The Regional Ministry of Health and Consumer Affairs has reinforced the Mental Health Clinical Management Units with 26 professionals who will develop an intensive suicide prevention programme, prioritising vulnerable patients with risk factors such as adolescents and patients with severe mental disorders.
The incorporation of these professionals is part of the ‘Action Plan for the Prevention, Care and Prevention of Suicide’ promoted by the Regional Ministry of Health and Consumer Affairs, which proposes 50 actions to reinforce clinical care with the aim of reducing the incidence, prevalence and impact of suicidal behaviour in Andalusia and to be implemented homogeneously in the health areas. In this context, the Plan also foresees the creation of commissions for action on suicidal behaviour in the Mental Health Units, with referents from all Mental Health, Emergency and Primary Care services.
The Regional Ministry of Health and Consumer Affairs is also working on a ‘Suicide Code’ which will be incorporated into the digital medical record as an alert in case of need to ensure adequate follow-up in the event of suicidal behaviour, always with the patient’s consent,
Andalusia joins one more year the commemoration of the International Suicide Prevention Day 2022, which will take place tomorrow 10th, and which this year is celebrated under the slogan ‘Creating Hope through Action’, the same slogan as last year. World Suicide Prevention Day is an opportunity to raise awareness about suicide and promote action through measures that have been proven to reduce the number of suicides and suicide attempts worldwide.
As explained by the Comprehensive Mental Health Plan, “the slogan ‘Creating Hope through Action’ is a reminder that there is an alternative to suicide and aims to inspire confidence in all of us; that our actions, no matter how big or small, can bring hope to those who are suffering”.
Suicide is often preventable and anyone can be an active part of suicide prevention. Thus, we can all play a role in supporting people experiencing a suicidal crisis or those bereaved by suicide. In this context, stigma is a major barrier to help-seeking. Changing the narrative around suicide by promoting hope can create a more compassionate society in which bereaved people feel more comfortable seeking help.
New Suicide Prevention Plan
The Andalusian Integrated Mental Health Plan is also working to establish links with other key areas and agents in suicide prevention, such as Education and Community Social Services. Furthermore, in order to make further progress in suicide prevention, a working group has been created which is developing proposals in the different areas of prevention for the general population and for at-risk groups and people who already present suicidal behaviour. The working groups are made up of professionals from different fields: health, education, public health, addictions, media, university, and other organisations such as the Telephone of Hope and the Papageno Association.
The actions, which are also 50 in number, will take the form of a Suicide Prevention Plan for the period 2022-2026, with both short- and medium-term objectives, including awareness-raising, training, coordination and improved registration, among others.
The Andalusian Public Health System has been developing prevention strategies to tackle this problem that include actions by the different sectors involved: health sector, social services, education, the judicial sector, the workplace and the media, among others. The Andalusian Comprehensive Mental Health Plan develops universal, selective and indicated prevention strategies, with suicide prevention programmes at all stages of the life cycle and paying special attention to people with mental illness.
The SAS has produced several documents aimed at health professionals and people with suicidal ideation and their families. Primary care professionals also have a document with key information to provide information on this problem. Precisely, Primary Care professionals play a key role in the detection of suicide risk due to their permanent contact with the community and their knowledge of real and potential problems.
With regard to Promotion and Prevention, the SAS has developed a section dedicated to in the Mental Health section of its website, with special attention to suicide prevention. In this section there are different guides and practical tools, as well as links to other organisations and institutions dedicated to suicide prevention, in line with the theme of World Suicide Prevention Day.
Situation in Andalusia
In Andalusia, 793 deaths by suicide were registered in 2020, 576 males and 217 females which means an increase of 153 deaths compared to 2019 (23.9% more), specifically 98 males and 55 females. An increase is observed in all age groups. Over the last few years, from 2016 to 2020, it can be observed that, throughout the period, the suicide rate is highest in the over 65 age group, with a general increase in the rate as age increases.
The suicide rate per 100,000 inhabitants per province in the period 2016-2020 varies considerably by province, from 11.97 in Granada to 7.64 in Cádiz, the average being 9.37 in this period.
Regarding the method used, adding both sexes, 55% was by hanging/strangulation, 21% by jumping from a high place and almost 8% by poisoning by drugs, with these three methods accounting for 84% of those used.
With regard to suicide attempts, the data available are from the episodes attended in Hospital Emergency Departments from 2015 to 2021. There is an increase of 904 cases in 2021 (4,294) compared to 2020 (3,390). This means a 21% increase, although with differences between provinces, with the greatest increase in Seville, Jaen and Cordoba, followed respectively by Almeria, Granada, Huelva, Malaga and Cadiz. As for suicide attempts in the period 2015-2021, 67% were women and 33% men. This data is in line with what is observed in our environment in terms of gender and suicidal behaviour. Men die more from suicide and women make more suicide attempts.
According to data from the National Statistics Institute (INE), in 2020, 3,941 people died by suicide in Spain, an average of almost 11 people per day; 74% of them were men (2,938) and 26% were women (1,011). This makes 2020 the year with the highest number of suicides recorded in the history of Spain since records began (1906). This means that the suicide rate by age and sex was 8.3 per 100,000 inhabitants, according to data from the Mental Health Strategy of the National Health System.
This is the first time in Spain that the number of deaths by suicide in women has exceeded 1,000. It is also the first time that Spain has reached 14 suicides in children under 15 years of age (7 boys and 7 girls), doubling the number of cases in 2019. In addition, suicide in people over 80 years of age has increased by 20%. Suicide is the leading cause of unnatural death in Spain, producing 2.7 times those caused by traffic accidents, 13.6 times more than homicides and almost 90 times more than gender violence, according to data from the Spanish Suicide Observatory of the Spanish Foundation for Suicide Prevention.
A turning point occurs at the adolescent stage, from 14 suicides in the under-15 age group to 300 suicides in the 15-29 age group. Adolescence is a time of risk. Regarding the trend, INE data for the last 4 years available (2017, 2018, 2019 and 2020) show that in the under-15 age group there were 13, 7, 7 and 14 deaths by suicide and in the 15-29 age group there were 273, 268, 309 and 300 suicides, respectively.
Regarding the methods used, in both sexes the three most prevalent methods are hanging/strangulation, jumping from a high place and poisoning by drugs.