Today is World Suicide Prevention Day. Few are aware of this, despite one person committing suicide every 42 seconds worldwide, according to the World Health Organisation.
A total of 804,000 individuals take their own life across the world annually (roughly twice the population of the Maltese islands).
Attempting suicide makes you a 100 times more likely to commit suicide in the future compared with those who have never tried before. Those who attempt suicide have a 20 per cent chance of repeating the act within a year.
People with a diagnosed mental health condition are at particular risk. About 90 per cent of suicide victims suffer from a psychiatric disorder at the time of death.
Suicide is the second leading cause of death among 15-29-year-olds. For each adult who commits suicide, there are more than 20 others attempting to take their own life.
Malta needs to continue to work to prevent suicides
Suicide rates are generally highest in people aged 70 years or over, whether they are men or women.
In some countries, rates are highest among the young.
Suicide leaves a transgenerational legacy of pain and suffering as relatives are destined for a lifetime with questions, anger, grief and guilt.
These loved ones are themselves at an increased risk of psychological disorders and committing suicide.
The stigma is huge: it is known that eligible men and women remain unmarried because they were labelled by society as being the relatives of that ‘so and so’ who took his/her life. The silent torture these people go through is hard to come to terms with and treat.
The biggest tragedy is perhaps the fact that suicides are preventable. It is with this frustration in mind that WHO issued its first landmark report called ‘Preventing suicide – a global imperative’ a few days ago.
It includes guidelines that mainly suggest how governments can make a solid commitment to put policies in place to discourage suicide.
The report calls for national multisectoral and comprehensive suicide prevention strategies. So far, only 15 per cent of countries worldwide have them.
The report strongly advocates limiting access to the means of suicide, which are most commonly pesticides, firearms and hanging.
WHO director general Margaret Chan said: “This report is a call for action to address a large public health problem which has been shrouded in taboo for far too long.”
There is no single explanation of why people die by suicide and the causes are multifactorial.
Significantly, a prior suicide attempt is the single most important risk factor.
For both suicides and suicide attempts, improved availability and quality of data from hospital-based systems and surveys are required for effective prevention.
But what about Malta and Gozo?
National Statistics Office raw data lists about 40 people reportedly committing suicide every year (about one third being women).
The figure is underestimated as some deaths are recorded as ‘accidental’. There is a dearth of local epidemiological papers on the subject.
It is also estimated that about six people are affected by every suicide for the rest of their lives.
Malta is in dire need of a national suicide prevention strategy. But what does this entail?
The WHO report neatly outlines the modus operandi of setting up this strategy to make it a successful, sustainable, cost effective and evidence-based, long-term project. Experts, policymakers and support groups all need to contribute towards the 11 steps the report recommends.
These include: proper data analysis, restricting the means of committing suicide, promoting responsible and educational media coverage, having access to specialist services through crisis lines and social websites, training and supporting staff, using the best treatments known, setting up and coordinating crisis, outreach and psychosis teams, improve support for suicide survivors, raise awareness, tackle stigma and, finally, establish institutions to promote and manage local research, training and service delivery.
Malta needs to continue to work to prevent suicides. We need a better-resourced and equipped crisis team to save lives.
We need a better-resourced outreach team to supervise those who already tried to commit suicide within the community.
We also need to set up a much-needed early intervention in psychosis team to detect those people who begin to develop severe mental illness, thereby spotting signs of suicide at an early stage.
A specialist consultant must coordinate these three teams.
Simply installing telephone booths at suicide sites can be an immediate measure to adhere to the WHO report.
Such booths have already saved thousands abroad when would-be attempters see a message of hope and use the telephone there.
Trained crisis staff would then be in a position to summon help for the person instantly.
We also need a suicidology branch at the University. Police cadets started receiving crisis management training this year but more needs to be done.
Finally, show solidarity towards those who died by suicide tonight: light a candle on your window to commemorate World Suicide Prevention Day.
Go out and exercise, a sure protective factor for mental illness.
Be vigilant and support those who are going through a hard time. Ask them about suicide because, ultimately, people want to be healthy and live a happy life!
You will be doing the right thing and joining thousands worldwide.
Mark Xuereb is a psychiatrist and University lecturer
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