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    NewsLatin AmericaUruguay, faced with the challenge of curbing suicides

    Uruguay, faced with the challenge of curbing suicides

    “Why am I going to speak if no one understands me?”, asks a 15-year-old adolescent, in the house of the National Youth Institute (INJU), in Montevideo, the capital of Uruguay. Her classmates, also teenagers, listen to her in silence. “There’s always someone,” replies one. Another of her regrets that adults do not take her seriously. “Sometimes I don’t even understand myself,” adds one in a soft voice from the background. Immediately, a boy explains that he was the target of ridicule on social networks. “I suffered enough,” he says. And he tells his story, closely followed by his colleagues.

    Dialogues of this type, with the kids as protagonists, are part of neither silence nor taboothe mental health campaign launched by the INJU and Unicef in educational centers throughout Uruguay. In this area, and in spaces such as the INJU house, more than 300 workshops are held, where young people between the ages of 14 and 19 have the opportunity to talk and talk openly about their emotions, among peers and accompanied by adults of reference. .

    “Mental health is a priority issue for gurises (children)”, affirms Felipe Paullier, director of the INJU. He explains that this concern has been repeatedly raised by Uruguayan adolescents, especially affected by the covid-19 pandemic, but also by an adult universe in general that is not inclined to listen to their concerns. In addition, Paullier cites a couple of data that emerged from a 2018 INJU survey, which gave rise to this campaign: 14% of Uruguayan adolescents and young people said they felt sad or desperate for two weeks in a row that year, to the point of leaving their usual activities, while 3.5% had thought about taking their own life. In total, 117,000 and 29,200 kids respectively.

    “Historically, mental health has been a taboo subject. That is why adolescents propose: ‘When you tell how you feel, you take the first step,’ adds Paullier. He says that, with these background data and the claims of the adolescents themselves, neither silence nor taboo seeks to promote their psycho-emotional well-being and thus prevent youth suicide, a phenomenon that throws up worrying figures and many questions.

    14% of Uruguayan adolescents and young people reported feeling sad or desperate for two weeks in a row in 2018

    In 2021, according to the Ministry of Health, 758 people took their own lives in Uruguay (3.4 million inhabitants), of which 203 were between 15 and 29 years old. One more year, suicide was the leading cause of violent death in the country, doubling those caused by traffic accidents or homicides.

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    The total figure represents a rate of 21.3 suicides per 100,000 inhabitants, the highest in the Americas, together with those registered in Guyana and Suriname (the world average is 10.5 suicides per 100,000 inhabitants, Spain’s eight per 100,000). ). And this is not a novelty in Uruguay: the phenomenon has been increasing in the last 20 years. It transcends, therefore, the undeniable effects of covid-19 on the mental health of the population.

    Sociologist Pablo Hein, from the Group for the Comprehension and Prevention of Suicidal Behavior at the University of the Republic, considers that suicide is a problem that Uruguayan society has not yet come to terms with. “We put veils on a mirror that gives us a very raw reality,” he says. Frequently, he continues, these veils appear in the form of myths (Uruguayan melancholy) or stigmas (he was crazy), which do not contribute to understanding him.

    For Hein, the variables that are known about these deaths are “very brief.” They show that eight out of 10 suicides were males; that occurred mainly in men between 25 and 29 years of age and in those over 70; that was more frequent in the eastern region of the country and that most of them were caused by hanging. But little or nothing is known, he remarks, about the life trajectories and circumstances of these people.

    In this context, the reasons that determined suicides are, to a large extent, an enigma that people took with them. And to try to explain them “there are no simple answers”, says the psychologist Marilen Bettini, because they are multifactorial phenomena “related to the most critical of existence”.

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    Bettini points out that in the case of older adult men (those most affected by suicide in Uruguay) the loss of affective ties, physical wear and the appearance of chronic diseases come into play, in a society that does not give the place that it used to he gave to his elders. On the other hand, adolescence and early youth (the other most vulnerable group) are stages of existential crisis, marked by the entrance to sexuality and the passage to the adult world.

    In 2021, more than 700 people took their own lives in Uruguay (3.4 million inhabitants), of which 203 were young

    For this reason, Bettini continues, the protective factors of suicidal behavior are defining: affective ties, recreation spaces and participation in society. In this direction, the sociologist Hein prefers to speak of suicide as a “community health problem” and not reduce it to an individual mental health issue, because that approach, in light of the results, has failed.

    Paullier, from INJU, highlights the central role that the educational community has in the campaign neither silence nor taboo. For its execution, he explains, 450 facilitators were trained, most of them teachers from all over the country, who have materials based on testimonies or stories of the adolescents consulted, from different regions. In addition, the resources are available on a website, so that the workshops will be able to continue beyond the planned schedule, between August and October of this year.

    As Paullier points out, the campaign manual suggests not to “pathologize” the emotions that are part of the adolescent process: sadness, anxiety, confusion… but neither does it minimize suffering, taking into account that during this stage there is a “clear risk” of developing a mental disorder. Along these lines, the manual explains to teachers how to act in the face of major cases that may arise, such as self-harm or suicidal ideation.

    “The teacher can be an emotional interlocutor and companion, but he cannot be left alone”, says the psychologist Bettini, who participated in the preparation of the campaign. In complex cases, she emphasizes, it is essential for the professor to create ties with his colleagues, with family members, who do not hesitate to go to psychology or psychiatry professionals from the national health system.

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    Regarding the latter, the Uruguayan State has implemented three suicide prevention plans since 2011, which include, among other actions, comprehensive mental health care and mandatory registration of suicide attempts in emergencies (in the process of being digitized). ). In addition, in 2018 it provided a free suicide prevention hotline service, which this year has received an average of 12 calls per day.

    The psychiatrist and suicide expert Silvia Pelaez, from the NGO Ultimo Recurso, recognizes that there has been progress in addressing this “silent pandemic”, but warns of the structural problems that persist. He gives as an example the lack of psychiatrists in the interior of the country, the delays in care in the health system or the lack of registration of suicide attempts, essential for monitoring patients.

    Faced with the increase in deaths by suicide, the expert recommends putting in place prevention plans in accordance with the socio-cultural characteristics of each affected community and that take into account their referents. In this sense, she enthusiastically sees the realization of a national campaign as neither silence nor taboobecause in every adolescent with skills in managing emotions there is a potential replicant, he says.

    “Who said that men don’t cry?”, launches a kid in a workshop in the Manga neighborhood in western Montevideo. “When you cry, you let off steam,” says another. “If not, you stay with the anger inside and it’s worse,” he points out. Immediately, with torrential energy, the 12 participants in the activity exchange words and ideas about sadness, confinement, sexual freedom, death, shame, trust, frustration or love.

    At the end of the workshop, the teacher, surprised, congratulates them for having remained focused for an hour and a half. They applaud the experience and rush out, with adolescent urgency, because it’s three-thirty, time to play ball.

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    Source: EL PAIS


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