Mexico City. Suicide is a growing public health problem around the world, so its prevention should be considered a priority. At the international level, more than 800,000 people commit suicide annually, that is, every second 40 people kill themselves. In the last 45 years suicide rates have increased by 60% globally. Suicide is currently the second leading cause of death among 15 to 29 year olds.
Suicide is a reality that hurts and hurts an entire society; It causes a strong emotional burden on the family and friends of people who for some reason decided to take their own lives, since in addition to the pain of loss, it generates feelings of guilt regarding a fatal event that could have been avoided.
In Mexico, the numbers of hopelessness have also increased in the last 50 years, especially among young people of working age and elderly men. In 2017, the total number of deaths due to suicide was 6,494, with a more pronounced trend in men (8.7 per 100,000) than in women (1.9 per 100,000), the national average being 5.2 per 100,000 inhabitants. . The group from 20 to 24 years old stands out, with a rate of 15.1 suicides for every 100,000 young men.
Suicide, a complex and multifactorial problem
Despite the high emotional and economic burden that suicide means, this is an event that can be prevented by identifying risk factors and improving the mental health of the population. Dr. Edilberto Peña, neuropsychiatrist and teacher in medical sciences, explains that the first step to prevent suicide is to focus on its causes, which are multiple. “Suicide is a complex problem, involving psychological, social, biological, cultural and environmental factors.”
The World Health Organization (WHO) indicates that mental disorders, such as major depression, bipolar disorder, alcohol-drug abuse and schizophrenia, are a very important factor associated with suicide, with a total prevalence of 80 to 100% of mental disorders in cases of completed suicide.
“Most suicides have been preceded by verbal or behavioral warning signs, although some of them are committed without prior warning. Still it is important to know the warning signs, such as statements or threats of suicide, deep hopelessness, drug or alcohol use, getting rid of loved possessions, saying goodbye or asking for forgiveness, isolation, hurting themselves, talking about death as a way out of problems or presenting abrupt changes from a state of euphoria to a state of deep sadness “, indicated Dr. Peña.
The neuropsychiatry specialist warned that the Covid-19 crisis may be a risk factor for an increase in suicides. “The problems triggered by the pandemic can generate psychological mediators such as sadness, worry, fear, anger, frustration and guilt.”
In times of Covid-19 there are psychosocial risk factors associated with suicide such as social isolation, loss of loved ones, stigma towards people with Covid-19 and their families, loss of employment and financial stressors, interruption of education and anxiety about the future, domestic violence and alcohol use, fragmentation and social tension, availability of means to commit suicide and low-resource settings.
Suicide prevention and intervention strategies promote social well-being
Through timely and effective interventions, based on treatment and support, both suicides and suicide attempts can be prevented. Dr. Peña explained that among the specific prevention strategies are accompaniment in grief; promote tools to promote mental health; mitigate the adverse effects of isolation; implement educational and awareness programs for patients, families and healthcare providers; facilitate problem solving, and avoid loneliness and disconnection.
“Therapeutically speaking, there are effective ways to prevent suicide, such as pharmacotherapy, psychotherapy and follow-up after an attempt. It is also important to restrict access to lethal methods and share good practice guides with the media, ”said the specialist. Antidepressant management significantly reduces the rate of suicide attempts, especially in young populations.
At the government level, a comprehensive legislative strategy is necessary to establish policies that help prevent suicide, improve mental health care for the population, and provide tools for specialists who attend to this public health problem. Dr. Peña de León pointed out that until now there is no article in the General Health Law that refers to any prevention strategy or action against suicide.
For her part, Sara Montero, general director of Mexico, Central America and the Andean Countries of Lundbeck pointed out that: “A single life lost by suicide means a lot. The way forward is for authorities, health professionals and society to work together to prevent suicide, and the time to act is now. As a global company and leader in mental health, we collaborate with authorities, patient groups and other interested sectors in different countries to support communities and society in the prevention of suicide ”.
1. Pan American Health Organization (PAHO) / World Health Organization (WHO). World Suicide Prevention Day 2019. “Working together to Prevent Suicide”. Available at: https://www.paho.org/hq/index.php?option=com_docman&view=download&slug=trabajando-juntos-para-prevenir-el-suicidio-claudina-cayetano-esp&Itemid=270&lang=es
2. World Health Organization. Suicide. Available at: https://www.who.int/es/news-room/fact-sheets/detail/suicide#:~:text=%20Datos%20y%20cifras%20%201%20Cerca%20de,en%20pa % C3% ADses% 20de% 20income% 20low% 20y …% 20More% 20
World Health Organization. Suicide prevention. Available at: https://www.who.int/mental_health/prevention/suicide/suicideprevent/es/
3. Pan American Health Organization (PAHO) / World Health Organization (WHO). World Suicide Prevention Day 2019. “Working together to Prevent Suicide”. Available at: https://www.paho.org/hq/index.php?option=com_docman&view=download&slug=trabajando-juntos-para-prevenir-el-suicidio-claudina-cayetano-esp&Itemid=270&lang=es
4. Hernández Bringas, Héctor Hiram; Flores Arenales, René. Suicide in Mexico. National Autonomous University of Mexico. Pap. poblac vol.17 no.68 Toluca Apr./Jun. 2011.Available at: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-74252011000200004
5. INEGI. “Statistics regarding the World Suicide Prevention Day (September 10)” Available at: https://www.inegi.org.mx/contenidos/saladeprensa/aproposito/2019/suicidios2019_Nal.pdf
6. Hernández Bringas, Héctor Hiram; Flores Arenales, René. Suicide in Mexico. National Autonomous University of Mexico. Pap. poblac vol.17 no.68 Toluca Apr./Jun. 2011.Available at: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-74252011000200004
7. California Central Coast Family Services Agency. Suicide warning signs. Available at: http://fsa-cc.org/wp-content/uploads//2014/01/Señales-de-Alerta-de-Suicidios.pdf
8. Brown & Schuman, 2020; Gunnell et al., 2020; Thakur & Jain, 2020
9. Brent DA. Antidepressants and Suicidality. Psychiatr Clin North Am. 2016;39(3):503-512. doi:10.1016/j.psc.2016.04.002.