What needs to be done to decrease the suicide rate?

Every year thousands of people end their lives, what can be done to raise awareness?

According to data provided by the World Health Organization (WHO) more than 800,000 people die by suicide every year and many more attempt suicide unsuccessfully. In 2001, the number of suicides registered worldwide exceeded the number of deaths due to homicide (500,000) and war (230,000), while in the vast majority of countries it is the leading cause of unnatural death, ahead of traffic accidents or murder.

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

The stigma and taboo of suicide.

First of all, in order to know how to intervene on the generalization of suicide attempts, it is necessary to take into account that it is difficult to do research on this topicIt is covered by taboo and stigma. From the data we have seen, many more cases are assumed than officially reported because death by suicide is a very sensitive issue, even illegal in some countries, and may remain misclassified under deaths due to "driving accidents" or "cardiac arrest".

Studies on this aspect, such as those by psychologist Thomas Joiner, show that more than 40% of people who have lost a loved one to suicide would lie about it to hide the fact that they had lost a loved one to suicide. would lie about it to hide the truth.

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

The Werther effect and information restriction

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

The Werther effect (or its variants "copycat", "domino", "call", among others) is based on the novel The Sorrows of Young Werther written by Johann Wolfgang Von Goethe in 1774, in which 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.

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

In fact, the idea that suicide has a "contagious" aspect to it.i.e., that if a famous person takes his or her own life or a similar story comes to light it will lead others to consider suicide as a desirable option, is very difficult to prove, and the studies that report it are contradictory. Suicide rates remain stable over time and this is corroborated by statistics available from the 19th century onwards, which has led to a worldwide agreement among all specialists on the most common causes.

The main causes of suicide

Among the main risk factors are: mental illness, depressive disorders and psychosis, as well as drug use and addictionsThe most frequent, with 60% of cases, is the breakup of a couple (in the end, we still commit suicide for love), preceded by problems in the family environment and economic problems.

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 find themselves in these situations and thinking about it on a recurring basis? Certainly informing and raising awareness can propel a person who has conceived of ending his or her life into action as that straw that breaks the camel's back, but at the same time, it is the only way for people to know that they can ask for help, it is the only way for people to know that they can ask for help when they have reached this point when they have reached this point and the only response they find is silence.

According to the psychiatrist and expert in suicidology Carmen Tejedor, responsible for the first suicide prevention plan carried out in Spain, in order to prevent suicide, people must be allowed to talk about suicide.

Attempts to end one's own life

No one wants to die; the idea that suicide is an act of free will, understood as a person voluntarily deciding on his or her actions, derives from a romantic concept of personal freedom. There is no freedom in suicide, only the 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 at stake to try to end it. These attempts are the approximations that the individual makes, trials, to see how to face the fear, the physical Pain and the rupture with his own sense of self-preservation. the rupture with his or her own sense of self-preservation.. It is false the expression: "who has not succeeded in killing himself is because he was not really going to do it". If a person has attempted suicide once, it is very likely that he/she will try again, and it may be that the next attempt will be successful.

Psychological intervention and prevention

Most attempts or unsuccessful attempts may open up options that include pharmacological and psychological treatments through which many people discover new reasons to continue with suicide. 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 with specialized intervention only 10% will do so.

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

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

However, it is necessary to go further and coordination of institutions. First of all, responsible reporting by the media to break the stigma, particularly around mental disorders and suicide. The lack of such responsibility makes it impossible for people who are thinking of taking their own lives or have tried to do so to receive the help they need.

Secondly, in relation to the above, the availability of reliable information whose data allow further study of suicidal behaviors with a view to their prevention (only 60 Member States have good quality civil registration data that can be used directly to estimate suicide rates) including civil suicide registries, hospital registries and nationally representative studies.

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