Editorial: Preventing the unthinkable

The government has launched a consultation on its first strategy for suicide prevention. In its foreword, Health Minister Jo Etienne Abela staes: “It is essential to recognise that every life lost to suicide is a profound tragedy.”

There is an undoubted stigma related to suicide which may make the problem less visible: if nothing else, this consultation document will bring it into the open.

Is it an issue? The numbers tell the tale: suicide claims the lives of over 700,000 persons annually (WHO, 2021). Admittedly, Malta has a low suicide rate per capita – even by EU standards – with around five per 100,000 of population. But the numbers do not even begin to capture the trauma caused by the loss of a loved one.

Thankfully, the rates are dropping, not just in Malta but also globally, which makes it all the more important to focus on prevention. The consultation document explains there are more than 20 suicide attempts for each suicide death, according to estimates.

And there is another important statistic: 75% of those who attempt suicide will have previously reached out to a medical professional.

This is why one of the proposals in the document is to train specialists in family medicine to be able to recognise the signs of mental health problems.

There are other important proposals spanning six major areas, with the main priorities being early intervention and the creation of a supporting environment.

It includes a new Acute Psychiatric Unit and a dedicated psychiatric area within the Emergency and Accident Department at Mater Dei Hospital.

The document makes sobering reading – even though the need for up-to-date research is a plea heard in so many contexts. It highlights that the risk of suicide is 10 times higher in the month after an adverse life event, such as relationship conflict, family-related conflict, legal problems and abuse.

And suicides are nine times as prevalent for men as for women: the most vulnerable group are those between 30 and 60, who are single or separated, and who are either unemployed or retired. 

Other risk factors are social isolation, being a member of a stigmatised group, engaging in self-harm, being chronically ill or in pain, and having a family history of mental health problems.

The €2.08 million strategy was drawn up by the National Mental Health Services under the Ministry of Health and Active Ageing, after consultation with over 40 key stakeholders: not only with ministries, entities and NGOs, but also with individuals affected by suicide. This has given it a credibility that has filled those involved in this sphere with optimism.

Making sure there is a well-trained and well-functioning infrastructure to help those in need of help is an important step in prevention.

The strategy will also make it harder for those planning suicide: according to the WHO, if you make it harder to see plans through, those who are facing acute distress take time to find alternatives, time that could allow that acute distress to pass – before taking fatal action.

A 2021 study had identified suicide hotspots, as the result of which a fence was put up, reportedly reducing suicides from there. However, it is not enough to put fences across notorious suicide locations: the problem needs to be shifted not only to another location but to early intervention.

Rather than hiding behind the devastating veil of helplessness and guilt, the government’s intention is to offer assistance before the intention becomes an irreversible action.

The plea should be loud and clear: there is no shame in seeking help.

If you are feeling depressed and need support or guidance on how to help someone who is suicidal, call 1579. You can also call Richmond Malta’s helpline on 1770. One can also type OLLI.Chat on their desktop, mobile or tablet browser to chat with a professional. If you have been affected by suicide, you can call Victim Support Malta on 2122 8333 or info@victimsupport.org.mt