Updated 6pm with warning by the Commissioner for Mental Health
Malta may soon have a national suicide crisis line as mental health professionals will be coming together to discuss a way to make this happen, according to psychiatrist Mark Xuereb.
“A lot has already been done to tackle mental health, including suicide, but we need to work together. It’s time to stop talking and take action,” said Dr Xuereb who is a member of Crisis Resolution Malta (CRM) – a private network made up of experienced professionals from various backgrounds.
CRM is working on bringing all stakeholders together, under the patronage of the Presidency, to create a three-digit national suicide crisis line, he said.
People having suicidal thoughts will be able to call 24/7 to get all the support they need from trained professionals – for free.
CRM, which currently operates a generic support line 9933 9966, was already in touch with UK suicide prevention charity Samaritans and international charity Befrienders Worldwide for training support, he added.
Recent figures tabled in Parliament showed there were 137 suicides between 2013 and 2017 in Malta. Various support lines are already available for people suffering from mental health problems, including those having suicidal thoughts. The problem is that there is no one centralised service dedicated specifically to suicide prevention.
Dr Xuereb has long been calling for a national suicide helpline and the setting up of a crisis resolution and home treatment team – made up of doctors, psychologists, psychiatrists, social workers and lawyers among others.
Dr Xuereb added that CRM was also in the process of issuing a call to bring together stakeholders to put together a National Suicide and Self Harm Database.
The database would include statistical data and demographics of all those who self-harm and die by suicide in Malta and Gozo. This will be put together into an annual report that will help guide policy makers and inform strategy, he said.
However, Dr Xuereb added, while knowing the facts and the theory was a great start, it was not enough.
“Something needs to be done. We need to start acting,” he said.
“Pills, therapy and electroconvulsive therapy are all effective forms of treatment – but it can take weeks to see results.
“My team has been working behind the scenes and have been piloting a new form of treatment. With theta burst transcranial magnetic stimulation (TMS) we can reduce suicidal behaviour by between 53 and 56 per cent within 24 and 72 hours.”
TMS uses a principle called electromagnetic induction that involves applying a pre-set changing magnetic field to a wire to induce an electromotive force or current in the conductor - the neuron. An external magnet is applied to produce theta waves close to certain parts of the brain that are known to be the brain’s portal to mood and suicidal thinking.
In so doing, this harmless, non-invasive and safe treatment induces the nerves deep within the brain to regrow and reconnect by a principle known as neuroplasticity, Dr Xuereb claimed.
“Now we have a tool that allows us to send people home under supervision rather than send them to hospital,” he said, cautioning that no one should stop or change treatment without seeking advice.
In February, the Malta Association of Psychiatry had said that while TMS could prove useful for people with depression who were not responding well to other methods, it was not a recommended first-line treatment in line with international guidelines.
Commissioner for Mental Health sounds warning on TMS
The Commissioner for Mental Health also sounded a warning, saying on Wednesday that transcranial magnetic stimulation (TMS) is currently not approved for use in reducing suicidal behaviour by leading international regulatory agencies such as the Food and Drug Administration (FDA) in the United States of America, the European Medicines Agency (EMA), and the United Kingdom National Institute for Health and Care Excellence (NICE).
"Evidence-based treatment and care requires thorough scientific analysis of efficacy and safety studies that have been done or still need to be conducted. Meanwhile it is incumbent upon local academia, professional organisations and national regulatory authorities to provide leadership, definitive results and direction. Our people deserve this," the commissioner said.
"Published reliable scientific data indicates that TMS is only approved for use in the treatment of refractory depression. This means TMS may be considered for use only in cases of severe depression that has not responded to other forms of standard treatment, such as medication or psychotherapy, or where such forms of treatment may not be suitable. More safety studies are needed to
determine long term effects."
The commissioner urged the authorities to urgently implement the National Emergency Psychiatric Response Service, appropriately resourced and functioning in accordance with best practice.
"Such a service should provide an adequate and timely response to persons and families experiencing a psychiatric emergency within the community, prevent unnecessary psychiatric hospital admissions, and provide follow-up to individuals and their families in their own homes or within their own communities," the commissioner said.
If you are thinking about suicide or need somebody to talk to, dial 179 or visit Kellimni.com