fundamental decisions about their own life, including dying by suicide.

Speaking more about their work, Sumithrayo shared that the organisation was established on the same principles and practices of the Samaritans in the United Kingdom (UK). Samaritans Founder Chad Varah inquired from Joan de Mel in 1971 about the need for a similar service in Sri Lanka, given that the latter was leaving London to get married and settle down in Sri Lanka.

“Starting a new life in Sri Lanka, Joan was hesitant. However, later in Colombo, with much encouragement from her husband, the first crisis centre of Sri Lanka, Sumithrayo, was established in 1974 as the 11th Branch of Befrienders International, the international arm of Samaritans under the patronage of President William Gopallawa,” a Sumithrayo member, who wished to remain anonymous given the sensitive nature of the work carried out by the organisation, shared.

As Sumithrayo marks 49 years of service in Sri Lanka, The Daily Morning Brunch took a closer look at the organisation and the importance of the services they offer.

Sumithrayo is celebrating its 49th anniversary this year. How has the organisation and also its services changed over the years?

With the passage of time, Sumithrayo has expanded its services to meet emerging needs. Since 2005, Sumithrayo has provided befriending services via email, and in the recent past, used WhatsApp as a communication tool for befriending on an appointment basis, especially for those seeking support from overseas and who are unable to afford a lengthy overseas telephone call. In addition, during the past few years, Zoom, Facebook, Instagram, and YouTube platforms have been used to create awareness and disseminate information.

Without being confined to its walls, Sumithrayo also promotes emotional wellness and suicide prevention through community outreach, education, and prevention services. Awareness and education programmes are set up to change the attitudes and values of the community regarding the practice of suicide and also minimise the risk factors in the community at large.

As Sri Lanka’s first suicide prevention organisation, what can you say about the importance of establishing Sumithrayo in 1974 as well as the role it plays today given the pressures and challenges faced by those in the country?

The need for a crisis centre was broached by a medical doctor at the National Hospital of Sri Lanka, who had seen four suicide attempts being brought to the hospital one day. He had inquired from Joan whether anyone who was suicidal could contact any organisation. There began the journey of initiating this much-needed service. Today, with the increasing pressures on mental health and wellbeing due to the challenges faced by society, there is a high demand for mental health support services.

The World Health Organisation (WHO) defines mental health as a “state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

Sumithrayo helps people to cope with whatever is troubling them and empowers them to find their own solutions. Some issues may not have solutions; hence Sumithrayo is simply a listening ear.  A cup of tea with empathy is our speciality. 

Have you noticed any significant factors regarding mental health over the past five decades?

Over the past five decades there has been a rise in suicides with the peak being in 1995, the world’s highest suicide rate. Since then, due to the formation of the Presidential Task Force on Suicide Prevention in 1997, which advocated restricting the import and sale of lethal pesticides and promoting safe storage and the interventions and preventive and awareness work of organisations such as Sumithrayo, there has been a marked reduction in suicides.

Further, the development of transport, improved healthcare services, education of healthcare workers, decriminalisation of attempted suicide, and dialogue between media personnel on responsible media reporting of suicides may be cited as some of the active measures that brought about the reduction. However, suicide as a social concern remains a significant factor, with about 10 deaths per day, which is also high and a cause for concern. Above all, the attempts are said to be 10 times or higher, which indicates the need for continued and enhanced active prevention and awareness work.

It can be said that there is increased acceptance of counselling services and awareness of mental health concerns. This has resulted in more and more people, especially the young, reaching out for help. However, the stigma associated with suicide and mental health issues remains a barrier to seeking help among certain people.

How does Sumithrayo work towards raising awareness in the country?

Sumithrayo never lets go of an opportunity to increase awareness about mental health. Some of the actions include conducting awareness programmes on request for the corporate sector or any organisation and regular social media campaigns through Facebook, Instagram, and YouTube. Additionally, annual poster campaigns and awareness programmes are planned during World Suicide Prevention Day and World Mental Health Day through seminars or webinars on related topics in addition to media conferences inviting all news and digital media organisations to discuss awareness, prevention, and responsible reporting.

There are many misconceptions about mental health services in Sri Lanka, one being that Sumithrayo and similar services are only for those who are suicidal. How far from the truth is this?

One does not have to be suicidal to seek the services of Sumithrayo. Often, suicide is seen as the last resort to an endless struggle, where a person may think that it is the only way out. There is no single reason or cause for feeling suicidal, and those who have survived say they only wanted the “pain” to be over. It is a result of a state where “pain” exceeds the resources for coping.  Be it the loss of a loved one, the breakup of a relationship, issues related to employment, legal or financial issues, domestic violence, loneliness, mental health issues, addictions, gender issues, or any other situation, the distress one feels is unique to them. Often, there is no one who would listen to them with care and respect without telling them what to do. All the advice in the world may not suffice when one is overwhelmed with negative feelings. What one needs is someone who will listen to their feelings and accept them non-judgmentally, with care, concern, and respect, to be with them to help them cope with their negative feelings and assist them in finding their own way.

Anyone can access the Sumithrayo service. Seeking support at the early stages of any distress or despair is the key to overcoming taking extreme measures such as suicide. It is a free confidential service, where one does not have to worry about divulging personal information while receiving emotional support. All Sumithrayo volunteers are bound by the confidentiality policy that is a cornerstone of the ethos of the organisation. 

Sumithrayo also operates a drug demand reduction programme. Can you share more details about Mel Medura and the services offered?

The Sumithrayo Drug Demand Reduction Programme (Mel Medura) was set up in 1984 as the ancillary or outreach arm of the Colombo centre when it was realised (and reported) that more than 30% of suicides in Sri Lanka were connected to alcohol and drug addiction. Permissive family attitudes towards substance use, persistent behaviour problems, low commitment to school, and association with peers who use alcohol or other drugs (AOD) locked in with disruptive social forces such as poverty, unemployment, violence, abuse, and family dysfunction (and conflict) contribute towards the manifestation of substance addiction, misuse, and abuse.

Mel Medura thus studies and assesses the biological, psychological, and social (or environmental) factors of a person’s life to improve diagnosis and treatment. This is referred to as the bio-psychosocial approach which Mel Medura strives to focus on and implement. Emphasis is on respect and the focus is on strengths, the importance of personal choice, and self-determination of goals – all of which are crucial for the person struggling with AOD abuse. It must be mentioned that a vast majority of contacts are very ambivalent and expect instant or even magical cures.

Mel Medura offers instead to work together with the user to change their lifestyle (or social support system and activities) so that the road to and during recovery becomes more rewarding than alcohol or drug use. This is a community-based rehabilitation programme. Apart from alcohol, tobacco, and other substances, Mel Medura also focuses on behaviour addictions (BA) in this same manner because BA display the same characteristics: compulsive use – that gets out of control –  and continued use despite knowing that it is causing harm, as well as the development of tolerance, withdrawal, and relapse.

Is addiction a major issue in Sri Lanka? How can addiction impact one’s mental health, especially with regard to depression and suicide?

Addiction is certainly a major issue in Sri Lanka and is a disease of the brain, so the lead-up to abuse and then dependency definitely affects the mental health of the user. Often the inability to cope with withdrawal and the stigma associated with addiction can bring about suicidal thoughts in the user or cause depression and other mental health issues. We often speak of the lethal triad where (1) an upset person (2) uses a substance to numb the pain, and (3) has access to means. When these three factors are present, the risk of self-harm/suicide is high.

Studies have shown that a high percentage of people (in Sri Lanka) who attempt to take their lives have alcohol in their system. Alcohol and other drugs make a person impulsive and then prone or vulnerable to risky behaviour. The primary drivers of repeated substance use shift from positive reinforcement (feeling pleasure) to negative reinforcement (feeling relief), as the person seeks to stop the negative feelings and physical illness that accompany withdrawal. Eventually, the person begins taking the substance not to get high, but rather to escape the low feelings to which, ironically, chronic drug use has contributed.

As Sumithrayo moves towards its 50th anniversary, are there any programmes or projects you hope to launch?

We hope to organise a national awareness programme to publicise the much-needed service and to create awareness amongst the public about how they can contribute to reducing suicide and help promote seeking help for emotional distress and mental health issues.

In addition, Sumithrayo hopes to launch a mobile hotline while also looking into providing regular services via WhatsApp or Facebook. A special email service to assist those who are divorced or contemplating divorce is another project that is underway.

The launch of a healthy lifestyle society in schools was launched early this year, and it is envisaged that this will be enhanced in all schools and institutions, to enable youth to seek support while also supporting each other.

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