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February 19, 2003

Issue 4

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What is behind Scotland’s suicide secret?

Karin Strohecker searches for answers to Scotland’s high suicide rate and examines the recently launched ‘Choose Life’ campaign.

A MULTI-MILLION pound campaign was launched by the Scottish Executive last week to tackle the startling suicide rate in Scotland. Health Minister Malcolm Chisholm kicked off the ‘Choose Life’ campaign in Edinburgh last Monday allocating £12 million to this “urgent public health issue”.

The campaign has been developed over the last two years in co-operation with researchers and welfare organisations to get to grips with suicide rates. In the last three decades, Scotland has seen a strong upward trend of self-inflicted deaths with over 600 people taking their own lives last year alone.

Scots are ranked high in the European statistics and are nearly twice as likely to kill themselves than the English, the Welsh or the Irish.

But what is it that makes Scotland so vulnerable to suicide?

There are few solid conclusions but various reasons are being linked to suicidal behaviour in our society.

Professor Steve Platt is Director of the Research Unit in Health, Behaviour and Change at Edinburgh University and has been a Scottish Executive consultant for the ‘Choose Life’ campaign.

He explains that there are a whole range of triggers and causes that need to be addressed.

Firstly, there are individual factors that put people at a higher risk like psychiatric conditions, substance abuse or a prison sentence. Psychiatric conditions are posthumously diagnosed amongst 90 per cent of people taking their own lives, with depression accounting for most of these. Often these illnesses pass undiagnosed and unrecognised because of stigma, ignorance or denial.

Professor Platt points out that research suggests as many as 15 per cent of all people suffering from depression will eventually kill themselves.

Secondly, strong links have been suggested between alcohol abuse and suicide, especially amongst young people. In Scotland, 15 to 34 year-olds account for the fastest growing group amongst Scottish suicide victims and the largest group of self-harmers. Of all self-inflicted deaths committed in Scotland more than 30 per cent have a history of deliberately injuring themselves. Platt explains that around two thirds of self-harm episodes are committed under the influence of alcohol. Studies in the USA have shown that one out of three teenagers trying to commit suicide are drunk. The danger for young Scots is not so much that a continuous alcohol dependence will lead to suicide, but that its temporary effect causes people to lose control of themselves and their reactions. This is common knowledge in disputes between people, and research suggests that the same applies to the conflict inside.

There are other factors that affect the statistics.

In terms of gender, the numbers show men aged between 25 and 34 are nearly six times more likely to kill themselves than their female peers. Professor Platt reasons that new gender structures in society have bereaved young men of their bread winning status in the classic family structure.

“Women did a lot of catching up whereas young men are not so sure about what their position in society is anymore,” he says. As the insecurity and pressure mounts, adolescent Scots seem often to have fewer support networks in place where they feel they can communicate their troubles.

Further statistics show demographic and social triggers exist. For example, individuals are at a higher risk if they are divorced, socially deprived, or have experienced imprisonment.

Professor Platt explains that during the economic depression of the early 1900s the graph for unemployment mirrored that of suicide. Nowadays unemployment is still considered a factor, but it is just one amongst many. “Despite the economic boom of the nineties we have not seen rates decrease. That brings us to the point that we have to look at suicide in a much more complex way. There are individual factors like substance abuse and depression. There are sociological factors like marriage or intact family structures. There are economical factors like unemployment and recession. There are even studies suggesting that our society simply became more tolerant towards taking your own life and therefore people would commit suicide more easily. The truth is: we don’t really know why the numbers are so high.”

This makes the ‘Choose Life’ campaign all the more challenging.

The answer for Malcolm Chisholm is to take a multi-track approach towards the issue.

“If we tackle suicide as a 'one issue' policy we will fail. Our collective attempts to prevent suicide and reduce the suicide rate are directed at the heart of our Scottish Executive policies,” said the Health Minister.

The campaign is designed as an umbrella trying to amplify already existing local resources whilst coordinating them at a national level.

The plan of action focuses, on one hand, on high-risk groups such as young men or ex-prisoners.

On the other hand, geographic areas where suicide rates are traditionally high - such as socially deprived or isolated areas - are bring targeted with special support programmes.

But the real issue will be whether the campaign will be able to tackle the root and not the symptoms of suicide in Scotland.

Malcolm Chisholm has vowed to address strategic key issues like “economic regeneration, social justice, inequality, education,” and many more in his campaign.

Pledging for a firm commitment across all government agencies and departments, the initiative shows that the problem will have to be addressed on a much broader level.

“A housing officer in Wester Hailes or Craigmillar is very much aware that he is doing much more than just allocating and managing housing. They can see every day what impact their decisions might have on personal lives somewhere way down the line,” explains Professor Platt. “The big question will be if they get support from their managers all the way up to the top.”

So what can we expect from ‘Choose Life’?

Malcolm Chisholm aims at cutting the suicide rate by 20 per cent before 2013. But Professor Platt warns against attaching numbers to what should be achieved: “We might just be at the beginning of a major recession in Scotland, that alone could push the number up to unpredictable peaks.”

For him the achievement lies not so much in the numbers, but on a higher level in public awareness.

Platt is pleased that suicide has finally come out of the research and social care closet and made it onto the general political agenda.

“Whenever a decision is made to build a city bypass we will always consider the benefits versus the costs. We have to consider the impact of our politics towards the costs and benefits for human health, including human safety,” he says.

As the Professor sits in his office in the centre of Edinburgh contemplating a new society that will make life more liveable for so many, he is aware of the challenges ahead. But he hopes we are able to find a new approach to the value of each individual life in our society.

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