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More and more middle-aged men and women are taking their own lives. Teenagers, who so far have usually only made suicide attempts, are dying more and more often, says Professor Bartosz Łoza, head of the Department of Psychiatry at the Medical University of Warsaw. He is concerned about the easy access to lethal substances in Poland and the promotion of suicidal behavior in the media, which encourages him to take on his own life.
- Poland is in the group of 25 countries with the highest number of suicides. It is believed that poverty is conducive to suicide attempts. – Prosperity protects against nothing. The world leader in suicide threats, South Korea, is a highly developed country, but similar to Poland in the so-called “Junk contracts – adds prof. Osier
- When Marieke Vervoort, the Belgian Paralympic champion from London, announced that she would consider euthanizing after the Olympics in Rio de Janeiro, among dozens of reports on this subject I did not find a comment on how to help a sportsman, says Prof. Bartosz Łoza
- What to do when someone says that he or she does not want to live, that he is thinking of suicide? Prof. Bartosz Łoza says: «To talk. Don’t run away. Show understanding. Provide support. Research has shown that talking reduces the risk »
Zuzanna Opolska, Medonet: Professor, according to WHO, every 40 seconds someone takes their own life. We live in times of suicide?
Prof. Bartosz Łoza, Medical University of Warsaw: Marieke Vervoort, the Belgian Paralympic champion from London, announced that she would consider undergoing euthanasia after the Olympics in Rio de Janeiro. He suffers from a degenerative spinal cord disease. Among dozens of reports on this subject, I did not find a comment on how to help an athlete. So, suicide has become something ordinary, accessible, and attractive as a way to solve all problems. This situation is reinforced by legal solutions and practice in many countries, mainly in the Netherlands and Belgium, regarding voluntary euthanasia and assisted suicide. In 2015, a total of 5500 people died this way in the Netherlands. So the answer is yes, we live in “suicidal times”.
Poland is in the group of 25 countries with the highest number of suicides. Do we have data from this year?
According to the police, the number of fatal suicide attacks in 2014 was 6155 (16 per 100000 inhabitants). Unfortunately, it is very bad with suicide reporting in Poland. There are actually three statistics. The police relies on a reporting system (Themis) that collects data when there is a suspicion of a crime. This statistic reveals a huge (+50 percent) increase in suicides in Poland in 2013–2014. In turn, the GUS system is based on death certificates and has a reporting delay (currently covers 2013). The CSO usually presents indicators higher than the police, in some years even by several dozen percent. In fact, the numbers of suicides recorded by the Central Statistical Office and the police do not reflect the actual state of affairs. In the statistics of the police and the Central Statistical Office, many deaths that could have been caused by suicide are recorded as deaths due to another cause (e.g. trauma, poisoning, unknown cause). The only thing we know is that Poland has become one of the leaders among countries with a suicide risk – not only in Europe, but also in the world.
The lowest number of suicides was committed in 2007 – 3530, and the same year saw one of the largest economic increases 6,7. What is the impact of the wallet on our psyche?
There are several cultural patterns that favor suicide. Unfortunately, prosperity does not protect against anything. The world leader in suicide threats, South Korea is a highly developed country. At the same time, it is worth noting that South Korea is similar to Poland in the use of low-quality employee security (“junk contracts”). Besides, people commit suicide not because hot tap water is flowing, but because it stops, or actually, it may stop flowing. This feeling of exclusion, losses, and the burden of responsibility are risky, not the absolute level of wealth.
In many areas (Germany, England, Wales, Hungary, Scandinavian countries, France) the suicide rate has been stable for decades – how to explain this phenomenon?
The suicide rate is never stable anywhere. It’s just a matter of perspective: short, medium or long term. In Poland, this indicator increased after the Second World War, it dropped in 1980 and 1989 – due to public enthusiasm to increase again in recent years. In Europe, in the 90s, the popularization of antidepressants resulted in a decline in suicidal behavior. It is not true that the current crisis of increasing suicide in Poland appeared “out of nowhere”, and even paradoxically in opposition to economic success. Although 10 years ago the threat index was relatively lower, even then the growth dynamics was one of the highest in the world (again, just like in South Korea). We shouldn’t, so now pretend to be surprised. Since 1989, Poles have been chasing the developed world, breaking world records with their work and it can be seen that they are largely doing it beyond their own strength.
According to the American Foundation for Suicide Prevention, in the United States, 50 percent of suicides choose firearms, how is it with us?
In Poland, almost all suicides are committed by hanging, while poisoning dominates among suicide attempts. In turn, in the United States they are disastrous for having easy access to weapons. Almost daily reports of the mass use of weapons create a false image of the country. In fact, firearms cause twice as many suicides as there are homicides with them. In general, there are three times more suicides than there are homicides in the United States. And yet, in every American thriller, someone kills someone. It is such a cultural distortion and concealment of threats. In Poland, this ratio (suicide to homicide) is even more varied: 10 to 1.
Statistically, men take their own lives four times more often than women, in Poland this disproportion is greater, why?
In Poland, this proportion is approximately 6 to 1 (5237 to 928 in 2014). The explanation is probably “double”. At the same time, two male models have become obsolete: cultural and economic. Men are no longer rewarded for fighting, aggression, victories, and at the same time the modern economy has eliminated traditional male professions (miners, steel workers, soldiers, farmers, etc.). The males unable to adapt “go away”.
Let’s characterize a potential suicide: age, gender, mental disorders?
Most often, suicides in Poland are committed by a single man, over 50, after losing his job, with limited education, living outside large agglomerations, addicted to alcohol. Suicide attempts are the domain of young people, suicides are more frequent in proportion to life expectancy.
Does he suffer from mental disorders? American statistics show that this is the case of 90 percent of suicides, the most common being depression …
This is, unfortunately, a harmful simplification. Suicide dangers actually accompany mental disorders. Associations with depression are known. But many studies also show that they create a largely separate phenomenon. For example, research on the new drug, esketamine, shows the fundamental distinctiveness of depression and suicide risks. The greatest conceptual challenge introduced by the current classification of mental disorders (DSM-5) is the project of a new disorder called suicidal behavior disorder, under the so-called section III, DSM-5. What is innovative about this project is to recognize the fact that suicidal behavior has a distinct dynamic, not just accompanying other mental disorders.
Second and third place are bipolar disorder and schizophrenia …
Severe, chronic and relapsing diseases such as schizophrenia and bipolar disorder increase the risk of suicide. In the course of both disorders, the risk of suicide reaches 1/10 of the population. But it is equally important to recognize that effective treatment of these diseases reduces this risk. Anyway, most cases of euthanasia and assisted suicide in the Netherlands are not mental disorders, but somatic diseases, especially cancer.
What are the other risk factors for suicide?
Suicides in Poland are increasing among middle-aged men and women. Population aging will aggravate this group’s stress. More and more teenagers, who so far have usually made rather suicide attempts, are also dying. Some professions are associated with a higher risk of suicide, including physicians, including female physicians, as well as psychiatrists, military personnel and police officers. Certain types of trauma are at risk, including post-traumatic stress disorder (PTSD), job loss, and parting. The risk is increasing in the LGBT community, among people with weight disorders, among chronically ill and terminally ill patients. Easy access to lethal drugs and the promotion of suicidal behavior in the media are dangerous.
Can we inherit a suicidal tendency?
Such a risk, eg through the modeling mechanism, exists. However, this mechanism works on a much larger scale by promoting suicidal behavior in the media.
American suicidologist Farberow says you can even “mold” a suicide. Is it possible?
Unfortunately it is possible. This is what is happening today, on a massive scale, with people mobbed at work. The Polish Penal Code recognizes such and similar phenomena as a crime in three articles (persistent harassment – Article 190a, bullying – Article 207 and abuse of a soldier – Article 352). Our society is afraid of a multitude of abstract threats, and does not notice the nightmare of the domestic “bullies.”
Are there times of the year when assassinations are more common?
Yes, the risk increases during the holiday season. December is especially complicated, this month the risk initially decreases and increases directly during the Holidays and New Years. It is a complicated time characterized not only by promises and attempts to change, mostly unreliable, but also by “balance sheet” decisions. However, in fact, the absolute risk is greatest during the summer holiday months. It could be generalized that what is stereotypical and routine is protective.
What signals are sent from a person who is about to take his own life?
Such a person talks about it. All studies reveal that most of the suicides spoke to doctors, but also to other close people. Unfortunately, the surroundings try not to hear it at the same time. It creates a kind of “dance of death”.
What should we do when we hear that someone is trying to commit suicide?
Talk. Don’t run away. Show understanding. Provide support. One well-researched myth is whether talking increases or decreases the risk of suicide. Research has shown that talking reduces the risk. Further actions are, unfortunately, more and more theoretical in Polish conditions. They should be advised by a professional (who is hard to find and hard to get to) from a crisis center (who does not exist). The proposal of long-term psychosocial interactions aimed at reducing stress, rebuilding functioning and revising goals should be obvious.
How to help a person who has tried to commit suicide?
This question shows that we have completely wasted time since Norman Farberow created the first suicide center in 1958 in Los Angeles. We do not have such centers in Poland, the National Health Fund does not contract such “benefits”. Few local governments organize crisis intervention centers on their own initiative, but more of an ad hoc social support than a comprehensive approach. In Warsaw, detoxification takes place in a hospital with no psychiatric ward. How many more are we going to build “technology parks” and “water towns” with EU money, instead of reforming psychiatry, to create specialized support centers within it? I know many stories of people who, after suicide attempts, “rebounded” from the mediocrity of psychiatric services offered in Poland. I once interned at a specialized suicide prevention center in Salzburg. When looking for help of this quality in Poland, we will only experience frustration. This situation currently concerns, what I want to emphasize, the entire offer of public and non-public benefits.
For 80 percent of the suicides committed, a person was examined by a doctor in the year before death, and 45 percent in the previous month. How to heal in order to avoid disaster?
These numbers show how false the claims that suicides are unexpected and that victims do not seek help are false. It is exactly the opposite. This environment rejects those seeking help because they are helpless, full of fear, or simply reluctant and cynical about helping. I am convinced that the creation of competent help centers would make the environment more willing to initiate an intervention, because it would not involve their personal responsibility and commitment.