As suicides rise, Spain seeks answers despite social taboo

And she’s outraged by the lack of preventive measures over suicide, which remains a taboo subject in the country.

At her side was her 31-year-old daughter Maria Fernandez-Cavada, who pointed to the campaigns against deaths on the roads, through cancer or gender violence, which have reduced the numbers in recent years.

“Death in itself is a taboo subject,” she said — but talking about suicide “is even more difficult”.

“It’s like an atomic bomb which completely destroys your family,” she said, as she looked through photos of her brother.

With the latest figures showing eight suicides per 100,000 inhabitants every year, Spain is below the European average, which according to World Bank figures from 2019 was 11.3.

But although the European numbers have been falling for the past 20 years, in Spain the figure is rising in a way that cannot be explained away by the impact of the pandemic or social media, nor by growing levels of anxiety or poverty.

Last year, a new record of 4,097 suicides was set, up from 3,371 two decades earlier.

And these figures “are clearly underestimated”, said clinical psychologist Javier Jimenez, honorary president of RedAIPIS-FAeDS, a charity specialising in suicide research and prevention. It also supports the family and friends of victims.

The official figure, he said, did not take into account the fact that many of the 8,000 accidental deaths that take place every year are suicides, in the absence of any form of “psychological post-mortem”.

“Other countries have more reliable statistics because there isn’t such a taboo or so much stigma” around suicide, said Jimenez, pointing to Spain’s deeply Catholic heritage in which suicide is classed as a grave sin.

He also denounced the almost systematic prescription of medication for depression as well as the inaccessibility of psychological help, both due to prohibitive costs and a lack of therapists.

The coronavirus pandemic did serve to raise awareness about suicide in Spain, which was badly hit at the start of the outbreak in spring 2020 and experienced one of the world’s strictest lockdowns.

The following year, the government released 100 million euros in funding for its 2022-2024 plan to address mental health issues normally managed by the health authorities in its 17 regions.

It also launched a hotline in spring 2022 which received 15,000 calls in its first month, and has since averaged some 335 calls per day.

In February, politicians unanimously approved a bill to grant 15 days of paid leave for family and friends of people with suicidal thoughts who are medically considered as high risk in terms of taking their own life.

Details of the scheme are still being debated.

“It’s the absolute least they can do,” said De la Serna, recalling the depths of her own “immense pain” and “overwhelming hopelessness” after her son’s suicide, the difficulty compounded by emergency services personnel who lacked the training to help.

The Madrid region, which has close to seven million residents, took the lead in 2019 by creating a psychologists’ unit within its emergency services.

Today there are six of them trained in everything from road accidents to suicides and gender violence, who are dispatched with the emergency services to assist in cases involving psychological need.

Providing around-the-clock support, they attend more than 500 incidents per year.

“Yesterday we had a case in which a patient had suicidal thoughts, his wife had recently died,” said Marta Alvarez Calderon, a clinical psychologist with the team.

Assessing him as being at low risk of an actual suicide attempt, she did not recommend hospitalisation but she was still concerned, hoping he would take up the offer of getting in touch again.

In the first three months of this year, the service received 3,429 calls for suicide-related cases.

There is a need to increase the number of trained therapists, she said, but also “to end the taboo” on suicide by talking about it in schools with teenagers “because by talking about it, we reduce the stigma”.

“Suicides are preventable,” the World Health Organisation has said, flagging the importance of prevention measures.

For De la Serna, help came in the form of a support group that served as “a place of comfort, a protected space where nobody judged us”.

Today she works to help other people facing the trauma she lived through. And her daughter Maria has also been on a long journey of acceptance over her brother’s suicide.

“For years I’ve lied about how he died so that I didn’t have to deal with other people’s reactions,” she told AFP.

“But what we’re trying to do here today is to prevent suicide… and if my story can help just one other person feel better, that’s enough.”