• REBECCA YANKE

    @RebecaYanke

    Madrid

  • PHOTOGRAPHS: JOSÉ AYMÁ

Updated Thursday,11May2023-09:41

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  • 11 lives X-ray of suicide in Spain: more deaths, greater risk among young people and a growing but insufficient effort in prevention

Practically anyone has lived the trance of accompanying someone to the emergency room, sitting in the waiting room and, suddenly, hearing the phrase: "Relatives of ...". One comes shotgun to see what has happened and how our family member is. What happens here is more shocking: the doctor asks about someone's family and no one answers, because no one has accompanied him. This is the reality denounced by social workers and psychologists in our country: the percentage of people living alone has increased worryingly in the last 30 years. And loneliness, along with other circumstances typical of the elderly, such as chronic illness, dementia, depression and fatigue of living produce an explosive cocktail that, sometimes, ends in suicide. The oldest people in our country are the group that commits suicide the most in Spain. In 2021, "999 suicides were registered in people over 70 years of age, one in four", of which "519 were over 80 years old", according to data from the Spanish Foundation for Suicide Prevention (FSME).

It is also not uncommon to find any death by suicide in someone over 100 years old. A scenario in which isolation and comorbidity prevail, and that is difficult to understand if one does not take into account that the causes are usually "silent", that the elderly "have difficulty expressing themselves, and divide the world into what to do and what not to do, without attending to the emotion they feel". This is explained by Enrique Galindo, psychologist and author of Stop suffering or stop living with Francisco José Celada Cajal (Oberon Books): "There is a progressive increase, the older you are, the more suicide. And detecting risk is complex. To loneliness are added own stressors, sensory losses, difficult living conditions, but vulnerability, hopelessness, lack of self-esteem, the feeling of worthlessness prevail ...".


Associations and telephone numbers that offer help

Drop-down

-In case of imminent vital emergency call directly to the emergency telephone number 112.

-If you have suicidal ideation 024

- Telephone of Hope: 717.003.717.

- Suicide Prevention Telephone (Barcelona): 900.92.55.55.

-Telephone/Chat ANAR to Help Children and Adolescents 900 20 20 10

- Telephone Against Suicide- La Barandilla Association (Madrid): 911.385.385.

- RedAIPIS-FAeDS Association

- Papageno 633 169 129 supervivientes@papageno.es

-The Yellow Girl Association

-P81 Social Association

- APSAV. Association for Suicide Prevention. Green hugs. Asturias.

- AFASIB (Familiars i Amics Supervivents per suïcidi de Les Illes Balears (Balearic Islands)

-AIDATU. Basque Association of Suicideology

- APSAS: Association for Suicide Prevention and Survivor Support. (Girona)

- APSU: Association for the prevention and support affected by suicide (Cdad. Valenciana)

- ASAM: (Burgos).

- BESARKADA-Embrazo: Navarra.

- BIZIRAUN: Basque Country

-BIDEGUIN: Basque Country

- After the Suicide: (Barcelona)

- Alaia Foundation (Madrid)

- Metta-Hospice Foundation (Valencia)

- Goizargi: Navarre

- Group Survivors of León.

- There is Exit, Suicide and Duel: (Cantabria)

- Ubuntu (Seville)

- Light in the Darkness Association (Tenerife)

-Asociación Volver a Vivir (Tenerife)

"The rates of the elderly can be 100 times higher", confirm from the Spanish Federation of Suicide Prevention: "From 0.2 deaths per 100,000 inhabitants in children under 15 years to almost 20 of those over 79 years. This is because there is also a very significant difference in the relationship between suicide attempts and deaths. If, in general, there is usually one death for every 20 attempts, in the youngest this ratio can be 200 to 1, while in the very old about 3-4 attempts are calculated for each suicide. The causes of this are that the attempts in the elderly are more planned, with less rescueability, more silent and with a more lethal method, "explains Andoni Ansean, president of the federation.

In addition, there is the fatigue of living, which has been gaining importance in psychological research. Just this week a report prepared by Dutch specialists - geriatricians, psychologists, social workers - published an exhaustive report on the state of the matter, and their approaches are especially noteworthy given that the Netherlands is one of the most advanced countries in the study of how to reduce the exhaustion of existing, personal abandonment and, as Laura Ponce de León says, Professor of Social Work at the UNED and researcher at the Center for Sociological Research (CIS) specializing in older adults, "the fact that there are people who, in the absence of significant relationships, let go".

The Dutch report shows that even in the elderly who do not have serious illnesses, the fatigue of living is palpable, "and that the keys are loneliness, chronic pain, difficulties in expressing oneself, existential fatigue and the fear of becoming a completely dependent being". In this sense, it is clarifying to attend to the analysis of the type of families that exist in Spain, where in three out of four households only one person lives. Single-person homes that were 10.8% in 1990 and, according to 2019 data, more than 25%.

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Ponce de León knows this because this is what his most recent publication is about: "The profile is that of a widowed or single woman, over 65 years old. How do we compensate for the experience of aging? With support from social services, yes, home help and telecare, but the most important thing is the consanguineous family if they have it, relatives or people in a similar situation. The family makes water in Spain. I know cases of neighbors who denounce the suicide attempts of a person who lives alone in his portal and who has no one, absolutely no one. Because in their situation, feeling that if they need it someone could help them is fundamental, that they accompany them to a medical test, that they visit them in the hospital ... In short, to have a quality of life that protects against suicide attempts."

That "having someone" is what is really crucial and, the pandemic has increased a situation that already existed. According to data from the National Institute of Statistics (INE), 4,003 people died by suicide in Spain in 2021. These are data collected by the Complutense University of Madrid, specifically by the Center for Biomedical Research in Mental Health Network (CIBERSAM), in collaboration with the Hospital del Mar in Barcelona, which analyzed the 2000-2021 time slot. Alejandro de la Torre, one of its researchers, then affirmed the "growing trend of suicide mortality since 2018", crystallized in 2021 with an annual growth of 6%. And it was also reported that "the rate was higher in people close to 64 years." And 31% of those who died by suicide in 2021 were over 65 years old.

The crossroads of mental health

In this sense, in addition to loneliness as a great factor, the psycho-emotional and mental health of the elderly is key. And also the combination of this with deterioration of aging such as the beginnings of dementia or neurological disorders such as Alzheimer's. Ponce de León says that this is where we should influence, and explains the loop of getting older: loneliness, dependence (physical and psychic deterioration), need for personal contact (physical and psychic). "Not forgetting dementias, often linked to depression."

From the FSME, in addition, they transmit concern about the possible consequences arising from the new euthanasia law. "We don't yet know how it can influence the deaths of very old people or their suicides. It could happen that the existence of this assisted death increases premature deaths of older people: How many deaths by euthanasia could have been deaths by suicide if this law did not exist? But the opposite effect can also occur: could suicides decrease knowing that the right to euthanasia can be exercised? In all cases, from the Spanish Foundation for the Prevention of Suicide we have to remember that, like suicides, euthanasias are also preventable. Or, put another way: do we do everything we can to prevent deaths by suicide (or euthanasia) before they occur or do we assume that death is the only solution to the problems that person suffers?"

There is also no specific plan on national suicide although psychologist Enrique Galindo points out that "almost all the autonomous communities have prevention plans and strategies." "In all there are lines of action for elderly and fragile people, and local programs even, accompaniment, volunteers, pets, rental of orchards ... Centers of mental health units, sheltered housing and others managed by associations, which every day take on more prominence given their proximity to individuals. "

But specialists insist that more than social networks and telehelp, the issue should be tackled from the fight against loneliness taking into account that "all people need physical contact". And "teach the population to eliminate myths or false beliefs about suicide," Galindo proposes, "as if whoever says it does not do it, they only do it to attract attention, only crazy people commit suicide or that if they talk about it, they incite to do it. Talking is the first step. Keep in mind that talking saves lives and silence kills."

Galindo, who believes that we can all contribute in the fight against suicide because it is at the end of the day simple and pure help to others, thinks that "nobody wants to die but to stop suffering." And that in our elders it is a problem that they have difficulties to express what they feel and, above all, "to find a meaning to life in that stage, in which they fall more into hopelessness."

"They're older, but they're not dumb or crazy. We must activate programs that aim to alleviate loneliness, with friendship groups, outings, visits with other elderly volunteers, clubs, associations, studies at their level ...". And, from health professionals, internalize that the elderly, when they come to see them, "tell what is expected of them, that they express pain or physical symptoms, while they are ignored if they speak of sadness, anxiety, fear of death or desire to die, treating them in those cases with antidepressants or anxiolytics. "

And he concludes: "We miss the warning signs that indicate a high risk of suicide: making a will is normal, saying goodbye to loved ones is normal, talking about death is normal, hoarding medication is normal; That they walk often to the train track, in a population with several suicides for this cause may not be so normal and you have to listen to them, even what they do not say. Not everything is solved by medicalizing emotions, but by listening and promoting leisure activities and meaning of life."


This report is part of the project 'Eleven lives' promoted by EL MUNDO for the prevention of suicide and of which Santiago Saiz, Yaiza Perera, Rafael Álvarez and Rebeca Yanke are part.



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  • Suicide Prevention