- People with suicidal ideation may have some risk factors that predispose them to ever attempt to harm themselves or end their life.
*This report by The Diary Originally published on September 10, 2023
The Venezuelan Observatory of Violence (OVV) has found a slight decrease in the number of suicides in Venezuela in recent years. However, cases are increasingly visible and disseminated in the media and social networks.
Although the number seems to be getting smaller every year, there are still phenomena and patterns that concern professionals, such as the incidence in certain states of the country and the cases of children and adolescents who commit suicide.
In 2021, 2,291 suicides were recorded in the country, while for 2022 the national figure was 2,173. Between January and July 2023, the OVV documented 256 suicides across the country.
Psychiatrist Carlos Tineo said that, although there are no official figures provided by the State, the data on suicides that non-governmental organizations (NGOs) manage to collect are worrying for those who study mental health in the country.
He argued that in order to understand the incidence of these phenomena, one must take into account the risk factors that may indicate that a person is more likely to commit suicide.
The first thing to be clear about is to put aside those myths that people who commit suicide are immoral, weak, sinful or selfish for not thinking about their family. Behind this decision there are a huge series of factors that have to do with both genetics and personal aspects,” Tineo said in an interview with El Diario.
Risk factors
An important risk factor is when there is a family history of suicide or depression, because there is already a genetic predisposition for a person to make that decision.
The psychiatrist explained that everything that happened in childhood should be analyzed as possible risk factors, especially if the person lived traumatic experiences such as abuse, sexual abuse, lack of family affection, poverty, substance abuse such as alcohol and drugs by someone in the family unit.
“Another risk factor is if the person has a diagnosis such as a depressive disorder. Although not only people with depression commit suicide, people with alcoholism, with bipolar disorder, schizophrenia and other personality disorders,” he added.
Physical health can also act as a risk factor. Tineo commented that some metabolic diseases such as hypothyroidism are also linked to suicidal ideation.
“People with extremely painful chronic illnesses are also at risk of suicide, because they constantly think and say ‘I don’t want to suffer anymore’ or ‘I can’t tolerate this anymore’ and that could be suicidal thoughts,” she said.
Social factors in Venezuela
The specialist pointed out that Venezuela faces very complex social factors that affect the mental health of its inhabitants and to which it cannot remain indifferent. He clarified that these are situations that were experienced even before the Covid-19 pandemic.
“We are in a complex humanitarian crisis and that puts us in very vulnerable conditions. All Venezuelans are constantly experiencing losses, because before I had something and now I don’t, before I could do this and now I can’t, before I could buy something and now I don’t have enough money, all of this produces despair,” he explained.
She stressed that a person’s economic situation can be a strong influence when thinking about suicide. She argued that if a person feels that the income they have is not enough to survive, help their family, pay debts or deal with a medical emergency, this becomes a highly stressful factor.
Tineo indicated that if a person has several of the risk factors mentioned above, he or she may consider resorting to suicide at some point.
Warning signs
The expert pointed out that risk factors can give an early indication that a person may commit suicide, but there are several warning signs that give clear indications that suicidal ideation is present.
A low-intensity sign is fleeting thoughts and comments with phrases like ‘I would like to die’ or ‘I don’t want to live anymore’. Here you should ask if they have thought about how they should die or if it is a constant thought. If the answer is negative, then the idea of suicide is not yet structured,” he added.
If the thought of dying is frequent and planned, the person is already at a high level of suicidal risk.
Tineo added that due to the social and economic situation in Venezuela, phrases such as “It’s just that you can’t live in this country anymore,” “You can’t survive in Venezuela,” “No matter how hard I try, I can’t guarantee food for my children,” “It’s better to disappear,” or “It’s better to die” are frequently heard. He clarified that if these expressions are very frequent and have aggressive or desperate tones, they should be taken into account as an alarm signal.
The specialist explained that drastic changes in some habits can be considered warning signs. He specified that attention should be paid to changes in eating habits, sleep, hygiene and social behavior.
The psychiatrist added that previous suicide attempts and self-harm are also serious warning signs.
How to address a possible suicide risk
Carlos Tineo indicated that if the person realizes for themselves that they have suicidal thoughts, they should seek professional mental health help. However, if the risk is identified by a third party, the protocol is different and two scenarios can occur.
“The family member or friend should ask the person if they have noticed or are aware that their habits and way of speaking have changed and if they have thought that they might be depressed. If the person accepts this, they may be given the opportunity to seek professional help,” he said.
The psychiatrist explained that the third party who suggests going to a professional should be very neutral and avoid making comments like “do your part”, “forget about it” or “we’ll go out and you’ll forget”, because these are expressions that can make the person feel worse.
Once the consultation is over, if the family member or friend wants to accompany the person, they should follow the specialist’s guidelines to support the therapy. Tineo recommends that the person accompanying the patient should preferably be someone for whom they feel respect and affection.
A second scenario is that the person denies the situation and does not want to seek help. If the case appears to be very serious because it meets risk factors and several warning signs, hospitalization may be considered.
“If the person meets all the criteria for persistent suicidal ideation, they should be hospitalized because if that person is deeply depressed and without energy, sooner or later they will attempt suicide. If a family member decides to hospitalize them, they may be able to save their life,” he emphasized.
Mental health services
In Venezuela, there are mental health services that fulfill different functions. Public and private mental health consultations seek to work through therapy in a preventive way or focused on a specific problem such as stress management, anxiety or trauma.
Triage and emergency services in psychiatry deal with slightly more complex cases and rule out when hospitalization is necessary, and finally there are psychiatric hospitals that provide constant care to patients while they are hospitalized.
Tineo explained that hospitalization is being carried out at the Caracas Psychiatric Hospital, but triage consultations are not active, which makes it more complex to deal with cases ranging from moderate to severe. He added that there are services of this type in the private sector, but their costs can be very high.
A very serious problem that we psychiatrists have is the shortage of psychotropic drugs in the public sector, because before the patient went to the doctor’s office regularly and received his treatment there, but now it is not possible. All these drugs in the private sector are expensive for the patient,” he said.
The specialist explained that a consultation can cost between 30 and 60 dollars and a psychotropic drug can cost up to 60 dollars, which makes it increasingly expensive to maintain medication for a disorder.
She added that while it is necessary for Venezuelans to be aware of the warning signs surrounding suicide, it is also important for them to have access to and availability of mental health services in optimal conditions to deal with each case.
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2024-09-10 15:21:00
