Think suicide is preventable

Suicide: It's time to bring the taboo down

More and more people in Switzerland are thinking of putting an end to their lives. However, many suicides could be avoided - if we spoke about them openly and invested more in prevention.

Alexander Maier, CFO in an automotive supplier company, subordinates his entire life to work. As a perfectionist, he wants to achieve the highest goals. Until he clashes with the new CEO Hans-Werner Brockmann. He blames him for a failed deal with a major investor. Maier sees only one way out, to put an end to the situation and take revenge on Brockmann ...

This is the plot of a film, “Jagdzeit” by Sabine Boss. It could very well have happened in real life, because the film is inspired by real events. He takes up a topic that is still a big taboo in our society: suicide.

Increase in suicidal ideation and high number of suicide attempts

In 2018, 280 people lost their lives in a traffic accident (road, rail, air traffic). Around 1,000 in 2016 due to suicide (excluding euthanasia). These figures show impressively: Fortunately, prevention works quite well in traffic, but there is still a great deal of action to be taken with regard to suicide.

A 2019 report by the Swiss Health Observatory (suicidal ideation and attempted suicide among the Swiss population) shows a worrying development. Around 7.8% of the Swiss population aged 15 and over said in 2017 that they had had suicidal thoughts at least once in the last two weeks prior to the survey. That is 7,796 people affected per 100,000 inhabitants. In 2012 it was 6.4%. It can be assumed that the rate is even higher because certain respondents find it taboo to admit that they have thoughts of suicide.

There are no major differences between women and men or the age groups. In contrast, people in cities, with little education and with a migration background think more often of suicide. Thoughts of suicide are often related to depression (over 50%). But other mental or physical ailments can also lead to suicide. A very important factor is self-determination: Almost 70% of people with suicidal thoughts feel that they cannot determine their own lives.

In 2017, 0.5% of respondents reported trying to kill themselves within the last 12 months. That corresponds to around 33,000 suicide attempts in Switzerland. If one also includes suicide attempts that were more than 12 months ago, the number skyrockets to 3.4% and well over 200,000 people.

Suicide prevention is at least as important as accident prevention

All of these figures correspond to the values ​​of comparable industrialized countries. However, this should not be a reason for Switzerland to lean back. We urgently need to speak more and more openly about the subject of suicide, the taboo must fall, and suicides must be prevented.

How can it be done? What works in traffic should also be successful in suicide - that is the vision of Roger Staub, project manager for ensa courses and the suicide module at Pro Mente Sana. “Almost all of them have completed emergency aid courses and know what to do in the event of an accident,” he says, noting: “Mental crises and problems are much more common than accidents. But hardly anyone is trained for it. " Pro Mente Sana, a foundation that works in the interests of mentally impaired people, wants to remedy this situation with courses (see box). "It would be ideal if every fifth person had a first-aid training in this regard," says Roger Staub.

There is still a long way to go. The federal government and individual cantons are running a campaign and, in addition to Pro Mente Sana, organizations such as Pro Juventute or Dargebotene Hand offer help. However, the resources are limited. "The situation with regard to prevention is bad in Switzerland because the insurers are not responsible for it," says Roger Staub. Mental health problems are illnesses and not accidents. There the financing is regulated differently than in the Accident Insurance Act, which has a prevention article. Something is missing in the health insurance law. “One also sees illnesses as something private that is not related to work,” adds Roger Staub.

A recent federal court ruling made people sit up and take notice. The highest Swiss court attested to a lawyer who had worked at the Federal Office for Migration that her burnout was due to her work. Dust believes that this is a step in the right direction. Incentives should be created so that employers address this issue. That pays off for her: “A burnout case in middle management can quickly run into hundreds of thousands of francs. Prevention is cheaper. "

Recognize warning signs

There is hardly anyone in whose circle of acquaintances no suicide has ever occurred. And who has never asked themselves: "What could I have done?" This question will be answered in a moment. First of all, it's about knowing if someone is suicidal.

"There are a number of warning signs," says Liliana Paolazzi, suicide prevention expert at Pro Mente Sana. She lists: “The most serious signs are certain when someone says that he no longer sees any meaning in life and that suicide is an option. Or when you notice someone starting to research suicide methods on the internet. Even if feelings of great hopelessness and self-criticism are expressed, one should pay attention. Further indications can be the withdrawal from the circle of friends and the restriction of activities or the abandonment of hobbies. Some people who want to commit suicide also start conspicuously saying goodbye or make subliminal hints that they can no longer see each other. Others give things away or give away their beloved pet. A very serious warning sign is when people who are in a mental crisis like severe depression suddenly become cheerful, relaxed and relaxed. "

Mental crises won't go away overnight, Liliana Paolazzi emphasizes. If you notice a sudden change in behavior, this could also be an indication that the person concerned has found a way out of his situation in suicide.

The suicide prevention expert warns: "You have to be aware that there are people who show several signs, but it can also be that none of them is visible or can be perceived."

As a rule, when someone is feeling bad, it is not usually first noticed in the workplace, says Roger Staub. But in the family and then in the circle of friends. “When you notice it at work, it is usually very late. Those affected do everything to hide their feelings there. "

First commandment: Talk to us!

What do I do if I see the warning signs described above on someone close to me or a work colleague? The answer is simple (and yet not easy, as we will see in a moment): "Speak up!" Says Roger Staub. And very directly and without prudding and without wanting to avoid the word "suicide".

But: who can do it so easily with such a difficult topic? For example, Roger Staub suggests the following formulation: «You, I'm worried. I notice ... are you thinking of killing yourself? " Even such words will not come off the lips easily, the suicide expert is fully aware: “The stupid thing is that you can't say something like this if you haven't practiced it. We are reluctant to utter something so monstrous when one has never done it before. " In addition, most of them assume that the person concerned will only commit suicide if he is spoken to about it. That is wrong, the opposite is the case.

The correct address can be learned in the ensa courses (first aid for mental health) from Pro Mente Sana. Roger Staub summarizes the content as follows: "We convey facts about suicide, dispel myths, draw attention to the warning signs and teach the three steps of first aid: speak / ask, ensure safety and bring professionals into play."

Last but not least, the courses are good for yourself. "Measurements have clearly shown that the mental health of the course graduates is also getting better," emphasizes Roger Staub.

Helping others and yourself - if enough people in our country do this, Roger Staub's vision can come true and we can make good progress in suicide prevention. Take part too!

Hansjörg Schmid

Wednesday, Mar 11, 2020