Shared responsibility in the face of the phenomenon of suicide
Suicide refers to the voluntary and self-inflicted death carried out by the individual. However, it is crucial to emphasize that the person who commits suicide does not wish to die, but rather to end persistent emotional suffering that leads to profound hopelessness, seeing this outcome as the only way to end their situation. According to the World Health Organization, 720,000 people die by suicide each year.
It is necessary to contextualize the terminology surrounding suicide in order to understand what we are discussing. First, it is necessary to define suicidal ideation , which refers to thoughts ranging from fleeting notions of wanting to end one's life to more entrenched, persistent, and recurring self-destructive images. These thoughts can vary depending on their intensity, frequency, and the intention to act on them. At the next level are suicidal communications , an intermediate stage between suicidal ideation and suicide attempt. These communications can be verbal or nonverbal and refer to the desires, ideas, or intention to end one's life, with actions such as writing farewell notes (not always present), engaging in closing-door behaviors, or planning the method. Following this, we have suicide attempt , which encompasses any self-inflicted behavior carried out consciously and voluntarily with the clear intention of ending one's life, but which does not result in death, either due to last-minute regret or because some external circumstance prevents the final outcome. Finally, we talk about completed suicide , which includes the voluntary death of the person in a self-inflicted manner.
Suicide is a complex phenomenon influenced by a wide range of interrelated factors of a demographic, social, economic, cultural, and psychological nature. These factors include, among others, the potential denial of basic human rights and lack of access to essential resources. Likewise, stressful life events such as loss of income, work or educational pressures, relationship breakdowns, discrimination, and other crises can play a significant role (Zhu et al., 2022).
Keys to preventing suicidal behavior
Stigma and suicide
I don't want to continue these lines without addressing the phenomenon from a more human, empathetic, and realistic perspective, because behind each of the people on the list of those who have died from this cause, we find the suffering of the person who sees this path as the only escape from a hopelessness that sweeps everything away, and also the suffering of family and friends who see their loved one fading away and giving up without knowing how to help them or which door to knock on in the effort to save their life.
We must consider those cases where those close to the bereaved become aware of the situation and the suffering, only when it is too late and there is nothing they can do to stop the death of their loved one. It is a moment when those around them face emptiness and a heart-wrenching pain , a pain that finds no solace and is filled with unanswered questions in a continuous loop of "what if I had said," "what if I had done." Ultimately, it is a series of "what ifs" and endless questions, because the reality is that the person who could provide answers is gone and cannot. We are condemned to a relentless and agonizing uncertainty, where grief, guilt, and often the stigma surrounding death by suicide are the only companions in navigating this complex grief. A grief that is often disavowed, not only by the survivor himself, but also by a society that is often ignorant and shrouded in a culturally perpetuated taboo, where it is easier to look the other way than to look at a problem that affects us all and of which no one is free from being a potential victim, directly or indirectly.
Grief over suicide is often discredited, not only by the survivor, but also by a society that is often ignorant and shrouded in a perpetuated taboo.
The social stigma surrounding suicide is conceptualized as the set of negative attitudes, beliefs, and behaviors directed toward individuals who have considered, attempted, or completed suicide, as well as toward those who are grieving or have suffered because of it. This stigma can extend to close family members, other loved ones, and the immediate environment of those affected.
There are many misconceptions surrounding it, such as considering suicide a selfish, cowardly, or morally reprehensible act; all of this reinforces social disapproval and self-stigma of the affected people (Corrigan et al., 2017).
The necessary attention for people who have lost someone to suicide
The taboo of suicide in the environment
While the stigma surrounding suicide is widespread, it is significantly intensified in rural communities , where a combination of factors contributes, including geographic isolation, unwanted loneliness, restrictive gender norms, lack of adequate access to mental health services, and culturally established social norms that emphasize self-sufficiency. All of these factors hinder both the person at risk of suicide and their family and close friends from seeking help (Bartik et al., 2015; Kennedy et al., 2018; Monteith et al., 2020; Perceval et al., 2018; World Health Organization, 2019; Soontae et al., 2022; Ongeri et al., 2022; Gearing et al., 2023).
Sometimes, people who survive a suicide attempt are seen as emotionally weak or unstable, while the families of those who have died by suicide face social stigma that they didn't do enough to prevent the tragedy, thus increasing the guilt so characteristic of grief after a suicide. These attitudes create an environment of isolation and silence, perpetuating a negative perception of suicide and those affected. The social stigma of suicide manifests itself through a combination of rejection, moral judgment, and exclusion toward those who experience suicidal thoughts, those who have made previous attempts, or those who have lost a loved one to suicide. This stigma takes various forms, such as discrimination, blame, and the spread of negative stereotypes.
Cecilia Borrás
Breaking the taboo surrounding suicide and grief requires a comprehensive approach that combines providing knowledge and awareness in the area of mental health, essential for dispelling myths and taboos; and promoting a proper understanding of suicide as a public health issue , fostering empathy and reducing the prejudices surrounding it. A genuine and honest openness to dialogue is indispensable, not only to break the taboo influenced by our own culture, but also, and equally important, to create safe and trusting spaces where discussion and conversations about suicide can be normalized. This will make it easier for people at risk of suicide, their families, and loved ones to seek help. Society can play a fundamental role in prevention, but also in postvention, by offering genuine and empathetic support to those affected by a loss due to suicide.
The taboo surrounding suicide makes it difficult for both the person at risk of suicide and their family and close friends to ask for and seek help.
The path toward prevention and postvention should not rest solely in the hands of professional teams; it is a shared social responsibility. Furthermore, it is essential to acknowledge the role of the media in promoting mental health, including everything related to the traumatic grief following suicide. When addressing this phenomenon, it is crucial to use language appropriate to the context, and to demonstrate empathy and respect for those facing loss, as well as for those who see suicide as the only escape from seemingly endless suffering and despair. Finally, and equally important, is the need for real and accessible public policies, taking into account healthcare resources. Equally important is ensuring that these resources are accessible not only in populated areas but also in rural municipalities, often overlooked, which have their own specific needs and, at times, less access to such resources.
Eva Berenguer
You are not alone
I don't want to miss the opportunity to send a warm message, not only to those at risk of suicide, but also to those going through their own painful and often lonely grieving process:
"To you who suffer, to you who struggle between intertwining your fingers and clinging to life with the last shred of strength you have left, or letting go, carried away by the force of that wave that sweeps you away, laden with hopelessness, despair, and loneliness, even though you are surrounded by people. To you, weary of fighting, of tirelessly searching for a door that will lead you to a state of relief, where the breeze of life gently caresses your cheeks, that door that seems never to arrive, that remains hidden amidst so much darkness. To you, and only to you, let me whisper that you are not alone. I cannot make your path my own, I cannot walk for you the arduous, rocky, and barren road that awaits you, in search of that light that will allow you to illuminate the darkness that now seems to surround you." But let me tell you that, if you need me, I will be the support you lean on, the one who listens without judgment, the one who sees you and validates what you feel, I will encourage you to keep going when you think you can't go on. I hold onto the hope that when you finally reach that serene light of calm and well-being, no matter how long it takes, I will be the one who reminds you that the credit was always yours, but that there are many of us who are happy that you are once again firmly embracing this life, which, while we know it can be very tough, also has beautiful things to offer you. You are not alone.
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