What must be done to prevent suicides?

According to data provided by the World Health Organization (WHO), more than 800,000 people die annually by suicide and many more commit the attempt without success. In 2001, registered suicides worldwide exceeded the death toll from homicide (500,000) and from war (230,000) while which, in the vast majority of countries, constitutes the leading cause of unnatural death ahead of traffic accidents or traffic accidents. murder.

It is clear that we are talking about a very serious public health problem, which, even today, continues to be a taboo subject for most governments and societies that suffer from it, as well as in families involved. What is being done to prevent part of the population from ending their own life? Next we will see what they are known measures to reduce the suicide rate.

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The stigma and taboo of suicide

First of all, to know how to intervene on the generalization of suicide attempts, it must be taken into account that

it is difficult to research on this topicas it is covered by taboo and stigma. From the data we have seen, many more cases than those officially reported are assumed because death by suicide consists of a very sensitive issue, even illegal in some countries, and may remain misclassified under deaths from "driving accidents" or "stops cardiac ”.

Studies on this aspect, such as those of the psychologist Thomas Joiner, elucidate that more than 40% of people who have lost a loved one due to suicide I'd lie about it to hide the truth.

The registration of a suicide case is a complicated procedure that involves several different authorities between police, personnel health, family and the media, who do not always face the facts with the transparency and information necessary to coordinate their prevention.

The Werther effect and the information restriction

The focal part of these difficulties lies in the stigma associated with mental disorders and suicidal behaviors, promoted mainly by fear and ignorance. One of the main pillars of misinformation rests on the well-known Werther effect.

The Werther effect (or its variants "copycat", "domino", "call", among others) is about the novel Young Werther's Sorrows written by Johann Wolfgang Von Goethe in 1774, where the protagonist suffers so much for love that he decides to end his life. This behavior was copiously imitated by many young people of the time, to the point where the novel was banned by the authorities.

Later, the sociologist David Phillips made an analogous study between 1947 and 1968 showing that when the New York Times published a story related to a suicide, these increased throughout the country the following month.

Actually, the idea that suicide has a “contagious” aspect, that is, if a famous person takes his life or a similar news comes to light it will lead others to consider the suicide as a desirable option, it is very difficult to prove, and the studies that make it known are contradictory. Suicide rates remain stable over time and this is corroborated by the statistics that can be consulted from of the 19th century, which has made it possible to reach a worldwide agreement among all specialists about the most common.

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The main causes of suicide

The main risk factors include: mental illness, disorders due to depression and psychosis, as well as drug use and addictions, chronic medical diseases with pain and, finally, major vital crises, being the most frequent with 60% of the cases, the breakup of a couple (in the end, we continue to commit suicide for love), preceded by problems in the family environment and problems economic.

It is also necessary to mention social isolation, uprooting and lack of affective ties with peers.

So, to what extent can talking about suicide help people who are in these situations and thinking about it on a recurring basis? Certainly, informing and raising awareness can prompt a person who has conceived of ending his life to take action as that straw that breaks the camel's back, but at the same time, it's the only way people know they can ask for help when you have reached this point and the only answer you find is silence.

According to the psychiatrist and suicide expert Carmen Tejedor, responsible for the first plan of suicide prevention carried out in Spain, to prevent it is necessary to allow people to talk about the suicide.

Attempts to end one's life

Nobody wants to die; the idea that suicide is an act of free will understood as that the person voluntarily decides on his actions derives from a romantic concept of the freedom of the person. There is no freedom in suicide, only constant and intense despair until the individual considers his death as the only way to avoid suffering.

For every completed suicide, there are between 20 and 30 people who put their lives on the line to try to put an end to it. These attempts are the approaches that the individual makes, tests, to see how to face fear, physical pain and the break with their own sense of self-preservation. The expression is false: "whoever has not managed to kill himself is because he really was not going to do it." If a person has tried to commit suicide once, it is very possible that he will try again, and it may be that the next attempt will be successful.

Psychological intervention and prevention

In the face of most attempts or unsuccessful attempts, options can be opened that include pharmacological and psychological treatments through which many people discover new reasons to continue living. It has been estimated that without an adequate suicide prevention plan, 30% of those affected will repeat the attempt, but thanks to a specialized intervention only 10% will do so.

The role of society is crucial, currently a few countries have included suicide prevention among their health priorities and only 28 countries have reported that they have a national strategy for the prevention of suicide.

The most direct measures have consisted of the information restriction and the restriction of lethal means (such as the selection of the disclosure of information on suicides, non-prescription drugs, stopping the use of barbiturates ...). It has been shown that if a person initiates suicidal behavior, but it is interrupted or inaccessible, he does not tend to run elsewhere to finish it. Limiting access to a lethal environment translates into the practice of installing physical barriers in risk areas such as windows of certain hotels and bridges.

However, we must go further and bet on the coordination of institutions. First, report responsibly from the media to break stigma, particularly around mental disorders and suicide. Lack of such responsibility makes it impossible for people who think about killing themselves or have tried to kill themselves to get the help they need.

Second, in relation to the aforementioned, to have reliable information whose data allow to deepen the study of the suicidal behaviors with a view to its prevention (only 60 Member States have good quality civil registration data that can be used directly to estimate suicide rates) including suicide vital records, hospital records, and representative studies at national scale.

Finally, it should be noted that the first WHO world report on suicide "Suicide prevention: a global imperative" published in 2014, seeks to raise awareness to the population of the importance of suicides and suicide attempts, as well as the urgent need to develop comprehensive prevention strategies within the framework of a multisectoral approach to public health so that Member States have managed to stabilize national suicide rates at 10% by 2020.