On the Difficulty of Preventing Suicides and Managing Mental Health Problems in the Community

From the New Yorker (shared by a friend on Facebook):

“Kate Spade’s handbags were playful and fun. Her quirky look was unmistakable and bespoke exuberance. Anthony Bourdain was almost inconceivably high-functioning, and won so many awards that he seemed ready to give an award to his favorite award.”

One's outside appearance and achievements have almost no correlation with what's going on inside. And the above proves it.

“If life wasn’t worth living for people such as Bourdain and Spade, how can our more ordinary lives hold up? Those of us who have clinical depression can feel the tug toward suicide amped up by this kind of news. The gap between public triumph and private despair is treacherous, with the outer shell obscuring the real person even to those with whom he or she had professed intimacy.”

I've many a times thought/talked about preferring to die early as the challenges to trying to achieve "success" is too overwhelming, and at times the only way to manage it is by managing expectations and prioritizing other things in life at a cost to career development. And occasionally talking to Siri about it. And I doubt that I'm the only one dealing with it; it's just that nobody talks about it (or is willing to hear/understand about it).

“A new Centers for Disease Control and Prevention report shows a vast increase in American suicides over the past decade, and asserts that fifty-four per cent of the suicides reviewed didn’t have a previously known mental-health issue. “Instead, these folks were suffering from other issues, such as relationship problems, substance misuse, physical health problems, job or financial problems, and recent crises or things that were coming up in their lives that they were anticipating,” Deborah Stone, a behavioral scientist at the C.D.C. and the lead author of the new study, told NPR.”

Aka "real issues". You don't need to be "clinically depressed".

“Opioid dependency drives self-annihilation, and many of the drugs to which people become addicted are easy to take in fatal doses, especially opioids in combination with benzodiazepines. A third of Americans are sleep-deprived, and sleep deprivation has a devastating effect on mental health.”

I wonder if there's a correlation with being a doctor and the above? Or being a doctor trying to achieve "career success" and the above?

“Rates of teen depression have risen since 2011, and students are carrying more debt and face more uncertainty about their lives.”

Earning power has continued to deteriorate with no end (and in Malaysia probably will stall for a while with the GST's elimination, but never improve)

“I hear from people who wake up, eat breakfast, go to a job at which they interact with a machine all day, pick up food on the way home, eat in front of a television, and then go to bed.”

Replace machine with patients (who aren't there to cheer you up), and you may get a doctor or two.

“Dr. Kelly Posner, who helped develop the Columbia-Suicide Severity Rating Scale (C.-S.S.R.S.), pointed out that more policemen die of suicide than die on the job; more soldiers die of suicide than die in combat; more firefighters die of suicide than die in fires.”

That the author misses out the extremely high suicide rate among doctors is unforgivable. You know, whose job is to in theory save lives.

““There was a point where I realized that, if I died of old age, I would win, because so many people with bipolar disorder kill themselves that simply not to kill myself would be a big goal. And I thought, ‘That’s really a low bar.’ And then I said, ‘No, it’s not a low bar, because it can be that hard.’ ” It’s hard for people who have never been suicidal to understand how seductive it can seem. Though their acts may have been impulsive, the likelihood is that both Kate Spade and Anthony Bourdain had struggled with demons for many years.”

It's never truly impulsive. And like I said, setting the bar low helps. But it's not easy for doctors, who are used to achieving academic success throughout their lives, until they meet the grueling training with its high attrition rates during both undergraduate and postgraduate training phases. With its real financial ramifications. And the "significant" collateral damage. And never having a so called "study break"; you study during whatever free time you've sacrificed out of your life after work to study. And maintain yourself as a high achiever with Special Forces-like physical and mental stress, minus the training (nor the mental health services) to build yourself up to be that resilient.

Mental health solutions will continue to be difficult to find, even more so in Malaysia. We even have a hard time accepting the existence of post-partum depression (and our Malay worldview of marriage = shit ton number of kids early or it's a failed marriage does not exactly help things); our community would just not accept other "more abstract" issues of mental health easily.

And that's unfortunate.

Shopping Malls and Their Praying (and Other) Amenities

When choosing a mall to go to during the evening, especially with family, the provision of prayer rooms is an important consideration. I've certainly complained in the past on Facebook how I dislike imams who pray too long for the Maghrib prayers and make elaborate du'as, making others wait in line. Look, Maghrib prayer times are usually around 75 minutes in Malaysia, and any delay eventually adds up for people at the back. One way to avoid this during Ramadhan (when there is typically a surge of Muslims shopping, making the Maghrib crowd even bigger) is to simply break fast with small amounts of drinks and food first, pray, and then have a proper meal once those who are "lucky enough" to have their proper meal early leave the eateries to go and pray (and stumble into the huge line of wait, or gasp skip praying altogether).

Anyways, I'm posting this after my experience at Sunway Velocity Mall, which I've never gone before, and after this may never go again during such hours (I went there looking to buy something that could be found only there and a few other places). I think that mall planners ideally should put more thought as to how they build their Muslim prayer rooms.

Here, there was (expectedly) a long line outside. But the inside the comparatively small prayer room (similar in size to Aeon Alpha Angle) was only a small number of people praying. The reason why is that there were only two freaking taps for ablution! Now imagine this: say if a person takes on average two minutes to take ablution, that would limit the number of people who can pray to only 150 people for Maghrib prayers, which is ridiculous in a huge shopping mall. The limiting factor should never be the rate that people take ablution. I came in line at 7.40 pm and finished praying only by 8.15 pm.

Now compare this with other malls that I'm relatively familiar with.

My favorite KL mall, Mid Valley Megamall, has 4 prayer areas, of which 2 of them (on the 3rd floor) are relatively large. Even the smallest of the prayer rooms (at ground floor Aeon) has I think 4 taps; there's always a crowd here during Maghrib hours as it's very convenient (hence should never be the first choice regardless of the month). The line for ablution barely exceeds the door with the prayer rooms at level 3. This mall has the best provision of prayer rooms to accommodate Ramadhan. My only problem with the arrangement here is that the one near GSC is I guess right next to a snooker bar; you'll be praying while vibrated by the loud music just beside the walls. Anyways, since it also has cheap parking rates (for KL) and is overall very family friendly (with the most number of elevators for example), it really is among the best shopping malls to come in with kids (or without).

There is only 1 prayer room in Suria KLCC, but it is spacious with around 10 taps for ablution. There's never a problem here to pray other than navigating the crowd. And this is especially so with the high number of Arabs praying here; they will either be the imam (with comparatively speedier prayers) or will push to make the turnover much faster (like intruding to the front as soon as a Malay imam tries an elaborate du'a at the end of prayers).

But I dislike this mall for a few reasons: the parking rates are now exorbitant, and until recently (when they added another lift at center court), it is extremely not family friendly, with only slight improvement with the addition of another lift (on top of the only two before this at center court). That said center court lift does not go to the parking floors, while those that do only do so from the ground - 2nd floor, in Parkson (which is where I park most of the time). There's another set of lifts in Isetan (but I don't think it goes up all of the floors either). And the pillars at escalators (preventing cheaters who use the escalators with their strollers) force people to use those lifts (with all of the inconsiderate people who use the lifts but don't really need to). I feel that the management is doing all this on purpose to limit the number of visitors and make it a mall for only a certain set of the population (rich and kidless).

Aeon Bandaraya Melaka is now similar to Suria KLCC but with a slightly lesser number of taps after their most recent renovation a few years back. However, I don't know how well it accommodates the Ramadhan surge now. In the past, they just couldn't, especially with the lack of space, taps, and Arabs (which became the context of my original rant against those who pray too long in public prayer rooms).

IOI City Mall has two relatively medium sized prayer rooms. During other months, the only problem is that people tend to go the more accessible room over on the top floor, creating a jam there. But due to the sheer size of the mall, it may not be easy to walk over to say, the other corner of the mall, to the lower most floor (near the shuttle bus parking area), just to avoid the crowd; walking there with kids may take you 20 minutes (inclusive of drama). Even during other months, this is a mall that just struggles to accommodate people trying to have dinner (you'd best plan having your dinner as the last activity as the mall closes) and also has quite a crowd in line at the lifts; I don't want to know nor experience how is the Ramadhan crowd there.

Quill City Mall has no such problems; any ghost mall has no issues for praying and going anywhere at any time and circumstance. The medium sized prayer room is at LG, while there's another small (and convenient to go to) prayer room in Aeon at level 2.

Aeon Alpha Angle (at Wangsa Maju) has a relatively small prayer room that struggles in normal months, and is managed by make-shifting a larger room during Ramadhan. Or at least that's how it was in the past; I've never gone there during Ramadhan in years.

Preferably, any mall should have all this properly planned in advance, but modifications can always be made later (ala Mid Valley). But to (in my view) blatantly get it wrong in Sunway Velocity Mall is really inexcusable.

Time Inc, Gone

From the New York Times:

“In 1929, the year of Mr. Hadden’s sudden death, Mr. Luce started Fortune. In 1936, he bought a small-circulation humor publication, Life, and transformed it into a wide-ranging, large-format weekly. Later came Sports Illustrated, Money, People and InStyle. By 1989, with more than 100 publications in its fold, as well as significant holdings in television and radio, Time Inc. was rich enough to shell out $14.9 billion for 51 percent of Warner Communications, thus forming Time Warner.

The flush times went on for a while. But then, starting about a decade ago, the company began a slow decline that, in 2018, resulted in the Meredith Corporation, a Des Moines, Iowa, media company heavy on lifestyle monthlies like Better Homes and Gardens, completing its purchase of the once-grand Time Inc. in a deal that valued the company at $2.8 billion. The new owner wasted no time in prying the Time Inc. logo from the facade of its Lower Manhattan offices and announcing that it would seek buyers for Time, Fortune, Sports Illustrated and Money. The deadline for first-round bids was May 11.”

Continue reading it to get an idea of the culture of excesses and affairs before it's decline by not adapting to the Internet.

I remember during the start of my debating years, I started off reading Time and/or Newsweek (another much fallen "giant" of the times, subscribed by my father), before you'd get serious and start reading the Economist and researching issues online via Google.

It's clear that the Internet has claimed many traditional media entities as its prey.

(via Daring Fireball)

Try out Backblaze for free and protect your precious files.