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Suicide as a health issue, but also as a social, cultural and political one

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Only depressed people commit suicide? explains the psychiatrist

Seven people. Seven people will end their lives by suicide when you finish reading this text, if your reading takes five minutes. One person every 40 seconds to be more precise, according to the World Health Organization. For no other reason, the yellow September theme is so relevant.




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We need to talk about suicide and ways to prevent it. Yes, we can prevent suicide. This is due to the fact that, in Western countries, in 90% of suicide cases there is a psychiatric condition, in particular depression, but also the abusive use of alcohol which is observed in 25-50% of cases.

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We can list individual risk factors for suicide, but there are also social or community factors. Regarding individual factors, we can observe the loss of work and money, the feeling of hopelessness in life, living with pain or chronic illness, having other people in the family who have committed suicide, but also biological and genetic factors, such as being a deficiency in a vector of an enzyme (MTHFR) that disturbs the metabolism of vitamin B9 (transformation of folic acid into methylfolate, the lack of which affects the formation of neurotransmitters) and is related to the family history of suicide.

Wars, natural disasters, social conflicts are some of the community stressors that can add to social discrimination (minority populations such as LGBTQIA +, people of color, immigrants, refugees) but also to the history of trauma and abuse, conflicts in relationships, sense of isolation and lack of social support. Access to means of inflicting death, such as firearms, pesticides, also increases the risk of achieving death, as they are more violent methods. Known risk factors are also the presence of bridges without guardrails or open access to the train tracks.

On the other hand, there are protective factors for an increased risk of suicide, such as cultivating strong personal relationships and creating emotional networks and emotional, financial and social support. Membership in religious and spiritual groups can bring support in times of crisis and help establish a sense of hope, although it can make it difficult for a member of these groups to communicate suicidal ideation, due to bias on the issue, by making a place of possible welcomed into a factor of greater emotional stress.

Only 28 countries in the world, according to the WHO, have a national strategy or action plan related to suicide for their populations. It is necessary to recognize the multifactorial aspect and that these strategies permeate. They affect not only the health system, but also the education system, social protection systems and cultural production.

Brazil has one of the largest public health systems in the world, the Unified Health System (SUS), with a myriad of institutional structures and actions with direct and indirect repercussions on the subject of suicide. However, the SUS has undergone a dismantling and an inversion of the welfare logic in which preventive action is not privileged.

And in relation to suicide prevention, Brazil clearly goes against what is recommended by the WHO. The number of people authorized to purchase weapons has increased by 473% over the past four years in the country. The consequences of this are seen daily in the newspapers: deaths from accidents and disputes between people to the stars, in a population afflicted for 15% by unemployment, 70% by debt, 25% by mental health problems, for the 13% from alcoholism and 50% from some degree of food insecurity.

Brazil is the third largest consumer of pesticides in the world. There is a suicide belt in Brazil, a line that extends from the west of the southern states and rises through the Cerrado states to the north of the country, overlapping the line of the new agricultural frontiers.

We live in a time of historical, social and environmental contingencies that can worsen this situation. Are we reflecting enough and acting accordingly? How long have you been reading this text?

* Alexandre Valverde is a sixth generation psychiatrist graduated from the Federal University of Sao Paulo

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Source: Terra

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