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C-08. Educational course: Prevention ofsuicide

Published online by Cambridge University Press:  16 April 2020

Abstract

Type
Interdisciplinary
Copyright
Copyright © European Psychiatric Association 2005

Approximately one million people commit suicide each year in the world. According to WHO estimates, 1,53 million people will die from suicide in the year 2020 and 10-20 times more will attempt suicide worldwide. There is a clear trend of increased suicide rates with age. An average global suicide rate for men is 25 suicides per 100 000 men, for women corresponding figures are for an overall rate 7 per 100 000 females. In suicide prevention, strategies can be directed at the general population or the healthcare services. Since suicide risk is high among psychiatric patients, adequate treatment of psychiatric disorders and improved detection of psychiatric illnesses in the general population are essential. Suicide-preventive effects of treatment with antidepressants, lithium, neuroleptics, dialectical behavioural therapy and cognitive behavioural therapy to date are encouraging. Suicide risk is particularly high among psychiatric patients in the immediate aftermath of their discharge from hospital. Careful follow-up and rehabilitation plans should therefore be provided to help patients adjust to their new life situation. Some patients need long-term treatment ¾ in chronic cases for several years. Moreover, psychiatric patients should be informed and prepared to seek help when new stressful events come to a head and their coping ability once more deteriorates when facing difficulties in new circumstances. In future suicide-preventive work, the emphasis needs to shift to an earlier stage of the suicidal process. A public-health approach, involving a change in attitudes towards the mentally ill, and also programmes aimed at disseminating knowledge of health-promoting measures, are important. Population-oriented suicide prevention focuses on building up supportive networks and strengthening the coping skills that enable people to deal with difficult life circumstances. Perestroika in the former USSR was history's most effective suicide-preventive programme for men. Strict limitations were imposed on the sale of alcohol, and a new discouraging attitude towards alcohol consumption was actively promoted. Some examples of suicide prevention in schools and of population-oriented suicide prevention - including environmental measures, such as restriction of access to dangerous means of committing suicide - will be given. Various psychiatric treatments have had very well-documented effects in suicide prevention. Nonetheless, for maximum overall impact, it is advisable for a public-health approach to go hand in hand with a healthcare approach. Reference Wasserman, D. (ed.) Suicide - An Unnecessary Death. ISBN: 1-85317-822-5. Martin Dunitz Ltd, London, 2001.

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