Monday, October 27, 2014
National Suicide Prevention Strategies: A Comparison (FREE PDF DOWNLOAD)
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