Suicide is a serious public health problem surrounded by stigma, myths, and taboos. Every year close to 800,000 people take their own life, corresponding to one person every 40 seconds. Contrary to common beliefs suicides are preventable with timely, evidence-based, and often low-cost interventions. It is estimated that for each suicide that occurs, there are more than 20 attempts. Suicide can occur at any age and it is the third highest cause of death among young people between the ages of 20 and 24 in the Region of the Americas
COVID-19 pandemic has resulted in loss, suffering and stress. Focusing on suicide prevention is especially important now, to remain connected to each other and to be aware of the signs of suicide risk and how to respond. During times of increased physical distancing, people can still maintain social connections and care for their mental health.
In the region of the Americas, about 100.000 premature deaths from suicide are reported each year. Suicide is the second leading cause of death among 15-29-year-olds, worldwide and is about 4 times more frequent in males, accounting for roughly 79% of all self-inflected deaths. The highest rate of suicide in the Region of the Americas is reported in males over the age of 70. The impact of these deaths on families, friends, and communities is devastating. Unfortunately, all too often suicide is not given priority as a major public health concern.
Despite an increase in research and knowledge about suicide and its prevention, the stigma surrounding it persists, and those who need help frequently do not seek it, feeling alone in the face of the risk. Even when people do seek help, many health services admittedly fail to provide it. The challenge is real and must be met.
Previous suicide attempt remains the most important risk factor for suicide. While the link between suicide and mental disorders such as depression and alcohol use disorder are well established, many suicides happen impulsively in moments of crisis such as financial problems, relationship break-up or chronic pain and illness. Suicides can be prevented by reducing access to lethal means (e.g. pesticides, firearms, certain medications) and promoting education and training in the community about the risk of suicide.
Stigma surrounding mental disorders and suicide prevents people from seeking help. It means many people thinking of taking their own life or who have attempted suicide are not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health in many countries. Under-reporting and misclassification are greater problems for suicide than for most other causes of death due to the sensitivity of suicide and the illegality of suicidal behavior in some countries.
The Mental Health and Substance Use Unit of the Pan American Health Organization (PAHO/WHO), in conjunction with WHO Collaboration Center at Brown University Center, has produced three publication on regional suicide mortality in the Americas. The first report was published in 2010, which evaluated the period from 2000-2004; followed by the second report, published in 2014, which analyzed the five-year period of 2005-2009. A third report in the series, evaluating the period of 2010-2014. These reports provide a general description of suicide mortality in the Americas, by subregions, countries, and it analyzes the distribution of suicide according to age, sex, as well as methods used.
In 2016, PAHO published a report on “Prevention of Suicidal Behavior” This publication was conceived as a practical tool that provides essential information to better understand suicidal behavior and the main strategies to combat it, from registry to the evaluation of interventions, taking into account the approaches already under way in the Region. One of the indicators of PAHO Mental Health Plan of action 2015-2020 is to monitor the number of countries that develop and implement national suicide prevention programs. The suicide rate is also one of the indicators for health target 3.4 of the United Nations Sustainable Development Goals. The PAHO technical unit provide technical support to countries in the development of National suicide prevention strategies. These strategies are essential for elevating suicide prevention on the national agenda, otherwise this challenge will remain neglected.
As part of capacity building for suicide prevention the unit has developed tutor lead and self-pace courses on suicide prevention. The virtual course on preventing self-harm/suicide: Empowering Primary Health Care Providers is available on the PAHO Virtual Campus for Public Health.
Using the mhGAP-IG as well as the mhGAP HIG, we delivered virtual and face to face training to primary health care providers as well humanitarian workers on detection and management of suicidal behavior.
Providing training and webinar to journalists on responsible reporting on suicide with the objective of guiding journalist on communicate to the public about suicide in ways that reduced stigma and promote access to care.