Dr Shekhar Saxena, WHO’s Director of the Department of Mental Health and Substance Abuse, says that a large number of individuals who commit suicide suffer from mental disorders – 80% from high-income countries and 50% from low-income countries. The most common health issue is depression.
Interestingly, the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness reveals that over 25% of suicide victims had contacted mental health services in the 12 months before their deaths.
A need to prevent suicide
Edward Mallen, a gifted pianist, shocked many when he committed suicide. His father, Steve Mallen, a commercial property consultant, recalled the aftermath as “staring into the most appalling abyss you can ever imagine.” Two weeks before his death, Edward was referred to an NHS crisis intervention team. He was not identified as suicidal.
Mallen strongly believes that deaths like Edward’s are preventable. Had more effective preventive measures been available, his son might have been able to get help during the stages of his depression.
Mallen made it his goal to improve the current suicidal prevention strategies for the sake of Edward’s generation. He is now a strong campaigner for suicide prevention and has helped health select communities.
Changing people’s attitude towards suicide
Suicide is thought to be a conscious and an inevitable action by at risk individuals. The deaths are somehow accepted as part of life’s course. Despite existing prevention strategies, such beliefs have remained unchanged for a long time.
Zero Suicide is a concept and practice which challenges that belief. The aim, just like its name, is to have a world without suicide.
David Covington, a Zero Suicide pioneer based in Phoenix, Arizona says that suicide individuals are often associated with phrases like “(they are) intent on it” and that “You can’t stop someone who’s intent on killing themselves”.
He also explains, “There is this strange logic that individuals who die couldn’t be stopped because they weren’t going to seek care and tell us what was going on.”
The Zero Suicide approach was developed more than 10 years ago in a Detroit hospital. Ed Coffey, the CEO of the hospital’s Behavioural Health Service then, reformed the existing Henry Ford Health System’s approach to reduce mental health related deaths.
Since many suicide deaths were related to mental illnesses, Zero Suicide treats every mental health patient as at risk for suicide. Suicide deaths are not accepted as an eventual action; instead, studied and reflected on. This initiative advocates techniques that emphasise on strong leadership, improved training of providers, better patient screening and the use of latest data and research.
The Henry Ford system reported startling results. In 1999, the annual suicide rate for mental health patients was 110 per 100,000. In the next 11 years, it dropped to 36 per 100,000. In 2009, there were zero suicides among patients. Another early adopter of Zero Suicide, the Magellan Health Service in Arizona, reported a 50% decrease in their suicide rate in the past 10 years.
Towards a world without suicide
Zero Suicide believes big goals are necessary in order to achieve high performance levels. According to Thomas Priselac, president and CEO of Cedars Sinai Medical Center, “When you design for zero, you surface different ideas and approaches that if you’re only designing for 90 percent may not materialise.”
The endless number of challenges related to suicide makes it extremely difficult to achieve a world with completely no suicide. However, Zero Suicide believes that the first step is to tackle the continuing shift in attitude towards suicide.
Health experts feel that a well-funded and more coordinated strategy could help to change the attitudes and approaches in each part of society. This includes schools, hospitals, police stations and the family home. In recent years, there have been other attempts to change attitudes and generate discussion on suicide. An example is the recent Netflix show “13 Reasons Why” which sparked the discussion of suicide in many American schools.
Preventing suicide is not limited to only clinical care or the efforts of individual practitioners. Zero Suicide requires a system-wide approach that involves the broader community such as suicide attempt survivors, family members, policymakers and researchers. MIMS
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