Fear, shame, difficulty in dealing with a difficult topic: these are the problems that emerge when we talk about self-harm and suicide. This is also why it is difficult to ask for help when there is someone in the family who expresses thoughts of death. To counter this silence, the project of the National Suicide Observatory was born in Piedmont, one of the Italian regions most affected by the phenomenon. It is a “study center set up by the family of a suicidal person to study the phenomenon starting from local realities and identify the most appropriate prevention models”, explains the psychiatrist. Roberto Merli, director of the psychiatry complex of the ASL of Biella.
Words that hurt
You have to fight the myth of “I have to do it alone” which makes it difficult to ask for help. “Still many people fear that they will be judged weak and unreliable if they manifest psychological distress,” said the psychiatrist. There are situations in life, sudden changes such as the end of a love, a bereavement, an illness or the loss of a job, “which can appear as insurmountable problems, which change the perspective of life, and where the idea of suicide can be made. road as a solution to eliminate unsustainable mental suffering “, explains Merli.
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“In these cases it is important to help people not to abandon themselves to despair, but to seek and discover alternative solutions for their existence”. There are also those who manage to react to an existential upheaval thanks to an innate inner strength or environmental protective factors, such as a good social support network: “One of our objectives – explains the psychiatrist – is precisely to identify the tools that can help to overcome the period of crisis “.
Boys in the storm
Even among young people, the lockdown seems to have increased suicide attempts: “It is not easy to get data, but in recent years there are more and more boys or girls who arrive in the emergency room because they think they are taking their own life or have tried to do so, too. the average age has decreased, “he explains Arianna Terrinoni, neuropsychiatrist of the developmental age at the Policlinico Umberto I and professor at the University of Rome La Sapienza. Among adolescents, the fantasies of death are frequent and not necessarily pathological, more worrying if anything is a real suicidal ideation, which can materialize in a violent gesture. “Suicidal fantasies can appear in any person, but they do not always translate into a concrete gesture”, Merli recalls, “As for real suicidal impulses, they generally have a limited duration, from a few minutes to a few hours, they are peaks of suffering during a condition of crisis that has been developing for some time “.
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The warning signs
And upstream of the crisis there may be various types of alarm signals, such as the onset of mood disorders – more frequent, or rather more easily diagnosed, among girls – but not only: “Let’s think of the boys who get scorched earth around, drastically reducing social relationships, to certain school failures that become real existential crises “, explains Terrinoni:” Or to self-injurious behaviors, such as cutting oneself, which represent one of the highest risk factors, and if they are not sufficient to calming the pain can bring out more dramatic thoughts. ” In general, any behavior that deviates much from the usual one must be monitored.
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“It is true that we live in an emergency situation, but even before Covid it was not easy for young people to find a reference professional figure to confide in”, continues Terrinoni. “Many adolescents send signs of great suffering that school or parents should grasp: they must not be left alone in such a delicate phase of life, in which they enter the world of emotions”.
Reduce risk factors
It is important for everyone to reduce risk factors, both individual and environmental. Among the most important are mental disorders “but also the consumption of alcohol or substances, which increases the risk because it facilitates impulsivity by reducing the ability to self-control”, explains Merli. And above all for the elderly, loneliness, “understood not so much as geographical isolation”, underlines the psychiatrist, “as a lack of a social network, with practical difficulties in daily life or the absence of gratifying relationships”. The most important risk factor is having made a suicide attempt, “which in any case remains an isolated episode in most people”, explains Merli.
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Support those who are ill
“In situations like these it is important to support those who have tried to take their own life, helping them to identify and develop protective factors”. And for children, when help is needed it is essential to involve the family, “and often also classmates or teachers”, explains Terrinoni. “Sometimes parents come to us hoping that the structure will solve the problem, but things are more complex”. Also for this reason, it is important to talk about suicide, “training for the general public, but also for health professionals”, stresses Terrinoni.
Talk to the sufferer
Tackling the subject with someone who is going through a period of crisis is not wrong, “on the contrary, a person in this situation needs someone who listens to him carefully”, observes Merli. “And it is not even true that nothing can be done to help those who think of taking their own life.” Those who seem apparently adamant in his decision retain a desire to live that can be brought out within a helping relationship. In short, even in those who think they want to die, the neuropsychiatrist concludes “there is a part that does not stop being vital, and that wants to be protected”.