"The work of a social worker is as valuable in suicide prevention as that of an on-call doctor"

Yaiza Perera Madrid

Madrid

Updated Sunday, February 11, 2024-02:33

• Suicide prevention All the reports in the Once Lives series

Thinking about death is the last destination on a path of intense suffering. In addition to one's own family and personal history, other stones are added to this journey that make the weight carried in the vital backpack seem impossible to bear.

Loneliness, inequalities, violence, poverty, unemployment and difficulties in accessing housing

are some of the main social factors that increase the risk of suicide.

Prevention experts insist on calling for an intervention that extends beyond the health area and involves all areas to strengthen the protection network for vulnerable people. On the ground, it is the social workers who carry out this accompaniment work, trying to resolve deficiencies and offering resources that make these 'stones' weigh less and, from their experience in the face of suffering, they ask the leaders for a greater "commitment" to community intervention. . "Suicide has to do not only with a mental pathology, but also with relational and coexistence situations," warns the General Council of Social Work, which calls for

measures to enhance "care, aid, social and emotional learning programs, combating violence and harassment, changing attitudes and strengthening rights"

.

For 26 years, Diaconía has offered accompaniment and support to especially vulnerable groups such as women victims of trafficking, immigrants or homeless people and is firmly committed to this comprehensive approach. Esteban BuCh, general coordinator of Diakonia, explains the importance of the work of social workers in suicide prevention and the need for their specialized training to be on the first line of care.

What is the role of a social worker in suicide prevention?

We do not dare to make an in-depth intervention on behavior or suicidal ideation as such, but more on preventive effects and in that sense it has to do with everything from the social impact of public policy to the questions that a worker can ask. social much more in the field such as the management of a shelter, for example. They are all elements that add up and end up reducing risk factors. Many of the social policies that we have today in our country translate, sorry, into nothing. Not because they do not have a good intention, but because, for example, there are many plans that do not have a budget allocation and this means that measures are not taken.

What is the work that Diakonia does in this area?

When we go down to work in the field, the work we do is training in suicide prevention with the teams that do direct intervention, whether they are social workers, psychologists, educators, doctors, social integrators or volunteers from different entities, including ours. . At Diaconía we are working with especially vulnerable people who have an accumulation of risk factors, mostly social index, and these vulnerabilities also have an impact on mental health. It can favor the appearance of suicidal ideation, or in the worst case, consummation. For example, we have a shelter for homeless women. We make a social diagnosis, assess the background and current situation in order to plan an individualized intervention where the person also participates. We take into account what risk factors have to do with or can directly affect suicidal behavior. We incorporated indicators that were previously only considered in the clinical, medical or health field, and we have extrapolated them to the social field because they certainly have an impact. If we have identified that there is a risk, mild or serious, the intervention that the social worker makes is the support in access to the different resources where the person can be treated by a specialist, in addition to being there for and by the person.

What are the most common social determinants that can increase the risk of suicidal behavior occurring?

They depend on the vulnerable group we are referring to. The feeling of loneliness and hopelessness is latent in refugees, women victims of trafficking, homeless people... it is transversal. This translates into the absence of support networks and, without a doubt, the impact is enormous. With the refugee population or asylum seekers, we identify some risk factors that are clear. The first of them is the inability to support the economic needs of their cohabitation unit, that is, the impossibility of freely accessing the labor market or a regulated rental market. And I say regulated because they do access a rental market but it is totally abusive and negligent towards these people. Rental of rooms where they do not have any type of contract or are clauses. For example, also the low levels of social support, to which we add the language barrier and, of course, everything that the immigration process has placed on the person that affects their health (including mental health). I would say that this is transversal to all groups and not only to people who come from outside, but also, for example, people who live on the streets, who have a more complex situation, such as the absence of support networks. . The lack of these networks does have an impact. Refugees, for example, are at greater risk of suffering from depression or anxiety, especially due to migratory transit to the host country, that is, fleeing from a war with all that it entails. Millions of things can happen to them and many of them have to do with a violation of their rights. Women victims of trafficking have not only had a migration process, but have also been exploited and abused. It's a backpack that you fill with stones. They also suffer prolonged hopelessness due to the uncertainty of the administrative situation, which keeps them in suspense for a long time, among other issues. As also happens to chronically homeless people.

Are unemployment or difficulties in accessing housing risk factors?

At a social level we increasingly see that they are two of the main determinants of mental health. I don't want to link it closely to suicide, but it certainly has an important impact. We are not only talking about unemployment, we are also talking about precarious employment and its instability. Exactly the same thing happens to us with the question of housing. Not only is the difficulty of accessing housing a traumatic process, but maintaining it becomes worse. The precariousness of jobs and salaries together with the increase in rents has an impact on the maintenance of a home. Rentals today in Spain are practically inaccessible for newcomers, for example. And this, of course, adds links to this circularity of the problem that impact the suicidal experience. Yes, we can affirm that employment and housing can become important risk factors in the suicidal experience. To this, of course, we add personal factors.

In Spain there are nearly 30,000 homeless people. How could we advance the protection network?

In countries like Sweden or Finland 'homelessness' is being eradicated and this has to do with the model proposed by the institutions. In Spain we maintain models that are called 'staircase'. That is, first you enter a shelter, then a semi-autonomous apartment, then an autonomous apartment and finally we get a home. People suffer from exhaustion because each floor has an infinite amount of bureaucracy, an infinite number of papers. And there is something that is the underlying problem that many of them know that they are apartments in which they have a departure date. When homeless people are on the street, time stops and when they enter these devices is when time starts running. yaiyaNow they have deadlines. Many people who are on the street are not because they do not want housing, but because they do not want housing with so many conditions. They feel like they have been put on a countdown timer. And it is not that it is more profitable for them to be on the street because that is not the case, far from it. That is why the methodology that is being attempted is the 'housing first' model. What he talks about is first accessing housing and then doing the work of inclusion. The results are much more positive than in the opposite case, because autonomy is achieved more easily, because it comes at will, not against the clock.

What changes are necessary in the public protection network system so that it is truly effective in protecting vulnerable groups?

On the one hand, focusing on the economic, it is the budget allocation and above all in deepening the link that must be increasingly stronger between public administration and third sector entities.

Suicide prevention has been addressed until now especially from the health field. Do you think progress is being made towards a comprehensive intervention that takes into account social determinants?

Diaconía is one of the state-level entities that is influencing suicide prevention from a social perspective, but as part of a comprehensive response. There are entities that call us to have awareness-raising and training meetings with them, because not only are they unaware of this phenomenon, but they are not aware of how the social factors that they themselves address in their daily lives impact the beneficiaries they accompany. . There is still a way to go and also to break many myths. The work of a social worker is as valuable as that of an on-call doctor. For a worker to ask a person in the morning 'how is she' can be very decisive in a moment of crisis. Meaningful links can be created. One of the purposes of 'Project Zoé' is to be able to train people to act as primary agents, shock personnel. Be caregivers of our environment, work and personal. We share countless hours with co-workers. There is also a work of prevention and care, right? The same with our neighbors, with the people we share time with, with the soccer team, the music team... We try to ensure that this training reaches all levels, specifically at the grassroots, let's say non-professional level. The title of the suicide prevention workshops is 'And I, without being an expert, what can I do?'

This interview is part of the 'Once Lives' project promoted by EL MUNDO for suicide prevention and which includes Santiago Saiz, Rebeca Yanke, Rafael Álvarez and Yaiza Perera.