Suicide Prevention

Can suicide be predicted? Can we be effective in your prediction? Although this behavior, like all human behavior, is complex and involves many variables with different weight, there are some indicators that can guide us towards its detection and prevention.

Some populations may be considered at risk and some circumstances as risk factors, or possible triggers, for future suicidal behavior. These include mental illnesses, especially depression and schizophrenia. Personality disorders, especially borderline and antisocial disorders, and disabling chronic physical illnesses that produce biological and / or psychological vulnerability.

Suicide prevention has always been a concern. For this reason, different action protocols have been developed  in almost all levels of the Spanish National Health System (SNS). In fact, the World Health Organization (WHO) estimates that one million people in the world commit suicide each year; at the same time, it  is one of the three main causes of death in adolescents and young adults, and the tenth in the general population, having increased its rate in the last 50 years by 60%.

“Abandoning pain without resisting, committing suicide to escape it, is leaving the battlefield without having fought.”

-Napoleon I-

How can we approach suicide prevention?

Suicide prevention can be approached in two ways:

1) Strategies for high-risk populations, such as psychiatric cases with a history of suicidal behavior, affective disorders, alcoholism, etc. In these cases it is proposed:

  • Optimize the treatment of mental disorders and ensure the personal integrity of the patient.
  • Improve continuity of care and social and health coordination in relation to patients at high risk for suicide, once they have been discharged from a psychiatric hospitalization unit, especially without interrupting therapeutic contact.
  • Improve the psychiatric training of primary care physicians to achieve early care and effective treatment of patients with mental disorders that increase the incidence of suicidal behavior.

2) Strategies aimed at the general population, such as:

  • Inform the public about suicidal behaviors: prevalence, risk factors, behavioral changes, etc.
  • Recommendations to the media to prevent the effect of imitation, especially among young people.
  • Psychoeducation in civic, school, work centers, on improving the quality of life and health promotion, learning resources or strategies for coping with stress, social skills, etc.
  • Restructuring the availability of means for committing suicide and security measures in places used by suicides
  • Actions on the consumption of alcohol and other drugs.

“Many times it is valuable to preserve life.”

-Séneca-

Wrong beliefs

Next we are going to see a series of beliefs that a good part of society holds and that are erroneous or qualifiable:

Wrong Criterion Scientific Criterion
The person who wants to kill himself does not say so Of every ten people who commit suicide, nine clearly stated their intentions and the other hinted at their intentions.
The person who says it doesn’t Any person who commits suicide expressed with words, threats, gestures or changes in behavior what would happen.
People who attempt suicide don’t want to die, they just brag Although not all people who attempt suicide wish to die, it is a mistake to call them boastful, since they are people whose useful coping mechanisms have failed and find no alternatives, except the attempt on their life.
If he really wanted to kill himself, he would have thrown himself in front of a train Every person at risk of suicide is in an ambivalent situation, that is, with the desire to die and to live. The method chosen for suicide does not reflect the wishes of the person who uses it to die, and providing him with another more lethal method is classified as a crime of assisting the suicide (helping him to commit it), penalized in the current Penal Code.
The person who recovers
from a suicidal crisis is in no danger of relapse
Almost half of the people who went through a suicidal crisis and committed suicide, carried it out during the first three months after the emotional crisis, when all believed that the danger had passed.
The person who attempts suicide will be in danger for life Between 1% and 2% of people who attempt suicide succeed in the first year after the attempt and between 10% to 20% will commit suicide in the rest of their lives. A suicidal crisis lasts hours, days, rarely weeks, so it is important to recognize it for its prevention.
Every person who commits suicide is depressed Although every depressed person is likely to make a suicide attempt or suicide, not all those who do have this mismatch. They may suffer from schizophrenia, alcoholism, personality disorder, …
Every person who commits suicide is mentally ill People with mental illness commit suicide more frequently than the general population, but you don’t necessarily have to have a mental disorder to do so. But there is no doubt that every person at risk is a person who suffers.
Suicide is inherited It is not proven that suicide is inherited, although several members of the same family can be found who have ended their lives by suicide. In these cases what is inherited is the predisposition to suffer a certain mental illness in which suicide is a main symptom, such as affective disorders and schizophrenias.
Suicide cannot be prevented as it occurs on impulse Before committing suicide, every person shows a series of symptoms that have been defined as presuicide syndrome, consisting of constriction of feelings and intellect, inhibition of aggressiveness, which is no longer directed towards other people, reserving it for themselves, and the existence of suicidal fantasies; everything that can be detected in due time and prevent its purposes from being carried out.
Talking about suicide with a person at this risk can encourage them to do so It has been shown that talking about suicide with a person at such risk instead of inciting, provoking or introducing that idea into his head, reduces the danger of committing it and may be the only possibility that the subject offers for the analysis of his self-destructive purposes.
Approaching a person in a suicidal crisis without the proper preparation for it, only through common sense, is harmful and wastes time for its proper approach If common sense makes us assume a position of attentive and patient listening, with a real desire to help the person in crisis to find solutions other than suicide, prevention will have begun.
Only psychiatrists can take steps to prevent suicide. It is true that psychiatrists are professionals experienced in the detection of the risk of suicide and its management, but they are not the only ones who can prevent it. Anyone interested in helping people in this
situation of risk can be a valuable collaborator in their prevention “Suicide is the worst kind of murder, because it leaves no room for repentance”

“Suicide is the worst kind of murder, because it leaves no room for repentance.”

-John Churton Collins-

Where to seek help?

When a person begins to have suicidal thoughts there are several resources  they can turn to for help:

  • CEIFEM : Spanish Center for Information and Training on Mental Illness.
  • Health Centers : Primary Care and Community Mental Health Teams.
    Web: http://www.sas.junta-andalucia.es/principal/default.asp
    36 | Suicide prevention guide for people with suicidal ideation and their families
  • Associations members of FEAFES : Spanish Confederation of Groups of Families and People with
    Mental Illness.
  • Health Respond.
  • Hope Telephone : 24-hour telephone service, where help is offered to overcome emotional problems.
  • Health professional.

These resources are invaluable, but they are of little use or do not reach the person who is at risk. Hence, as a society we all have a fundamental role as communicators and linkers.