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The price of silence — 150 thousand suicides

Цена молчания — 150 тысяч самоубийств

Konstantin Minkevich — psychotherapist with experience more than 15 years. Does cognitive therapy work with errors of thinking. Including the issues that arise when trying to understand themselves and each other.

In the story of Lieutenant Potapovich there is one question I want to answer in more detail. Why no one did nothing after Potapovich April 1, whether has sent a warning letter, or has made a suicidal attempt?

I can’t know anything about this particular story and even don’t want to build any concrete assumptions on this subject, and to comment on any details of this case: do not believe it is the right and ethical. In the end, talking about tragedy, about death. So I will try to answer this question in a General way.

Let’s start with the frequent cognitive errors, where people after the occurrence of certain events, imagines what he could to prevent it if have taken into account some circumstances. The error is that those circumstances (or true interpretation) was unknown, they were opened late. At the same time, when the decision about further developments, no one knew.

Now our Lieutenant, presumably resolvem warning to colleagues. Who? No idea, for example, the same 22-year-old lieutenants. Now imagine yourself in the place of Lieutenant of the traffic police, receiving the letter with the text: “I don’t want to live, I will kill myself”. And what do you do? Where to go? What to do?

Few people understand the issues of suicidal behavior. In people’s minds contain different degrees of detachment from reality ideas. Suicide in the eyes of the General public whether unnecessary a wimp, or a dangerous lunatic, or a fool, or all of the above.

What reaction should we expect from colleagues? Fear. Incomprehensible fear. And the desire to dissociate itself, to forget, to transform the case into a stupid joke.

But okay. Imagine that someone took the warning seriously. What’s next? What should he do? A lot if people in General know what to do in a situation when a familiar person shows the desire to commit suicide? How to behave with him? It is necessary to say something? To do something? And if you do worse?

I can easily imagine how concerned the person is with a heavy heart that refuses any response, fearing to make things worse.

Finally, the third time. Effects of a reaction. Just mentioned a concerned colleague or perhaps a relative, tries as he can to reassure and support a potential suicide himself. But not reported “where follows”. Why? Because the word “stigma” I know the units, but the phenomenon known to all.

Let’s imagine what would happen if a young Lieutenant of militia, written in the suicide. Goodbye career in bodies, right? This begs the decision to suspend him. But that’s not what a janitor is the person in the performance, with a weapon, among other things. And his ouster will mean almost certainly a dismissal. Therefore, I can easily imagine how anybody anywhere says nothing. Away from sin. You see, raging, and here life is to spoil the guy.

 

Цена молчания — 150 тысяч самоубийств

 

This is not fiction. The suicidality is generally quite a complex phenomenon, and we with more simple and obvious things is not always possible to understand, especially to non-specialists. There are situations when a person with psychosis his family deny to the last, if only to avoid psychiatric diagnosis, to say nothing about the words about wanting to die.

Once to me brought the advice of the young teacher. He came to fulfill the distribution went to work, but his colleagues have discovered new employee “some oddities” that they were worried. Surprising: during the examination the patient showed an acute psychosis, it is quite poorly understood where and why he is there and what actually happens. Personally, I generally could not understand how he was able to go to work. Of course, after his tour he was sent for treatment. The continuation of the story I don’t know, but that after treatment he was all good and he was able to return to work is possible. The fact that in this case, changes in the human condition was a gross and obvious, nevertheless, about a week his colleagues doubted what to do. What do you want from people in much more ambiguous situations, statements of suicidal intent?

Well, psychologists with the colonels are just people. Even if you imagine that information got to the authorities (given the above, it is not the fact), it is the boss, thinks the same way. And at your level, you may dismiss. Or decide “not to spoil a guy’s life.” Or “not to spoil the performance”. Hardly the Belarusian internal Affairs agencies are delighted when young lieutenants are unfit for duty. And to lower business on brakes may seem like quite a good idea. Not suspended, not to show it (God forbid) a psychiatrist, and quietly arrange a conversation with a psychologist (to beat the crap out of your head) and forget, especially when the signals stopped coming.

I once had exactly the informal request of the authorities, to counsel, it seems, Director of a company, who has discovered a severe depression, of course, with suicidal ideas. Frankly, I really don’t remember what the outcome of that story, of course, I insisted on the treatment: the human condition threatened his life, and he, like my boss, I asked “sorry” and not to “ruin his career” diagnosis and hospital.

If you think that these stories are rare and vulnerable to them, except that patients in mental hospitals, then, alas, it does not. Depression is a very common disease, they (often, of course, in the form of light) affects about 300 million people worldwide. But even mild depression may cause suicide. Belarus is already a quarter of a century among the world leaders in suicide rates. Despite the recent downward trend in their number in 2018 from suicide died 1806 people — 1.5% of all deaths in the country. Suicide attempts are approximately 10 times more. While the world health organization indicates an existing for various reasons, a possible underestimation of the number of suicides in the statistics.

Compare: from the accident in 2018 were killed 759 people, 2.5 times less.

And now remember, how often have you heard about the prevention of accidents and mortality on roads. Often, right? So why this silence in relation to suicide?

I think that for several reasons. The topic itself is quite sensitive, it is difficult and scary to discuss. Mortality from traffic accidents, if we are talking about it is, in principle controllable: a good organization of traffic on the roads allows to significantly reduce it.

Mental life human to handle is not so simple. When 10 years ago I was actively engaged in suicide prevention, after my next speech at a conference one of the leaders, tired of all those endless intractable problems, asked: “So what we need to push the button, that they were not?” You can understand that he wanted a simple and effective recipe, but this recipe was not there (including me).

It turns out that people die, and around of death — silence. This conspiracy of silence is possible to maintain, unless there is some really quite outrageous case, which will resound throughout the country. Then run once again through the minds rustle: “Yes how so? Why no one did nothing?” — yeah and try to forget this matter as soon as possible.

Because the most important rule that I learned, the fewer conversations about suicide, the better. If someone said I don’t want to live, or rather just ban him to think about it. But if on the contrary, to maintain such a conversation, it will trigger to commit suicide. But this is a myth that is described in all manuals on suicide prevention, not conversations contribute to suicide, and is shy and fearful silence under the guise of sensitivity.

While the society and the state does not recognize the existence of the problem until it will be to write and speak until the shame, fear and loneliness are the main feelings of people experiencing crisis, people will continue to die. Man can not stop thinking about the fact that it oppresses, even if to deny it to him, but may stop looking for the person who hears it and support who will find the strength to say,”I know you’re very hard now, so hard I could die, and I want to help. Tell me about it.”

During my work for the past 15 years, according to official statistics, suicide has killed more than 30 thousand Belarusians. By simple calculations (the country’s population — nearly 10 million. Will die in the end. The proportion of suicide in total death rate now at 1.5%) we find that, if you continue to remain silent, about 150 million living of Belarusians (population conditional Borisov) die from suicide.

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