WE DO NOT HAVE CERTAIN DATA. But in Italy, as in several other countries, especially in Asia, the phenomenon could be on the rise. Also (and it must be emphasized: also) due to the pandemic: uncertainty of the future, economic worries, fear, stress and generalized anxiety that, in fragile people and already tried by other conditions, can trigger a suffering such as to push to take one’s own life. Not a cause-effect relationship, therefore, but a suffering that affects already critical conditions. Suicide in fact – as Maurizio Pompili, full professor of Psychiatry at Sapienza University of Rome and animator of the site www.prevenireilsuicidio.it points out – must not be understood as an approach to death, but as a distance from intolerable pain, from negative emotions intolerable and from an inner devastation. Conditions that the pandemic can accentuate, although it does not necessarily represent the cause.
Suicide alarm among young people: with the pandemic increased by 20%
by Nicla Panciera
Suicide is a complex problem and it is necessary to talk about it in the appropriate way, as is also requested by the World Health Organization. The risk is in fact the so-called “Werther effect”, the romantic hero of Goethe’s novel whose pains of love had led him to shoot himself in the temple: the spread of the book had actually generated emulation in several young people at the end of the eighteenth century. But the question of the increase is on the table. “The phenomenon has been under observation since the beginning of the pandemic, also thanks to the creation of an international task force of which I belong, and thanks to which our gaze is wider than national borders”, continues Pompili. The impression of some experts is that in recent months the cases of suicide are more numerous, a figure still not supported by official statistics. Moreover, that economic and social crises can cause an increase in suicides is a known fact: during the economic crisis of 2008 in Italy there was a 12% increase in suicides in adult males. Some estimates go as far as to quantify the likely increase in suicides in the United States at over 75,000 more people in ten years. The truth, however, is that in the absence of official estimates, all of this has the flavor of conjecture, however alarming. The accounts can only be made when Istat elaborates and makes public the data relating to the period of the pandemic.
According to the latest available data in Italy about 4000 people take their own lives every year, mostly (almost 80 percent) men. In general, death rates from suicide are higher in the northern regions and, in particular for men, in those of the north east, while the lowest values are recorded in the southern regions, for both men and women.
To monitor the trend of the phenomenon, on the occasion of the World Day for the Prevention of Suicide 2019 (10 September), the Istituto Superiore di Sanità also presented the Epidemiological Observatory on Suicides and Suicide Attempts (Oestes), a project in collaboration with Istat, Ministry of Health and Department of Neuroscience, mental health and sense organs (Nesmos) of the La Sapienza University of Rome. The Observatory’s objective would be to provide an accurate epidemiological picture on suicides and suicide attempts in Italy thanks also to information from the emergency rooms and hospitals. But there is no news of his activity yet.
World Day for Suicide Prevention: “No to TV series that inspire emulation”
marta pattern
In any case – write Monica Vichi and Silvia Ghirini, respectively of the Technical Scientific Statistics Service (STAT) and of the National Center for Addiction and Doping of the ISS – “the danger that the current health crisis, with the associated economic and social consequences, can also cause an increase in suicides is a very probable but perhaps not inevitable scenario. The situation the world is going through is somewhat unprecedented and the long-term effects of ‘social distancing’, confinement at home, living with a family member affected by COVID-19, as well as limitations on access to health services and prevention and treatment (routine or emergency). The most disadvantaged social classes, in particular, also see the satisfaction of their basic needs, due to the loss of work or the reduction of income due to the stoppage of production activities. All this, combined with the fear of being positive vi to COVID-19 and getting sick and / or making loved ones ill, has generated a strong state of anxiety and concern for the future that will inevitably affect the mental health of the population and can also impact the risk of suicide by going to add and interact with pre-existing risk factors “.
If for Italy there is only a widespread feeling of the weight of the pandemic on the problem, for other countries the data is more solid and much more worrying. In Japan, for example, the trend is now under everyone’s eyes, much to the bewilderment of the authorities, given that there are far more victims of suicide than those of coronavirus. The “Japan Times” writes that the toxic mix of stress and anxiety generated by the pandemic meant that for the first time in just over a decade, the number of those who took their own lives in 2020 exceeded that of 2019 , reversing years of work to curb a stubbornly high number of self-inflicted deaths. According to preliminary data from the Ministry of Health, 20,919 people died of suicide last year – a 3.7% increase over the previous year. And, in absolute terms, a frightening number when compared to the 3,459 coronavirus-related deaths in the same period.
Coronavirus, 71 pandemic-related suicides in Italy since March
by VALERIA PINI
Even in the United States the phenomenon is constantly monitored, even if the country appears to be in countertrend. A recent study in “Jama” led by a team led by John W. Ayers of the University of California San Diego, for example, examined Internet searches related to suicide during the early stages of the COVID-19 pandemic, to intercept changes in the population related to suicidal behavior. The researchers analyzed Google queries related to the word ‘suicide’, comparing the period before and after the second week of March 2020, when then President Trump declared a national emergency due to the pandemic. And the results look comforting: All queries containing the word ‘suicide’ fell by an average of 22% in the 18 weeks following the declaration. In other words, the researchers say, this is about 7.8 million fewer searches than expected. Of course, scholars admit, this does not necessarily imply that there have been fewer suicides in the population. Yet, they add, the scientific literature on catastrophic events supports this type of finding. In the sense that at times, the dramatic events that hit a country can generate, as a consequence, greater social cohesion, unifying the national community, and are therefore associated with a reduced number of suicides.
As always, the most vulnerable groups pay the highest toll to pandemic stress: women, along with young and old. Traditionally, in fact, men are the most likely to die from suicide, yet last year in Japan the number of women who committed suicide went from 885 to 6,976, while suicides among men decreased slightly. At the same time, the data relating to twenty-year-olds or younger would have grown, according to the newspaper ‘Nikkei’, by 17% and 14% respectively. “In general, the prevalence of suicide is 1 woman and three men,” explains Pompili, but with significant exceptions in some Asian countries, where the prevalence is reversed, and women commit suicide more often. The reason for this phenomenon is not entirely clear: perhaps, adds the psychiatrist, there is the role of culture, of the roles covered and of the interpretation of successes and failures. In general terms, however, there is a sort of ‘gender paradox’, as the literature defines it: apparently men use more lethal methods, while women leave more room for the possibility of being rescued. We do not have certain estimates on suicide attempts but it is estimated that in general in women suicide attempts are 10 to 25 times greater.
Suicides on the decline in Italy, but 10 people a day take their own lives
Not just women, however. Among the most fragile categories there are also people with difficulties in accessing mental health care, people at risk of domestic violence or abuse, people with a socio-economic disadvantage, people marginalized due to sexual orientation or group ethnic group, and people who occupy more than one of these categories, as Christine Moutier, of the American Foundation for Suicide Prevention in New York, writes in “Jama Psychiatry”. And the pandemic has only exacerbated all of these factors. Starting from this, continues Moutier, specific strategies must be put in place for suicide prevention. Because suicide can be prevented, as Pompili explains. “In the first place, a message of hope must be given to people at risk: there are other options to get out of this unbearable mental pain, this internal contradiction in which life appears very far from what we had desired”. And then, continues the psychiatrist, a public opinion awareness work, to introduce the concept of prevention, to help distinguish what are considered the warning signs. The verbal ones, in the first place, that is the communication of the idea of suicide: I can’t take it anymore, I give up everything. But also the behavioral ones: a change in the rhythm of sleep, with insomnia, anxiety and agitation. And then sudden anger, or sudden mood swings. The increase in the use of drugs or alcohol. Or, Pompili continues, the lack of precautions: the fact that we protect ourselves less from the dangers of everyday life, because we care less about our own safety. Attention also to the so-called preparatory actions: giving away something you have always cared about, whether it be jewels or the jersey of your favorite team. In conclusion, suicide is not a bolt from the blue. “People at risk of suicide must be supported and helped – concludes Pompili – that is why the issue must be tackled in a preventive sense. Therefore, if we find ourselves at risk of identifying a person at risk, we must take him to a mental health professional, at a center mental health or call the national emergency number “.
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