The Canary Islands have been working for a year on the development of a Suicidal Behavior Prevention Program that has already received numerous praise. It will be the fruit of several years of work that has come to fill a gap that had to be filled urgently since the islands are among the autonomous communities where the most people take their own lives of their own free will in all of Spain (it occupies fourth position). . The latest data available is from 2020: that year. 208 people died from this cause. A figure that represented an increase of 7,4% compared to the previous year and that chained two years in a row of increases. Throughout the national territory, a total of 3.941 people took their lives during 2020 marked by the beginning of the COVID19 Pandemic and isolation: 300 of these deaths involved young people between 15 and 29 years old. And that is why it is crucial that the prevention and detection of these suicidal behaviors begin in the educational center. Of the 12 requirements suggested by the WHO for this type of programs, the Canarian draft meets 11 and is the most demanding and complete in Spain. The only failure is the absence of a budget item dedicated to this purpose, a requirement that none of the regional texts meet either.
But what are the risk factors that may indicate the presence of these suicidal behaviors? That is one of the focuses that experts focus on to try to identify the problem before it happens: previous suicide attempts are no longer enough. Now we must address issues such as the existence of family conflicts or within one's own groups of friends or fellow students. “When we reach adolescence and the first years of adulthood, the risks change and are more linked to the existence of life disorders such as depression, impulse control problems, substance abuse, or the existence of serious family problems.” , indicates Carmen Pitti, chemical psychologist and technician of the General Directorate of Public Health of the Canarian Health Service. But within the educational center we must pay attention to other realities such as academic failure or bullying. “There are many variables that teachers must pay attention to,” she explains.
The first phase of the development of the protocol is already completed. And there is already a draft. “Now we must continue working with experts and technicians to finalize the final text that not only serves to identify risk factors; It should also be a useful tool to take the first measures to prevent these behaviors,” comments Francisco Javier Acosta, psychiatrist and technician of the Mental Health Service of the Canary Islands Health Service. Teachers will be a fundamental element of the strategy: “It is vital to educate teachers so that they are able to identify those warning signs that indicate the risk of suicidal behavior.” The school is the first battlefront of this war.
The Canary Islands are among the four autonomous communities with the highest suicide rate in Spain; It may seem that we are facing a very complicated challenge, although according to the ratios used by the World Health Organization (WHO), the Canary Islands ratios can be considered average. But that does not mean that the problem is less: it exists and requires coordinated and planned responses. “These numbers should not reassure us,” adds Carmen Pitti. “They should motivate us to implement more actions,” says the psychologist, who recalls that last year the Suicidal Behavior Prevention Program was launched, a project that came to light after two years of work and that was the fruit of work of a large number of experts and professionals. ”Organizing and structuring a program requires a lot of effort: first do a bibliographic review of everything that is published worldwide and then involve all the parties that must implement the plan to meet the set objectives,” says Pitti. The theoretical framework is not enough, she recalls the SCS technique: “each objective must be accompanied by actions and an adaptation to reality that requires working tables, agreeing on work and protocols. "They are not easy tasks."
Carmen Pitti points out that to address a topic of this importance we must start from the basis that “suicidal behavior is very destructuring and leaves behind many affected and traumatized people beyond the affected person themselves.” An issue that, according to the psychologist, highlights the imperative and urgent need to put the issue of mental health at the center of public debate at all levels. “In the Canary Islands we have a slightly different epidemiological profile from the rest of Spain; In recent years this problem has affected those over 50 more and although the data always has a two-year delay, we can already see the effects that the Pandemic and confinement have had.” But that does not mean that we do not have to do prevention work focused on the younger population: “it will be an investment for the future so that they later reach adulthood with greater protection of their mental health,” says Carmen Pitti. And hence the importance of collaborating with the educational community to implement this suicidal behavior prevention program at school.
Treat symptoms early
The key to success in a matter as traumatic as this is knowing how to identify “the warning signs” that occur a long time before the suicide occurs. “We have to be attentive to comments that the affected person may make; to his way of acting and his state of mind,” comments psychiatrist Francisco Javier Acosta. “You have to know how to identify these signs well; because it is not the same for someone to say that any day he will kill me than for him to express that he has clear intentions to commit suicide. The SCS doctor highlights that, in this prior identification work, the work of teachers will be crucial. And that is why, in the protocol itself, importance will be given to teacher training to identify these symptoms. “But they should not only know how these alerts manifest themselves; “They must also be prepared to take the first preventive actions.” The educational center, says Acosta, plays a crucial role in this early warning scenario. This does not mean, he clarifies, “putting all the responsibility for this detection on teachers; "We will work in a joint and coordinated manner and always with the close collaboration of perfectly prepared health personnel."
According to the participating experts, the key to more effectively preventing this suicidal behavior must focus on good prior mental health: “previously, more research was done on mental illnesses and less on prevention or what protects our mental health,” explains Pitti; but in the last 15 years, research has focused more on that preventive stance. And key to this are access to healthcare facilities, the existence of a powerful family network, a strong social environment and the restriction of access to everything that can cause a decline in mental health. And that is where the role of the educational center comes into play when it comes to taking advantage of the potential of young people to relate to each other and prevent problems at a key age.
