On the occasion of the World Day for the Prevention of Suicide on September 10, the First Psychiatric Clinic E.K.P.A. points out the significant increase that suicide can have on mortality rates in young people – along with accidents – while sounding the alarm, as often the intention to end a person’s life goes unnoticed by those around them.

The most common causes that lead to suicide – or attempted suicide – are also discussed in detail, as well as the factors that can act as a deterrent to protect the person in this vulnerable position. The negative impact of the Internet is also highlighted. Finally, it is worth noting that even if the suicidal person’s familiar environment eventually realises what is happening and suggests a visit to a specialist, the person himself or herself strongly refuses to respond.

More specifically, according to with the A’ Psychiatric Clinic of the National and Kapodistrian University of Athens (EKPA), despite the fact that suicide is a rare phenomenon and represents a relatively small percentage of total deaths in the population, its importance is great because it significantly increases mortality at young ages (where other causes of death are much rarer with the exception of accidents) and because it is associated with a great psychological burden on the environment of the person who ends his/her life. Also, suicide attempts may, if they do not result in death, cause disability that accompanies the person for life. Risk factors for attempted or successful suicide include anxiety, depression, having a diagnosed psychiatric illness or personality disorder, low self-esteem, pressure in the school environment from the program or abusive peers, family and social problems. Factors that are protective and prevent suicide are social relationships, having friends, belief in a higher power and support from family. Very often, however, suicidal intent goes unnoticed by the person’s environment, which creates feelings of guilt in the family after the suicide. Unfortunately, even when the environment has understood that something is wrong and urges some help-seeking, it is not uncommon for the person to have denied that anything is wrong with them before the suicide, including a visit to a specialist.

Finally, the influence of the internet on suicide cannot be overstated. Many people find support from other patients in idea-sharing groups whose members help them cope with the desire to end their lives, their loneliness and the difficulty of expressing their feelings. Unfortunately, however, on the other hand, there is a significant emergence of other discussion groups (mainly affecting younger people) which reinforce self-harm and suicidal behaviour by presenting them as ‘normal’ or ‘revolutionary’ ideas, providing information on methods of achieving them and putting pressure on them to be implemented. These groups affect minors to a much greater extent and pose a significant challenge to internet control services, and raise the question of the extent to which parents should be supervised by parents in relation to their children’s online activity.

In recent social crises, the economic crisis and the pandemic period, no significant increase in suicides has been seen, despite widespread reports to that effect, while an increase in the number of suicides observed over the years worldwide is likely to be attributed to general changes in the socio-economic environment and working conditions that mainly affect the most vulnerable populations such as the mentally ill, the unemployed and people living alone.

The strongest risk factor for suicide, however, is previous attempts. In fact, as communication with patients and family has been found to be an important measure in preventing a second suicide attempt (which may be successful), all health professionals who offer services after a suicide attempt should be actively involved in scheduling a visit to the patient and his or her environment to mental health services, a psychiatrist, or a psychologist. And because the vast majority of people who die by suicide are suffering from a psychiatric illness (which may have gone unnoticed until then), treating symptoms of depression, psychosis, anxiety, and panic attacks has been documented to help reduce suicidality. This treatment can be accomplished through psychotherapeutic and psychosocial interventions, as well as the use of medications that have significant efficacy in reducing suicidal ideation, while having virtually no side effects or creating the potential for addiction.

In conclusion, mental health, family, internet and social circumstances play a significant role (positive or negative) in suicidality. Suicide prevention involves recognising the warning signs (previous attempts, symptoms of mental distress) and referral to mental health specialists, as psychotherapeutic, medication and other interventions are now available that are effective in reducing the risk of suicidal behaviour.

In Greece, the telephone “Suicide Intervention Line” 1018 and the “Psychosocial Support Line” 10306 provide anonymous and confidential 24-hour counselling services and offer immediate support and guidance whenever needed.