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HELP FIGHT THE STIGMA

© 2019 by Paula Fontenelle

Suicide is not a new phenomenon, but only recently has it received systematic attention within the mental health field. One of the main challenges regarding the investigation of self-inflicted death is its inherent complexity. In order to understand an issue, empirical science usually finds answers by looking at patterns, which in this area have just begun to be properly identified. Even then, when looked at individually, most of what we know still does not lead us toward solid answers. 

 

Take risk factors, for instance. None of them alone can predict suicide. You may find a male who has a family history of mental illness, who has himself been diagnosed with depression, and who is going through a significant loss, yet who does not think about ending his life. Likewise, a mother who was brought up by loving parents and has a stable marriage might make an attempt in an act of impulse after being fired from her job. It all comes down to the intricate nature of the human condition. When dealing with people, there is no definitive path to follow, no formula to foretell how they will react when under stress.

 

Moreover, any effort to combat self-inflicted death has to involve several layers of society, including policy-making, investments in research and treatment programs, the scientific community, the mental health field, and the general population, who needs to be educated about suicide so that they can actively participate in such efforts.

 

Although there are still no absolute answers, experience shows that in many cases, suicide can be prevented. In the US, where suicide is the second-leading cause of death in young adults, the implementation of the Signs of Suicide (SOS) prevention program in 17 Connecticut high schools achieved significant results. Ninth-grade students who were part of the program were approximately 64-percent less likely to report a suicide attempt when compared with the control group.

In another study conducted with soldiers in Israel, researchers found a 57-percent decrease in the suicide rate of the participants after the implementation of the IDF Suicide Prevention Program. The IDF program aims to reduce weapon availability, de-stigmatize help-seeking behavior, integrate mental health into service units, and train in recognition of risk factors and warning signs.
 

Many other examples of effective initiatives could be highlighted, but what's most important is to pinpoint the things such programs have in common so that the main aspects of prevention can be established. Such initiatives must include:

  1. A multidisciplinary team (doctors, mental health professionals, etc.).

  2. Early intervention and follow-up.

  3. Dissemination and investment in evidence-based treatment.

  4. Social support systems (family, friends, communities).

  5. Effective health care systems. Instead of emergency rooms, which are high-cost, for example, there should be more appropriate settings, such as crisis residences, in care, and out care facilities, drop-in centers, and community-based programs.

  6. Access to screening for mental illnesses and subsequent health care treatment.

  7. Insurance coverage for services that focus on prevention, not just treatment.

  8. Broadening of early intervention resources, such as hotlines and crisis centers.

  9. Efforts toward diminishing access to methods.

  10. Increased awareness.

  11. Combatting stigma.

In 2014, the World Health Organization published a worldwide effort aimed at reducing suicide rates across the globe. The report presented steps to be followed by countries interested in creating national strategies, including investment in surveillance, means restriction, media guidelines, stigma reduction, and training of health workers, educators, police, and other gatekeepers, as well as raising public awareness. The creation of crisis intervention and postvention services was also mentioned in the document.

No matter the extent of the prevention program chosen, when put in a simple, straightforward manner, it is crucial that the interplay between biological, individual, psychological, social, environmental, and cultural factors be taken into account. When all these aspects are considered, the chances of achieving positive results are enhanced.

 

When dealing with a suicidal person, the following aspects are also relevant:

  • Help create meaningful connections - The quality of relationships is more important than the number of connections.

  • Learn about the warning signs and risk factors associated with suicide.

  • Assess the level of planning involved.

  • Know what to do, as well as what to avoid in crisis situations.

  • Reduce access to lethal means.

  • Seek help.

  • Don't do it alone.

  • And remember that people who consider suicide are in extreme pain. They don't necessarily want to die, but instead, they seek a way out of an unbearably painful situation and see no other option. Ambivalence is the most common attitude in suicide.

Sources: 

1. The World Health Organization report on global suicide prevention strategies - CLICK HERE