Tuesday, September 15, 2020

Suicide - A preventable tragedy? – 1 International Perspectives on Suicide Prevention



 


How to know if friends or workmates need help

It was World Suicide Prevention Day last Wednesday and Australia’s R U OK Day (Are you OK?). These reflect an important and growing problem.  According to the World Health Organisation, around 800,000 people took their own lives in 2016 and for every suicide at least 20 other people attempted to do so.  Globally, it is the second leading cause of death among 15 – 29 year olds and the leading cause of death of young people in Australia. While suicide rates tend to be higher in poorer countries,wealthier countries such as Australia, Scandinavia, France and the USA had the second highest rates and higher rates than say, Mexico, Brazil or China.

These events don’t just affect the immediate family, but also their co -workers, their communities, the first responders  and so on, and if the work coming out of India is any guide, things will most likely get worse in the wake of COVID 19, as people experience job losses, economic loss, loneliness and isolation, uncertainty and bereavement.  I personally think we need far more than one day a year to consider this issue - it has taken me almost a week just to read some of the literature, but in this post I will just touch on what other countries are doing and the next post will be about Australia’s response. If you want to know more about what is being done around the world and in various sectors, click on the World Health Organisation’s full text here.

Some forty countries including Australia have put together Suicide Prevention Strategies. Broadly, the key concepts areas are summed up by the acronym LIVE LIFE

The first group of four (in red) revolves around what Governments could or should do:
The L stands for showing leadership by establishing policies and ensuring multisectoral collaboration between departments, schools, the medical profession and so on. The "I" stands for interventions and implementation. V is for Vision, Innovation and Financing and E is for Evaluation, Monitoring and Research.

The second L stands for less means. It is about reducing access to the ways in which people end their lives.  India for example, is putting laws in place to restrict access to pesticides, Switzerland is removing guns from the home to a central repository and restricting sales of both guns and pharmaceuticals. It is also looking at putting barriers on tall buildings. When the Israeli Defense force mandated that weapons must be kept on base at weekends, there was a 40% drop in suicide by Defense Force personnel. A study by the American Public Health Association shows that states which have tighter gun laws have fewer suicides.
 
Another example comes from the Republic of Korea where they have glass sliding doors between the platforms and the rails on subways which only open when the train is in the station, especially on the line which serves the main university in Seoul. 
 
The reasoning behind this is that everyone has bad days or bad moments like being fired from a job or getting bad marks, but suicide is an impulsive act, so the greater the distance and difficulty between the event and the act, the less likely someone is to carry it out. That is also the purpose of things like barriers on bridges, such as we have in Tasmania, or the proposed net California is building on the Golden Gate Bridge.

“I” is about interaction with the media – raising awareness, not sensationalising cases of suicide or enabling copycats by giving precise details.

“F” is about forward thinking - teaching young people to become more resilient and learning strategies to cope with life’s adversities. 

“E” is about early identification, assessment, management and following up of those at risk.


Many countries have had considerable success in implementing these concepts. Scotland for example, which has had a Suicide Prevention Strategy since 2002, has been able to reduce its suicide rate by 20% in the interim, making it much lower than most other European countries. Sweden which has had a “Vision Zero” policy since 2008 has also greatly improved with a 50% reduction in deaths attributable to road safety improvements alone. Both countries have also paid attention to dealing with alcohol and drug problems.Given that the American Public Health Association has put the cost of suicide to the US economy at  $70 billion a year, largely in lost productivity alone, there are sound economic arguments for national governments to consider their own strategies, quite apart from the human cost. 
  
Helping people to choose life
Helplines and Hotlines have also proven to be highly successful, responding to over two million calls in 2017. While it isn’t possible to list all these here, you can see those for your country  here  or on this WhatsApp site which also has a downloadable app. You could also check the Befrienders website which has contacts worldwide.


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