Sokkors Fil-Pront (SFP) was launched this week to commemorate World Suicide Prevention Day. This national foundation aims to provide immediate care to those who suffer in silence. This care will be provided by means of a free, 24/7 suicide crisis line manned by trained professionals. SFP will liaise with various entities to promote projects designed to quell self-harm and offer support to those in crisis. It will also offer professional advice to concerned loved ones and recommend where they can get help.
Run according to evidence-based guidelines, SFP is being moulded by the Befrienders Worldwide – the absolute, global authority in the field which gave birth to The Samaritans (SFP’s British sister organisation). SFP shall adhere to The Befrienders charter, which envisages “the provision of emotional support services for people who are suicidal and/or in distress”.
Thanks to laudable initiatives organised by healthcare professionals – including Crisis Resolution Malta (CRM), Malta’s only 24/7 crisis team – Malta has been sensitised to the stark reality of these preventable tragedies. Research shows that, with appropriate support lines and crisis teams, suicides can be averted.
Loved ones spend a lifetime gnawed by never-ending questions such as ‘Why did he do it?’, ‘Why didn’t she open up?’ or, worst of all, ‘Why didn’t I realise?’ Perhaps the ultimate tragedy lies in the fact that people who are bedevilled by suicidal thoughts actually want to talk about suicide. They want to open up to kill their pain and not themselves.
Myths pertaining to suicide, such as ‘talking about suicide perpetuates suicide’, only accentuates this lonely torment. Suicidal people want to live once they get help, as confirmed by suicide attempters who, thankfully, survived their attempt.
Members of the latter group often become staunch advocates about the futility of suicide. They talk movingly about reaching the point where they could see no alternative but to take their own lives and about the days, hours and minutes leading up to it.
About 30 to 40 people die unnecessarily in Malta every year
They describe the moment they realised that they did not want to die but instead wanted someone to intervene and stop them. Taking a minute to reach out to a friend, relative or a complete stranger and getting professional help can change the course of their lives (WHO, 2014).
Locally, CRM has campaigned to get people to talk since 2010. Some 80 lives have been saved as a result, in collaboration with the formidable police and emergency services.
Talking, therefore, saves lives. Unfortunately, not all were fortunate enough.
SFP offers a lifeline. It offers alternatives and encourages people to talk. We want to show others that, through crisis services, no problem is insurmountable. We want people to live, as epitomised by SFP’s slogan ‘Irridek Tgħix’.
SFP is also aware of the contagious aspect of self-harm, both within the family unit and when celebrities kill themselves, prompting the vulnerable to imitate their act.
The unambiguous statistics further confirm the need for this Foundation.
WHO states that approximately twice the population of Malta kill themselves globally per year (one every 40 seconds) and that for every suicide there are 20 trying to take their lives because they may not have access to crisis care. For every death, at least six surviving loved ones are psychological affected for life (WHO, 2014). These loved ones have a lifelong increased risk of suicide (65 per cent) and of stopping work or education (85 per cent) (Pitman, 2016).
Suicide is the second leading cause of death among 15- to 29-year-olds internationally after trauma (WHO, 2016) and the leading cause of death among drug users (three-fold for males and nine-fold for females) (Drasigic, 2015). A quarter of the population have a diagnosable mental or substance use disorder or both (Kessler, 2005).
Sadly, only 40 per cent get treated, hence, suicide often goes unnoticed (Wang, 2005). Prolonged illness, even in those with no record of mental health problems, raises the suicide risk (Ahmedani, 2017). Childhood adversity has been associated with an increased risk of suicide in adolescence. Highest suicide rates were found among those exposed to suicide in the family, parental psychiatric disorders and parental criminality.
Experiences of family withdrawal, integration difficulties and perceived lack of care may contribute to suicide within refugee populations (Wasserman, 2017). In the UK, middle-aged men are most at risk of suicide but there is a worrying rising trend among the under 25s (Samaritans’ Annual report, 2018).
CRM’s annual statistics and NSO numbers show that the suicide rate has remained stable at eight per 100,000 of the population (Eurostat, 2015). This means that about 30 to 40 people die unnecessarily in Malta every year.
CRM also reports that up to 1,000 people think about suicide every year, receiving some 15 crisis calls a week, day and night. A typical conversation can last more than an hour. In order to put this data into practical use, SFP will produce an annual report showing the demographics, nature and circumstances associated with self-harm and suicide. This will provide dynamic feedback to hone our national suicide prevention strategy.
However, it was not only this unembellished data that compelled us to act. People are not numbers.
SFP thus endeavours to cross the Rubicon and soar beyond the platitude of simply ‘raising awareness’ and stopping there.
We need everyone’s united support to continue the good work done by many as enshrined in the recently launched National Mental Health Strategy.
Dr Mark Xuereb is the founder of Fondazzjoni Sokkors Fil-Pront.