Suicidio: un problema de salud pública que la pandemia aumentó

……………………………………

Suicide: a public health problem increased due to the pandemic

José Alonso Andrade Salazar

Angélica Rodríguez Romero

Suicide is a public health problem that affects

individuals, groups, and communities; Its

severe repercussions for social and cultural

dynamics have multiple dimensions and

explanations from different disciplines and

theoretical perspectives. As a social problem, it

affects the communities impacted by the

consequences of this issue, such as the

perception of security, health, economic

stability, and psychological stability (World

Health Organization, 2018).

For psychology, these types of problems have

serious effects on the physical and emotional

health of those affected by its consequences

and harmful dynamics (Shneidman, 1992).

Therefore, issues such as depression,

emotional needs and other physical and

emotional illnesses can lead to the

deterioration of those affected. They may

suffer throughout their lives since emotional

vulnerability is a simultaneously social

vulnerability that usually remains for a long

time in those affected (Andrade et al., 2017;

Instituto de Medicina Legal y Ciencias

Forences - Forensis, 2017). For the Pan

American Health Organization (PAHO, 2020),

most of the suicides in the region occur in

people between 25 and 44 years old (36%) and

in those between 45 and 59 years old (26%).

Guyana and Surinam have the highest rates of

Revista investigación, desarrollo educación,

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July - December 2021

e-ISSN 2745-1194.

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…………………………………….

Psicólogo. Docente investigador Universidad

de San Buenaventura Medellín extensión

Armenia. PhD. Pensamiento complejo.

Magister Investigación integrativa. Email:

jose,andrade@usbmed.edu.co

Psicóloga. Magister en educación. Directora

del programa de psicología de la Universidad

de San Buenaventura Medellín. EMAIL:

direccion.psicologia@usbmed.edu.co

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suicide in the region (p. 2-3), the same as occur in other parts of the world. The rate of

suicide is much higher in men than in women and represents around 78% of all suicide

deaths.

The associated problems also have to do with the response capacity of social

institutions and the State to reduce the incidence of the problem. They are responsible

for communities that have not been affected by this dynamic and those that already

have. The communities alone do not have the means, mechanisms, or tools to

neutralize such effects (Forensis, 2018). In general, people, families, and groups tend

to respond to adversity with tools within their reach. That is to say, the learning and

strategies used in similar situations, but given the variability of the associated

conflicts, many of them are now obsolete.

In the Covid-19 pandemic, the suicides rate increased drastically during the initial

phases of the confinement or preventive isolation. They then decreased once the

countries established measures to enable mobility and encounter of people (González,

2020). However, the pandemic has not ceased increasing the risk factors associated

with this behaviour to date (PAHO, 2020). This situation showed that aspects such as

socialization, affective exchange, continuity of routines and external activities, and the

support of other people are necessary aspects to prevent this kind of behaviour.

Accordingly, the pandemic caused many families to increase little elaborated or

previously left tensions without an accurate solution. At the same time, the emergence

of new conflicts and strains derived from the coexistence and confinement; it is

essential to mention that women are among the most affected people by these kinds of

disputes. That is why domestic violence had a sense of gender during the pandemic

(United Nations - UN, 2020).

Hence, the aggressions, cyclical discussions, and domestic violence escalated in some

families in extreme cases. Frictions, shocks and crises arose as manifestations or

poorly adaptive responses to stress increased due to mandatory confinement. Other

effects include difficulties in adapting to new virtual relationship scenarios, mass

layoffs, collapsed financial situation of a household member, academic and work

uncertainty, or the existence of previous personal, family or social problems (British

Broadcasting Corporation - BBC, 2020b, 2021a). The risk factors of suicidal behaviour

increased in people who, before the pandemic, lived alone because of marital

separation, work, or study. It represented an added critical factor in those who had

previous suicidal behaviour. Nevertheless, in many of those cases, sharing with family

was an added protective factor for those at risk or not of suicide (BBC, 2021).

Additionally, many people had to isolate themselves and remain entirely alone. Due to

their socioeconomic, psychological, or familial situation, they reacted in a maladaptive

and extreme emotional level because of their higher propensity to suicidal ideation or

behaviour.

In the context of the pandemic, those at high suicidal risk are: adolescents with

domestic conflicts that increase their harmfulness because of the boost of virtual

educational responsibilities, the confinement and restrictions on sharing with their

Revista investigación, desarrollo educación, servicio, trabajo

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peers; people in grieve for the death of one or more relatives by Covid-19, linked by

ties of presence, absence or feelings of guilt concerning the fact of infecting a relative

who has already passed away or in danger of death; people with mild mental illnesses

background whose mental pathologies enhanced the incidence and chronicity, with a

diagnosis of depression, borderline personality disorder (BPD), bipolar disorders,

panic attack, among others; older adults in conditions of neglect or abuse; women

victims of sexual abuse or domestic violence and those who have a background of

suicidal behaviour that could relapse because of the tensions and crisis derived from

the pandemic (BBC, 2020a, 2020b, 2021a; OPS, 2020).

According to the above exposed and based on the worrying mental health situation

that the pandemic has generated, people affected by this type of problem need

continuous support in different aspects. It is important to note that State institutions

and NGOs must be part of the community to identify derived conflicts. At the same

time, they should be part of the construction of intervention measures, which embrace

thoughts, ideas, experiences, learning, and possible solutions to other emerging

difficulties from a cultural point of view.

Consequently, the community can provide contextualized solutions to these problems.

Such a problem-solving process enables communities to think critically and generate

theory, experience, and practice in a dialogical way. It will allow them to create

collective solutions with the help of those who have previously experienced related

emotional consequences.

In this problem and others that seriously affect society, it is necessary that the research

carried out by universities manages to identify the causes, processes, and

consequences associated with motivating, maintaining, and triggering events. Such

recognition and in-depth study can allow a much broader vision of the phenomenon,

a greater academic reflection on the problem leading to building proposals, programs,

projects, and intervention measures to reduce the high incidence of the phenomenon.

It should also aim at increasing the effectiveness of the intervention proposals

generated in an interdisciplinary way.

Therefore, it requires collaboration not only with the victims but the community in

general. The community can also become more active in hospitality, protecting those

at risk, and generating protective measures according to the context in which the

problems emerge and the risks they bring with them (Ayuso-Mateos et al., 2012; OMS,

2014).

Looking at problems of this type should exhaust the efforts to describe the issue. It

should also try to expand its field of analysis towards preventive intervention. For

example, preparing response measures before the situation happens, during the event,

and when the event is over. This description is what Social and Human Sciences call

primary prevention, secondary prevention, and tertiary prevention.

This type of prevention is applied by all disciplines, especially those with a social focus

and care for vulnerable people and groups. Its effectiveness lies in articulating all

preventive interventions to the context, the social and cultural elements that shape the

phenomenon itself, and the explanations that account for its particularities. This

Revista investigación, desarrollo educación, servicio, trabajo

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articulation should not reduce its description to a single logic, which becomes linear

and reductive if assumed from a single explanatory model.

Knowing the problem in depth is also one of the first ways to learn how to prevent it;

the more you know about a phenomenon, the greater the chances you have to

intervene early. It reduces the chances of severe damage in those who live it, directly

and indirectly.

It is essential to mention that social problems always come with other political,

economic, historical, religious, and cultural order issues. Therefore, these elements are

explanatory opportunities that open the possibility of dialogues between disciplines to

jointly build solutions that meet the care demands around the problem's vulnerability.

Such issues require inter-institutional cooperation and those who contribute to the

construction to implement intervention measures. That is, all those groups and

institutions capable of responding to the problem according to their installed capacity.

That cooperation shapes intervention. However, it also limits them to a great extent

because most programs aimed at meeting the needs of the problem depend on budgets,

political intentions and, in some cases, on the kindness of donors, which for mere

vocation tend to give protection to the needy.

Likewise, it is crucial to consider that many people are careless about the pain that the

problem brings with it. Those people think it is not their responsibility to intervene

nor their responsibility to reduce their incidence and help avoid risks factors or

increase protective factors. In these cases, some people usually consider that it is not

their competence to intervene and that the problem only requires the political and

economic activities of the Government. As it is a social problem, the entire society must

respond with its resources to reduce its incidence and provide support, protection, and

shelter measures to those in need. They should even account for those who are not yet

victims but who, given their current conditions of existence, are not far from becoming

direct victims of this problem.

Finally, we have to assume that this problem comes with a joint reflection on the

measures implemented to reduce its incidence and improve individuals, groups,

communities, and institutions. This challenge is a collective responsibility and task

that we cannot and must not avoid.

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