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Redalyc.Prevention, Assessment and Treatment of Suicidal Behavior Anales de Psicología ISSN: 0212-9728 [email protected] Universidad de Murcia España Sánchez-Teruel, David; García-León, Ana; Muela-Martínez, José-Antonio Prevention, assessment and treatment of suicidal behavior Anales de Psicología, vol. 30, núm. 3, septiembre-diciembre, 2014, pp. 952-963 Universidad de Murcia Murcia, España Available in: http://www.redalyc.org/articulo.oa?id=16731690020 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative anales de psicología, 2014, vol. 30, nº 3 (octubre), 952-963 © Copyright 2014: Servicio de Publicaciones de la Universidad de Murcia. Murcia (España) http://dx.doi.org/10.6018/analesps.30.3.148691 ISSN edición impresa: 0212-9728. ISSN edición web (http://revistas.um.es/analesps): 1695-2294 Prevention, assessment and treatment of suicidal behavior David Sánchez-Teruel*, Ana García-León and José-Antonio Muela-Martínez Department of Psychology at the University of Jaén (Spain) Título: Prevención, evaluación y tratamiento de la conducta suicida. Abstract: Suicide is a serious global public health problem in both devel- Resumen: El suicidio es un grave problema de salud pública mundial, tan- oped and developing countries. The results of the research reviewed here to en países desarrollados como en vías de desarrollo. Los resultados de las reveal that, in Europe, one person dies by suicide every nine minutes, and investigaciones analizadas muestran que en Europa muere una persona ca- that in Spain it is currently the leading external cause of death after road da nueve minutos debido a esta causa y que, actualmente, en España el sui- traffic accidents. This review presents the latest findings on effective sui- cidio es la primera causa de muerte externa por encima de los accidentes de cide prevention strategies in the general population as well as the most ap- tráfico. Se presenta una revisión de las últimas conclusiones sobre acciones propriate instruments for assessing the level of risk for suicidal behavior in eficaces de prevención del suicidio en población normal, así como los ins- a clinical population. The treatments that scientific literature reports to be trumentos más adecuados para evaluar el nivel de riesgo para cometer una most effective in the fight against suicide are also included. The most sig- conducta suicida en población clínica. También se ofrecen los tratamientos, nificant results in terms of both prevention and treatment are discussed que la literatura científica, ha detectado más eficaces en la lucha contra el and several limitations to this study are also raised, which may be consid- suicidio. Se discuten los resultados más destacados en la prevención y tra- ered for future work by practitioners and researchers interested in this field. tamiento del suicidio, y también se plantean diversas limitaciones de este es- Key words: suicide; prevention; assessment; treatment. tudio, que podrían ser consideradas líneas futuras de investigación para pro- fesionales e investigadores interesados en esta temática. Palabras clave: suicidio; prevención; evaluación; tratamiento. Introduction ganización Mundial de la Salud-OMS, 2006) conclude that suicide prevention is indeed possible, most countries lack Around a million people die by suicide annually, making it specific strategies to tackle this behavior. The reasons for one of the three leading causes of death worldwide this situation are determined by a lack of awareness of sui- (Fleischmann, 2008; World Health Organization-WHO, cide as a health problem, given that many societies still con- 2012). This equates to one death every 40 seconds (every 9 sider it a taboo to openly discuss this topic, meaning that the minutes in Europe) (Linehan, 2008; Hawton et al., 1998; mortality statistics for suicide are not reliable outcome WHO-Europe, 2008; WHO, 2010), resulting in considerable measures (Pritchard and Amanullah, 2007). However, it is emotional cost to the family and friends of the person who true that in the last decade or so some international organi- has taken their own life. Furthermore, in almost 90% of the- zations (OMS, 2002; IASP; 2008; WHO, 2012) have started se cases, the individual has suffered from some kind of men- working alongside the governments of certain countries to tal disorder (World Federation for Mental Health-WFMH, ensure that this behavior is no longer stigmatized, criminal- 2006) or attended a medical consultation in the six months ized or penalized, as well as to draw up prevention programs prior to the suicide attempt (World Health Organization- aimed at reducing suicide rates (Chávez-Hernández, 2008; International Association for Suicide Prevention-WHO- Callard, 2008; Fleischmann, 2008; Gould and Kramer, 2001). IASP, 2008; WHO, 2012). In some European countries, for In fact, only a handful of countries like Australia, Japan, the example, Spain, recently published data reveal that death as- United Kingdom and the Netherlands have included suicide sociated with suicide is seen as the number one external prevention among their national health priorities. cause of death, ahead of road traffic accidents (Instituto But what do we understand by suicide prevention pro- Nacional de Estadística (National Institute of Statistics)- grams? Some institutions (Spanish Confederation of Associ- INE, 2011). As can be deduced from these figures, suicide is ations of Families and People with Mental Illness-FEAFES, a problem that needs to be addressed in all public health 2006) define them as actions that include detection and in- policies (Sánchez-Teruel, 2010). However, to date, very few tervention in at-risk populations (Muñagorri and Peñalver, countries around the world view suicide as a behavior that 2008), together with extensive training programs for primary should be prevented, assessed and treated in a specific and care practitioners, other professionals (in a school, social particular way (Sánchez-Teruel, 2012). services, business environment) and non-professional agents who are capable of intervening when it comes to acknowl- Suicide prevention edging the problem. A key example of the latter (involve- ment of non-professionals) is a program carried out in Pan- Although recent studies (Fleischmann, 2008; Interna- ama that addresses the early detection and prevention of de- tional Association for Suicide Prevention-IASP, 2008; Or- pression (Pan American Health Organization-PAHO, 2005), and which boasts the collaboration of the hairdressing * Dirección para correspondencia [Correspondence address]: community, with hair salons being a place where mood dis- David Sánchez-Teruel. Departamento de Psicología. Facultad de Huma- orders are most easily detected. nidades y Ciencias de La Educación. Universidad de Jaén. Campus las la- The World Health Organization (Organización Mundial gunillas, s/n-Edificio C5 23007, Jaén (Spain). de la Salud, 2006), alongside other institutions (International E-mail: [email protected] - 952 - Prevention, assessment and treatment of suicidal behavior 953 Association for Suicide Prevention-IASP, 2008), have pub- and the proper treatment of mental illnesses in the media. lished numerous reports that can serve as reference for sui- The campaign was held in October 2008 under the title cide prevention. What‟s more, the ongoing research into this “1in4- Admit it- Mental health matters” (Junta de Andalucía, issue produces results that the WHO usually transfers to na- 2008). tional governments of those countries where behaviors of Many conclusions can be drawn from these national and this type are highly prevalent. An innovative example international experiences, most notably the importance of (Fleischmann, 2008) was the introduction of suicide preven- suicidal behavior prevention programs aimed at raising tion projects in China and Southeast Asia in early 2008. The- awareness in the general population (relevant information, se initiatives mainly focused on preventing self-poisoning addressing the stigma - shame, fear of rejection – associated with pesticides, which accounts for 60% of suicides in many with mental health problems), and the need for greater par- rural areas of these countries. ticipation from professional and non-professional groups It is therefore clear that one of the key functions of the and individuals, politicians, and senior staff from public ad- WHO is to build political commitment with national gov- ministrations, social services and the health care sector ernments to develop contextualized responses to suicide (Confederación Española de Agrupaciones de Familiares y prevention, as well as adapt strategies necessary for prevent- Personas con Enfermedad Mental (Spanish Confederation ing these behaviors on a local level and make significant of Associations of Families and People with Mental Illness) - headway in preventing this public health problem on a glob- FEAFES, 2006; IASP, 2008). al scale (Fleischmann, 2008). The celebration of World Sui- A considerable amount of scientific studies are available cide Prevention Day in 2008 whose theme was “Think which show that suicide is the result of complex interactions Globally, Plan Nationally, Act Locally” is an example of this between different risk and protective factors (Mościcki et al., (IASP, 2008). 1988; Gould and Kramer, 2001; Sánchez-Teruel, 2012; Vil- With regard to Europe, in January 2005
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