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When FHI researcher Kim Stene-Larsen examined anti-suicide measures, he did not find any aimed specifically at the risk group: middle-aged men who are not in contact with health services.
In early October, after more than 20 years in psychiatry, Ewa Ness sees something she has never seen before. An obituary in the newspaper contains four simple words that make her stop:
“… he took his own life.”
– I’ve never seen that before in an obituary. Sometimes you see that people write “he chose to leave us”, but the phrase “he took his own life” is the first time I see it. And I think that’s very good, because it makes it easier to go up and tell those in distress that ‘I read the obituary. How are you guys “?
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Ewa Ness is a specialist in psychiatry at Oslo University Hospital and head of the Psychiatric Emergency Room. The online newspaper interviews her shortly after it became known about the government’s new plan of action for suicide prevention. Ness is delighted.
– In all the years the health service has been blamed when someone has taken their own life. “Psychiatry has failed,” people said. Then we forget something very important: that suicide is usually an impulsive act, where only half have been in contact with the special health service in the last year.
PSYCHIATISTS: Ewa Ness is sure that we have gained more openness about suicide in society.
Photo: Ewa Ness
The idea that those who kill themselves plan for months and carry it out at the agreed time is a myth, explains Ness. So instead of putting all the blame on failed psychiatry, one should try to prevent impulsive actions.
One simply has to make it difficult to jump from bridges.
With that as a backdrop, the government has now come up with a plan that goes further. Eight ministries have participated and politicians are now introducing a zero vision of suicide in Norway. High bridges will be secured, fences will be placed around train and subway tracks, and austerity measures will be considered in regulations for the availability of firearms and alcohol.
SUICIDE PREVENTION: The Government’s action plan for suicide prevention has been much broader than before, here signed by nine different ministers.
Photo: Regjeringen.no
The legacy of Ari Behn
Openness about suicide is important for a number of reasons, Ness says.
Eliminate taboos so that those who fight dare to talk about it. But it also creates a space for those who have a bad feeling towards others to ask “how are you really?”
– Ari Behn’s family did something that no one else had done before, they said openly in the media that “he took his own life”, and they did gives occurred. It did not arrive as a trust a few years after the incident, as we have seen before. That meant a lot, says Ness.
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Ari Behn was not only a high ranking man with status. He was also in the risk group. Two out of every three who commit suicide are men and the average age is 47 years.
The father of three, Ari Behn, was exactly that, 47 years old.
Suicide was a topic in Prime Minister Erna Solberg’s New Year’s speech, but the risk group, namely middle-aged men, was not specifically mentioned. However, there was another group:
“In many countries, more young people are facing mental health problems. It is increasing especially among girls. We do not know why. Therefore, the government will take the initiative to map the causes,” Solberg said in the speech.
Ness is positive about measures to map the causes and help young people who have mental difficulties. However, the suicide rate among women ages 20 to 75 is between 5 and 10 per 100,000. For men, it is around 20.
In other words, a man is more than twice as likely to kill himself as a woman to do so.
– We listen more to young women asking for help. But it is middle-aged single men, who are not in contact with the health service, who take their own lives. These are the ones we have to contact, says Ness.
Psychologist Kim Stene-Larsen is a researcher at the National Institute of Public Health.
When he began researching anti-suicide prevention measures, he discovered to his surprise that there was not a single measure specifically targeting men. This despite the fact that for many years it has been known that men are the risk group.
– It is worrying, especially if one takes into account that only about 35 percent of men who kill themselves have been in contact with the health service in the last month.
FHI RESEARCHER: Psychologist Kim Stene-Larsen is a researcher at the National Institute of Public Health.
Photo: FHI
However, the new action plan is aimed at this group.
– To reach these men, we must know more about them. It is therefore very positive that the government is now focusing on more investigations associated with this group, says Stene-Larsen.
What do we know about “man (47)”?
To fulfill the government’s vision zero, we need more knowledge about the “man (47) who commits suicide.”
But we already know something, says Stene-Larsen:
- We believe that many of the men who kill themselves have an underlying mental illness that goes undetected. Studies have shown that around 90 percent of all those who have committed suicide have had a mental illness, most of the time depression.
- Men are more likely to use violent suicide methods and often have better access to effective methods such as firearms.
- Men, to a greater extent than women, try to cope with crises on their own. While women seek out their network or seek medical attention, men tend to think that they must fend for themselves.
– They can be ingenious and successful men who kill themselves without the people around them having anticipated it. Perhaps they have experienced something that they themselves consider a serious loss, be it a breakdown in a relationship or problems at work, and then they don’t talk to anyone, Stene-Larsen says, continuing:
– They wear blinders and see no other way than to end their lives.
The new action plan allows for more research. More knowledge and information provides a new and better basis for treatment.
– The government has implemented the best documented anti-suicide measures in the action plan, such as limiting access to methods, providing better monitoring of the mentally ill, and introducing measures to reach struggling youth This is all very positive, says Stene-Larsen.
Three myths that don’t match
There are mainly four strong risk factors for suicide, explains psychiatrist Ness:
It is not uncommon to have suicidal thoughts at some point in your life, often in a crisis, such as a breakup.
In Norway, there are between 500 and 600 who kill themselves each year, and for every suicide, there are around 10 times as many suicide attempts.
Suicidal thoughts do not necessarily result in suicide. But the more people talk about bad thoughts, the lower their risk of suicide, because it can lead them to seek help, Ness says.
The theme for this year’s World Mental Health Day was “ask for more.” Ask those around you how they are doing, and not least: accept the answer.
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Some of the myths associated with suicide have lived on for too long, experts say. How asking someone if they are considering taking their own life can make them do so.
– All research shows that this is not the case. You have no thoughts of killing yourself for talking about suicide, says psychiatrist Ness.
Another well-established myth is that those who kill themselves do so because they believe that everyone around them will feel better. That’s not the case either, says Ness.
– For many, the pain becomes too intense. They can no longer bear it. They don’t really want to die, but they think it will be “unbearable to live.”
Then we come to the third myth, which we discussed at the beginning of the article: That all suicides are planned.
– Most suicides are an impulsive act that usually takes place under the influence of drugs. Maybe you’ve been in pain for a long time, but then something happens that pushes you to the limit that night.
How to talk about suicide
The goal of dispelling these myths is to spread knowledge. Because if everyone thinks that those who take their own lives have been rigging themselves for months because they have decided that the world will be better off without them, many will think that they cannot be helped.
It’s wrong, says Ness, who encourages people to be more curious about others.
– But if you are going to talk to someone about something difficult, you must first be good at talking about something easy. It is not a coincidence who people trust if they are having a hard time, says the psychiatrist.
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She herself is the type of person that people trust. Not only because he is a psychiatrist, but because it accommodates him.
– It is not dangerous to talk about suicide. Try your best to meet people without prejudice or fear, says Ness, continuing:
– If it becomes too difficult to handle, you can consult. Ask them to contact the health service or suggest that they call one of the helplines.
NIPH researcher Stene-Larsen encourages people to follow their instincts.
– Especially men want to answer “everything is fine” if people ask them how they are doing. But if you have the feeling that all is not well, press a little more. Be more direct. Those around you can make a big difference, concludes Stene Larsen.
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