His decision is made.

He doesn't want to live anymore, he just wants to disappear from this world.

He cannot explain exactly why he dialed the emergency number of the Frankfurt network for suicide prevention that evening.

At the end of the call, his problems still haven't gone away.

Hardly anything has changed.

Only his plan is new.

He wants to try again, this complicated thing with life.

After the conversation, he is ready to accept help.

Marie Lisa Kehler

Deputy head of the regional section of the Frankfurter Allgemeine Zeitung.

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Andreas Reif, Head of the Clinic for Psychiatry, Psychosomatics and Psychotherapy at the University Hospital in Frankfurt, knows many stories like this.

Stories of people who are tired of their lives.

In order to provide them with a low-threshold offer of help, an emergency hotline was activated in 2017 for people who see no other way out than suicide.

The hotline is part of the "Frankfurt Project for the Prevention of Suicides Using Evidence-Based Measures" (Frappe).

Since then, the telephone number, which was primarily intended for people from the Rhine-Main area, has spread throughout Germany via the "silent message principle".

Not every caller who dials the number and gets through to a doctor on duty from the psychiatric clinic at the university hospital really has a serious concern.

"For every 20 calls that are less urgent, there is one for whom the call is very valuable," says Reif.

He is certain that the hotline has already prevented one or two suicide attempts.

Switching off the number cannot be ruled out

But the Frappe project has not received any financial support since the end of 2021.

The Federal Ministry of Health had previously supported the suicide prevention work for several years.

There is no secured follow-up financing.

The hotline is still trying to maintain the team of the clinic.

In the meantime, however, this can hardly be managed in the stressful everyday work, says Reif, who has announced a significant reduction in availability and cannot rule out the possibility of the number being switched off.

He sounds frustrated.

Because without secured funding, other components of the project cannot be continued.

"We have set up structures that we would all have to tear down again," says the head of the clinic.

It is already difficult to find sponsors for prevention programs.

For such,

which are located in the field of mental illness, it is even more complicated.

Because direct successes are difficult to present.

A prevented suicide attempt does not appear in any statistics, says Reif.

“Prevention work is never sexy.

You don't know exactly where you did something well and where you did something badly."

The aim of Frappe was to reduce the number of suicides and suicide attempts in Frankfurt.

For this, according to Reif, it was first necessary to get a better overview of the situation.

Are there days of the week when more suicides are reported?

In which parts of the city is the suicide rate striking?

What role do age, gender or socio-economic factors play?

On the initiative of the Frappe team, when patients were admitted to a clinic, the fact that they were attempting suicide was documented for the first time.

Information on the method or the place of execution was also recorded in a database.

In addition, measures were established to arrange a consultation with a specialist and other offers of help after a suicide attempt.

Reif criticizes that this is by no means a standard procedure everywhere.

The fact that emergency care is not only provided physically but also psychologically after a suicide attempt is still all too often “depending on luck”.

According to the head of the clinic, follow-up care for patients is extremely important: "After one attempt at suicide, the likelihood of others increasing."

A good data basis is important for targeted offers of help

The more complex the data situation, the more targeted offers of help can be made, says Reif about the basic idea behind Frappe.

Various hospitals, including the Markus Hospital, the Frankfurt University Hospital and the Höchst Clinic, have committed themselves to collecting as much data as possible on the subject of suicide during the project period.

The “Local Crisis Intervention” (Loki) project, which FAZ readers supported with donations in 2020, also benefited from the data collected.

Loki's current goal is to create low-threshold advice and help in those parts of the city where there are abnormalities in the frequency of suicides or suicide attempts.

“We have to go where the problems arise with our aid.

But that's only possible if we have a good data basis," Reif repeats the urgency of continuing to focus on this sector.

The structures to do just that are in place.

This is another reason why Reif is sticking to his vision.

He wants to set up a center for suicide prevention in Frankfurt, in which all relevant data on suicides and suicide attempts will be recorded in order to be able to carry out more targeted prevention work.

But the center also aims to do public relations work, further training and maintaining the hotline.

A private sponsor has already been found, but further support is needed so that the center can actually start its work.