1ST CITY CLINICAL HOSPITAL

Suicide prevention

06.09.2023

“Suicide is a cry for help that no one heard”

September 10 is World Suicide Prevention Day.

The global goal of World Suicide Prevention Day is to reduce suicidal activity in the population (reduce the suicide rate).

Suicide, suicide (from Latin sui - oneself, caedere - to kill) is the deliberate, conscious and quick taking of one’s life. The criteria by which one can draw the line between suicide and other types of death, as well as various “near-suicidal” phenomena of other types of death and “parasuicides” are the following: voluntariness, independence, consciousness, intentionality, sufficiency.

Every death is a tragedy. Every case of suicide suggests that the fear of life overcomes the fear of death. Studying the problem of suicide and analyzing specific cases show that most people decide to commit suicide in order to draw the attention of people around them to their problems. Therefore, every adult, every parent should know about these problems, know how to help a person in case of illness, danger, grief or weakness, how to incline his choice towards life, together with him find a way out of a situation that still seems insoluble, responsible for the life of his child.

PROBLEMS AND OBSTACLES

Suicide prevention has not received adequate attention around the world, mainly due to lack of awareness that suicide is a significant problem and because open discussion of the issue is prohibited in many societies.

Suicide prevention is a difficult but feasible complex task, to achieve which in the Republic of Belarus the efforts of many ministries and departments, organizations and institutions, local executive and administrative bodies, as well as public associations and traditional religious denominations are combined. Suicide prevention is an integral part of the policy of increasing the demographic security of the state.

Just a few decades ago, “suicide” ranked far beyond the 20th place in the list of causes of death in the world; now this cause of death is in the top 10 places. At the end of the 19th century, the Russian Empire ranked last in terms of suicide rates among European countries - it had 3 suicides per 100 thousand population, in 1988. in the USSR - 19 per 100 thousand population, in 2016 in the Republic of Belarus - 21.5 per 100 thousand population, and in 2018 – 19.0 per 100 thousand population of our country, while the republic returned to the category of countries with an average level of suicides (up to 20.0 cases per 100 thousand population). Today, suicide can be considered as a consequence of socio-psychological disadaptation or a personality crisis in the context of micro-conflicts experienced by it. There is no single reason for suicidal behavior and it depends on living conditions, the political situation, values ​​and traditions, and religious attitudes.

EFFECTIVENESS OF EVENTS

In the context of the effectiveness of ongoing preventive measures, in addition to basic strategies aimed at limiting access to common means of suicide, it is necessary to include approaches that cover interventions and activities at many levels (education, crisis intervention, socialization, labor, legal aspects, etc.) . There is also compelling evidence that appropriate prevention and treatment of existing physical and mental illnesses leads to reductions in suicide rates (early identification, treatment and care of people with mental disorders and various addictions, chronic pain and acute emotional disorders). We must not forget about responsible coverage of this topic in the media (formation of realistic and not distorted by prejudices ideas about suicide, as well as promoting the dissemination of educational information), the introduction of an alcohol policy to reduce the harmful use of alcohol, and the training of non-specialized medical personnel in assessing and managing suicidal behavior.

STIGMATIZATION

Stigma, particularly around mental illness and suicide, means that many people who consider taking their own life or attempt suicide do not seek help and therefore do not receive the help they need. Suicide prevention does not receive enough attention due to a lack of understanding that suicide is a major public health problem and that in many communities there is a taboo against openly discussing the issue.

There is a false belief among the population that turning to a psychiatrist, psychotherapist, or psychologist is something shameful and entails social consequences, which is a serious obstacle to the widespread early access of the population for the necessary help.

The existing system of providing psychiatric care provides for the establishment of dispensary observation only for patients suffering from severe, chronic mental disorders.

Seeking psychiatric, psychotherapeutic and psychological help does not entail any social consequences!

IT IS IMPORTANT TO KNOW!

Signs of emotional disturbances:

• loss of appetite or gluttony, insomnia or increased sleepiness;
• frequent complaints of somatic ailments (abdominal pain, headaches, constant fatigue, frequent drowsiness);
• unusually dismissive attitude towards one's appearance;
• persistent feelings of loneliness, worthlessness, guilt, or sadness;
• feeling bored when spending time in familiar surroundings or doing work that was previously enjoyable;
• withdrawal from contacts, isolation from friends and family, becoming alone;
• impaired attention with a decrease in the quality of work performed;
• preoccupation with thoughts about death;
• lack of plans for the future;
• sudden attacks of anger, often arising from trifles;
• pessimistic assessment of one's past, selective recollection of unpleasant events, pessimistic assessment of one's current state, lack of prospects for the future.

External manifestations of suicidal behavior may include:

• sad facial expression (sorrowful facial expressions), hypomimia, amimia;
• quiet monotonous voice, slow speech;
• brevity of answers, lack of answers;
• accelerated expressive speech;
• general motor retardation, inactivity, adynamia, motor agitation;
• the desire for contact with others, the search for sympathy, an appeal to the doctor for help;
• egocentric focus on one's suffering.

Autonomic disorders:

• The same in other parts of the body (head, abdomen)
• Tachycardia
• Feeling of a lump in the throat
• Tearfulness
• High blood pressure 
• Disturbed sleep rhythm
• Dry mouth (“dry tongue symptoms”)
• Dilated pupils
• Headaches
• Insomnia
• Decrease (increase) in body weight 
• Decreased appetite
• Lack of sense of sleep
• Increased drowsiness
• Menstrual irregularities
• Constipation
• Feeling of physical heaviness, mental pain in the chest
• Feeling of shortness of breath, lack of air

When to seek professional help:

• You feel hostility towards people you used to treat well;
• You have no interest in anything;
• Your health is significantly compromised;
• You become dependent on drugs or alcohol;
• You avoid society and spend most of your time alone;
• Are you thinking about suicide?

Signs indicating a suicidal threat:

Behavioral:

• Any sudden changes in behavior or mood that distance you from loved ones.
• Tendency to take unreasonably risky actions.
• Excessive use of alcohol or pills.
• Visiting a doctor is unnecessary.
• Violation of discipline or reduction in the quality of work or study.
• Parting with expensive things or money.
• Purchasing means for suicide.
• Summing up, putting things in order, preparing to leave.
• Neglect of appearance, neatness in everyday life.

Verbal:

• Beliefs of helplessness and dependence on others.
• Parting.
• Talking or joking about wanting to die.
• Reporting a specific suicide plan.
• Expressing self-blame.
• Dual assessment of significant events.
• Slow, unexpressive speech.

The desire to die is common among children and the elderly, and suicidal fantasies are quite natural among ordinary adults. These desires can be expressed in different ways: “If I died now, my parents would regret treating me so badly,” “It’s better to die than to continue to live and suffer like this,” “I’m tired of life,” “You It will be better without me, because... I am a burden to you,” etc.

It is these statements that are used in pre-suicidal conversations or notes. Threats can turn into actions. Instead of passive acceptance of insurmountable difficulties, there arises an active declaration of independence: death by one's own hands. The victim seems to be shouting: “At least I managed to do at least this.”

The risk of suicidal behavior increases if:

• The presence of a previous (unfinished) suicide attempt.
• Tendencies towards self-harm (auto-aggression).
• Presence of suicide attempts in the family.
• Alcoholism. Long-term alcohol abuse contributes to increased depression, guilt and mental pain, which often precede suicide.
• Chronic use of drugs and toxic drugs. They weaken motivational control over human behavior, exacerbate depression, and cause psychosis.
• Affective disorders, especially severe depression.
• Chronic or fatal diseases.
• Bereavement, such as the death of a parent, especially during the first year after the loss.
• Personal and family conflicts (divorce, illness, loneliness, unsuccessful love, insults from others, sexual incompetence).
• Conflicts related to antisocial behavior, including fear of criminal liability; fear of other punishment or shame.
• Material and everyday difficulties.
• Conflicts related to work or study (failures).

Requirements for conducting a conversation with a person contemplating suicide.

To begin with, it is necessary not only to accept the suicide person as a person capable of suicide, but also to recognize the person’s formal right to take such a step. And during the dialogue itself, the adult is recommended to:

• Listen carefully to your interlocutor.
• Form questions correctly, calmly and clearly asking about the essence of the disturbing situation and what help is needed.
• Do not express surprise at what you hear and do not judge for any, even the most shocking statements.
• Do not argue and do not insist that his trouble is insignificant, he lives better than others, but statements like “everyone has the same problems” will make a person feel even more unnecessary and useless.
• In children and adolescents, try to change the romantic-tragic aura of ideas about their own death.
• Do not offer undue consolation, but emphasize the temporary nature of the problem.
• Suggest constructive ways to solve it.

At the same time, strive to instill hope in a person, which, however, must be realistic and aimed at strengthening his strengths and capabilities.

NOTE

The republic has an emergency psychological assistance service called “Helpline”. What should a person do in such a situation if there is no one nearby who could support? Where to go, who to speak to, where to get help? Just questions?

Specialists will listen to your problem and give recommendations on what to do, make an appointment or tell you where to go next.

"HOLIDAY PHONES"

Minsk: 

• for adults 8-017-352-44-44, 8-017-304-43-70 (multi-channel, 24 hours a day)
• for children and teenagers 8-017-263-03-03 (24 hours a day)

Republican "Children's telephone line": tel. 8-801-100-1611