According to data provided by the World Health Organization (WHO), more than 800,000 people die by suicide each year, and many more make the attempt unsuccessfully. In 2001, recorded suicides worldwide exceeded the number of deaths by homicide (500,000) and by war (230,000) while, in the vast majority of countries, it is the leading cause of unnatural death ahead of road accidents or murder.

It is clear that we are talking about a very serious public health problem, which, even today, remains a taboo subject for most governments and societies that suffer from it, as well as for the families involved. What is being done to prevent part of the population from ending their own lives? Below we will see what are the known measures to reduce the suicide rate .

The Stigma and Taboo of Suicide

First of all, in order to know how to intervene on the generalization of suicide attempts, it is necessary to take into account that it is complicated to do research on this subject , since it is covered by taboo and stigma. From the data we have seen, many more cases are assumed than officially reported because death by suicide is a very sensitive issue, even illegal in some countries, and may remain misclassified under deaths from “driving accidents” or “heart attacks”.

Studies on this aspect, such as those by psychologist Thomas Joiner, show that more than 40% of people who have lost a loved one through suicide would lie about it to hide the truth .

The registration of a suicide case is a complicated procedure that involves several different authorities among police, health personnel, family members and the media, who do not always face the facts with the transparency and information necessary to coordinate their prevention.

The Werther effect and information restriction

The focal point of these difficulties lies in the stigma associated with mental disorders and suicidal behavior, promoted mostly by fear and ignorance. One of the main pillars of disinformation lies in the well-known Werther effect .

The Werther effect (or its variants “copycat”, “domino”, “call”, among others) refers to the novel The Sorrows of Young Werther written by Johann Wolfgang Von Goethe in 1774, where the protagonist suffers so much for love that he decides to end his life. This behaviour was copiously imitated by many young people of the time, to the point where the novel was banned by the authorities.

Subsequently, sociologist David Phillips conducted a similar study between 1947 and 1968 showing that when the New York Times published a news item related to a suicide, these increased nationwide the following month.

In reality, the idea that suicide has a “contagious” aspect , that is, that if a famous person takes his or her own life or a similar news item comes to light it will lead others to consider suicide as a desirable option, is very difficult to prove, and the studies that make it known are contradictory. Suicide rates have remained stable over time, and this has been corroborated by statistics that have been available since the 19th century, which has made it possible to reach a worldwide agreement among all specialists about the most common causes.

The main causes of suicide

Among the main risk factors are: mental illness, depression and psychosis disorders, as well as drug use and addictions , chronic medical illnesses with pain and, finally, major life crises, the most frequent of which, in 60% of cases, is the break-up of a relationship (in the end, we continue to commit suicide for love), preceded by problems in the family environment and economic problems.

Mention must also be made of social isolation, uprooting and lack of emotional ties with one’s fellow human beings.

So, to what extent can talking about suicide help people who find themselves in these tesseracts and thinking about it in a recurring way? Certainly informing and raising awareness can prompt a person who has conceived of ending his or her life to take action as that drop that fills the glass, but in turn, is the only way for people to know that they can ask for help when they have reached this point and the only response they find is silence.

According to psychiatrist and suicide expert Carmen Tejedor, responsible for the first suicide prevention plan carried out in Spain, to prevent suicide people must be allowed to talk about it.

Attempts to end one’s life

No one wants to die; the idea that suicide is an act of free will understood as the person voluntarily deciding on his or her actions derives from a romantic concept of personal freedom. There is no freedom in suicide, only constant and intense despair until the individual considers his death as the only way to avoid suffering .

For every completed suicide there are between 20 and 30 people who put their lives on the line to try to end it. These attempts are the approaches that the individual makes, trials, to see how to face the fear, the physical pain and the break with his own sense of self-preservation . The expression “whoever has not managed to kill himself is because he was not really going to do it” is false. If a person has tried to kill himself once, it is very possible that he will try again, and the next attempt may be successful.

Psychological intervention and prevention

In the face of the majority of attempts or failed attempts, options can be opened that include pharmacological and psychological treatments through which many people discover new reasons to continue living . It has been estimated that without an adequate suicide prevention plan 30% of those affected will repeat the attempt, but thanks to a specialised intervention only 10% will do so.

The role of society is crucial, currently a few countries have included suicide prevention among their health priorities and only 28 countries have reported having a national strategy for suicide prevention.

The most direct measures have consisted in the restriction of information and the restriction of lethal means (such as the selection of the disclosure of information on suicides, over-the-counter medicines, stopping the use of barbiturates…). It has been shown that if a person initiates suicidal behaviour, but it is disrupted or inaccessible, he or she does not tend to run elsewhere to end it. Limiting access to a lethal environment means in practice installing physical barriers in risk areas such as windows in certain hotels and bridges.

However, we must go further and bet on the coordination of institutions . Firstly, responsible reporting from the media to break the stigma, particularly around mental disorders and suicide. The lack of such responsibility makes it impossible for people who are thinking of taking their own lives or have tried to do so to receive the help they need.

Secondly, in relation to the above, to have reliable information whose data allow further study of suicidal behaviour with a view to its prevention (only 60 Member States have good quality civil registration data that can be used directly to estimate suicide rates) including civil registers of suicides, hospital registers and nationally representative studies.

Finally, it should be noted that the first WHO global report on suicide “Suicide Prevention: A Global Imperative”, published in 2014, aims to raise awareness of the importance of suicides and suicide attempts, as well as the urgent need to develop comprehensive prevention strategies within the framework of a multisectoral approach to public health so that Member States have succeeded in stabilizing national suicide rates at 10% by 2020.