This seminal work examines national suicide prevention strategies that had been in place for 10 years or more. The key question (examined by comparing annual rates of suicide for each country for years before compared with years after) was "Did the strategy reduce rates of suicide?" It appears that national strategies can and do work, and we then attempt to answer the questions as to how this may occur.
"Suicide is a behaviour, sometimes planned over time, but often
impulsive. It can sometimes be predicted, but often is quite unpredictable.
There are many life patterns that may lead to suicide. These may include the
bright young person from a caring family who seems to be happy and successful
but at a moment in time has some ‘bruise’ to their sense of self and decides
and acts within minutes; the person whose life has always seemed to be in
chaos, where the struggle against exclusion frequently gets to be too much, and
the attempt to find relief and solace in medication was misjudged; the middle‐aged
woman with severe depression, not yet responding to treatment and support where
a chronic sense of hopelessness and nihilism leads to the carefully made
decision; the person with a psychotic illness who appears to be improving, is
released from an inpatient unit and goes home to find their life is unchanged,
and the spectre of long term illness has added more burden; the elderly man who
has lost a spouse, his work and a sense of meaning, and feels that life is
over.
Along the pathway to suicide, there are many risks that can increase the
likelihood of suicide, or bring the likelihood forward. Risks may be biological
(as in the gene which controls serotonin synthesis, and therefore depression);
or risks may come from family or social interaction (for example from violence
or abuse); or risks may be related to societal factors (such as chronic
unemployment or social exclusion); or cultural (for instance at least in the
first and second generations, Greek
migrants may have a very low risk compared to those who migrate from the Baltic
States). One very common risk is the abuse of alcohol – we know that more than
80% of suicides have alcohol in their blood stream, while nearly 25% have
levels of alcohol that normally cause drunkenness (Smith, Branas and Miller, 1999). On the other hand,
there are protective factors that may support someone
with even the most intrusive of suicidal thoughts, or mitigate some of the
other risks. As an example we know that connectedness to other people is highly
protective against suicide in the context of suicidal thinking.Any national strategy purporting to be
comprehensive has to manage this complexity. The full picture from biological
risk and protection to societal risk and protection must be fully understood
and integrated, and strategies put in place at all relevant levels, and for all
appropriate contexts."
(Text taken from the introduction to this work)
Martin, G. & Page, A.,
2009. National Suicide Prevention
Strategies: a Comparison. The University of Queensland. ISBN
978-0-9808207-9-9. Commissioned review, DOHA, Canberra. Downloadable in pdf
format from http://www.suicidepreventionstudies.org/index.html Alternate source:
http://www.livingisforeveryone.com.au/Library.aspx?PageID=60&ItemID=1443
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