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Prevention of Suicidal Behavior Prevention of suicidal behavior - 1 - Prevention of suicidal behavior Washington, D.C. 2016 Also published in Spanish: Prevención de la conducta suicida ISBN: 978-92-75-31919-2 PAHO HQ Library Cataloguing-in-Publication Data Pan American Health Organization Prevention of suicidal behavior. Washington, DC : PAHO, 2016. 1. Suicide - prevention & control. 2. Behavioral Research. 3. Public Health Policy. 4. Americas. I. Title. ISBN: 978-92-75-11919-8 (NLM Classification: WM 165) © Pan American Health Organization, 2016. All rights reserved. The Pan American Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and inquiries should be addressed to the Communications Department, Pan American Health Organization, Washington, D.C., U.S.A. (www.paho.org/permissions). The Department of Noncommunicable Diseases and Mental Health will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights are reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the Pan American Health Organization concerning the status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the Pan American Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the Pan American Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the Pan American Health Organization be liable for damages arising from its use. Edited by Dr. Itzhak Levav Table of contents 1. OVERVIEW 1 2. PREVENTING SUICIDE: A GLOBAL IMPERATIVE 3 3. SUICIDE MORTALITY IN THE AMERICAS: REGIONAL REPORT OF THE PAN AMERICAN HEALTH ORGANIZATION/WORLD HEALTH ORGANIZATION 10 4. SUBREGIONAL SUICIDE OBSERVATORY FOR CENTRAL AMERICA AND THE DOMINICAN REPUBLIC 15 5. CREATION OF THE NATIONAL PROGRAM FOR SUICIDE PREVENTION IN CHILE 24 6. A COMPREHENSIVE APPROACH TO SUICIDAL BEHAVIOR IN CUBA 27 7. STRATEGY FOR THE PREVENTION OF SUICIDAL BEHAVIOR –– CENTERS FOR DISEASES CONTROL AND PREVENTION (CDC) 33 8. PROFILE OF SUICIDAL BEHAVIOR IN GUYANA: A RETROSPECTIVE STUDY, 2010–2012 43 9. EPIDEMIOLOGY OF SUICIDAL BEHAVIOR IN MEXICO 48 10. RESEARCH ON SUICIDAL BEHAVIOR IN NICARAGUA 57 11. SUICIDE IN PUERTO RICO: CHALLENGE AND COMMITMENT 59 12. THE ASSOCIATION BETWEEN SUICIDAL BEHAVIOR AND DRUG ABUSE: A CHALLENGE FOR PREVENTION 65 13. RELIGION, SPIRITUALITY, AND SUICIDE PREVENTION 72 14. THE STUDY OF PERSONALITY IN THE TREATMENT AND PREVENTION OF SUICIDE IN ADOLESCENTS 78 15. List of Authors 87 Overview THE PAN AMERICAN HEALTH ORGANIZATION ADDRESSES SUICIDAL BEHAVIOR In the closing days of 2014, the World Health Nacional de Psiquiatría Ramón de la Fuente Organization (WHO) launched the report Muñiz, a PAHO/WHO Collaborating Center, and Preventing suicide: a global imperative (1). In its the Government of Mexico. A regional workshop Foreword, Dr. Margaret Chan, Director-General of was held during the launch to discuss related WHO, stated that every suicide is a tragedy, noting experiences to date and the best ways to promote that an estimated 800,000 people commit suicide action to prevent suicidal behavior. each year and that for each death, there are many incomplete attempts. The impact of these deaths This publication on families, friends, and communities is devastating The Mental Health and Substance Use Unit of the and far-reaching, even long after the event occurs. Pan American Health Organization (PAHO/WHO), in Unfortunately, all too often suicide is not given conjunction with the aforementioned Collaborating priority as a major public health concern. Despite Center, produced this publication, which is based an increase in research and knowledge about on the presentations made in Mexico during the suicide and its prevention, the stigma surrounding regional workshop on the prevention of suicide. it persists, and those who need help frequently do not seek it, feeling alone in the face of the risk. Even This report was conceived as a practical tool that when people do seek help, many health services provides essential information to better understand admittedly fail to provide it. The challenge is real suicidal behavior and the main strategies to combat and must be met. As the Director-General of WHO it, from registry to the evaluation of interventions, declared: suicides are preventable (1). taking into account the approaches already under way in the Region. Also in 2014, the Pan American Health Organization (PAHO/WHO), Regional Office of WHO for the The contents have been organized for easy Americas, published its second Suicide Mortality reading, beginning with a worldwide overview of in the Americas report (2). Each year, some 65,000 suicide from WHO’s perspective. This is followed premature deaths from suicide are registered in by a summary of the PAHO/WHO report Suicide the Region. It is therefore not surprising that the Mortality in the Americas and subsequent reports Member States have acknowledged the extent and from Central America, Chile, Cuba, the Dominican importance of the issue and that the Strategy and Republic, Guyana, Mexico, Nicaragua, and the Plan of Action on Mental Health has given PAHO/ Associated State of Puerto Rico. WHO the mandate to strengthen its technical cooperation in this regard (3). In its most recent Next come chapters on several topics concerning Strategic Plan (2014-2019), PAHO/WHO included suicidal behavior, such as religion and spirituality, suicide mortality as one of the impact indicators to substance use, and the role of personality in evaluate in the Region (4). the treatment and prevention of suicide among adolescents. Both the WHO global report and PAHO/WHO regional report were launched officially in Mexico The closing chapter, authored by the Centers in October 2014, with the support of the Instituto for Disease Control and Prevention of the United - 1 - States, discusses problems and strategies related American Health Organization, which produced to the methodological components of suicide the publication, will be gratified to see this effort prevention programs. stimulate, guide, and support the individuals and groups committed to suicide prevention. The chapters are relatively brief and summarize essential information. A list of references is provided at the end of each. The few repetitions found in the chapters are deliberate, to ensure Dévora Kestel, MSc MPH that each one is complete and to guarantee easy Chief, Mental Health and Substance Use Unit reading. The tables and figures that illustrate the Pan American Health Organization (PAHO/WHO) text may be reproduced; the only requirement is Licentiate in Psychology, National University of La that their sources be cited. Plata, Argentina Master’s degree in Public Health, London School The authors of the various chapters and the of Hygiene and Tropical Medicine, United Mental Health and Substance Use Unit of the Pan Kingdom REFERENCES 1. World Health Organization. Preventing suicide: A global imperative. Geneva: WHO; 2014. Available from: http:// www.who.int/mental_health/suicide-prevention/world_report_2014/en/. Accessed 16 February 2016. 2. Pan American Health Organization. Suicide Mortality in the Americas. Washington, D.C.: Pan American Health Organization; 2014. 3. Pan American Health Organization. Plan of Action on Mental Health. 53rd Directing Council of PAHO (Document CD53/8 and Resolution CD53.R7).Washington, D.C.: PAHO; 2014. Available from: http://www.paho.org/hq/index. php?option=com_content&view=article&id=9774&Itemid=41062&lang=es http://www.paho.org/hq/index. php?option=com_content&view=article&id=9774&Itemid=41062&lang=en. Accessed 16 February 2016. 4. Pan American Health Organization. Strategic Plan of the Pan American Health Organization 2014-2019 [Internet]. 52nd Directing Council, 30 September to 4 October 2013. Washington, D.C.: PAHO; 2013 (Official Document 345). Available from: http://www.paho.org/hq/index.php?gid=14004&option=com_docman&task=doc_view. Accessed 16 February 2016. - 2 - Preventing Suicide: a Global Imperative Shekhar Saxena PREVENTING SUICIDE: A GLOBAL IMPERATIVE INTRODUCTION goal of reducing suicide rates by 10% globally by 2020. The purpose of this chapter is to provide an overview The Plan presents epidemiologic data on global suicide of the first global report on suicide, Preventing patterns and related protective and risk factors, setting suicide: a global imperative, published by the World the issue in a contemporary context. It also stresses the Health Organization (WHO) in 2014 (1).
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