Science

Faced with the scourge of suicide in France, the belated awareness of public authorities

“It was a topic that didn’t interest me at all. And maybe more: I told myself that if someone didn’t want to live anymore, it was sad, but that was the case. And then, when suicide hits home, you no longer see the world of the same way. It took me like a cannonball. ” The woman who talks like this is Mémona Hintermann, a former France 3 reporter. A strong woman, who has covered numerous armed conflicts around the planet. But when her husband, Lutz, attempted suicide, on the night of September 16-17, 2020, all her certainties crumbled. To try to understand what happened to them, to put words about their anguish and their guilt, he took up the pen and told his story in a moving testimony (1). Since then, the number of conferences and signatures at book fairs has increased: “Above all, I understood that my husband was just one case among many others. One among the 200,000 more people who try to escape every year. To kill.”

The journalist also discovered how France was behind in suicide prevention. Every year, more than 9,000 men and women end their lives in our country, a scourge that kills three times more than car accidents, until now in almost general indifference. “We kill ourselves more here than in most neighboring countries. The general public thinks that there is nothing to do, that if someone wants to commit suicide, they will. Actually, we can always do something. Scientific studies show that if we succeed Those who are in difficulties, if we support them, do not commit suicide “, says Professor Philippe Courtet, head of the department of psychiatry at the hospital center of the University (CHU) of Montpellier. In Great Britain and Sweden in particular, recalls this specialist , the active prevention policies carried out in recent decades have reduced suicide rates much more than in France.

A one-time, toll-free number on suicide.

However, the authorities are finally beginning to act. On the occasion of the Conference on Psychiatry and Mental Health that was held on September 28 and 29, a unique and free number (31 14) dedicated to suicide was launched, which should be open on October 1 (2). At the end of the line, 24-hour nurses and psychologists will serve people in suicidal crisis or their loved ones. “In the United States, there are already figures of this type. Large posters are placed near places prone to suicide. It has been shown that this had an effect on the number of deaths,” recalls Professor Pierre-Michel Llorca, head of the Department of Psychiatry of the Clermont-Ferrand University Hospital.

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Another device, called “VigilanS”, started in 2015 in Nord-Pas-de-Calais, is being implemented. Already deployed in 12 of the 13 metropolitan areas, it aims to maintain a link, written or by telephone, for a period of six months, with patients who have gone through an emergency department after a suicide attempt. With undeniable success: recurrences have fallen in the departments where this initiative was being tested. Finally, “sentinels” are beginning to be trained: “In universities, the police, schools or other places in the community, individual volunteers learn to identify people in psychological distress and to guide them”, explains Dr. Pierre. Grandgenevre, a psychiatrist from Lille. University Hospital. A first level of prevention that has also already proven its worth abroad.

Real progress, but still insufficient. Because VigilanS is intended only for people who have attempted suicide, an initiative was launched at the Montpellier University Hospital aimed at this audience, but also at patients who have been taken to the emergency room for suicidal thoughts. “Normally, after psychiatric evaluation by a doctor, people who are not hospitalized go home, without real support. In the reboot project, they first meet a nurse for an hour, who will inform them of the situation so that we can help them and involve them in care. Then we see them frequently, until the witness passes to another team of caregivers, “says Professor Courtet. If necessary, a social worker will also help them solve their more immediate problems. For example accompanying them in an association to fight against isolation if they suffer from loneliness. “If we let them go by offering to see them again in a month and simply giving them contact details of colleagues or support structures, we know that most will not go. And there is a good chance that ‘they will not come back.” , while they run a high risk of putting themselves in danger ”, insists this expert.

An additional position in half of the medical-psychological centers.

To obtain these means, Professor Courtet says that he had to struggle for a long time. How many of your colleagues today can offer the same help to their patients? Psychiatric services are understaffed, as are medico-psychological centers (CMP), in the first line with patients at home. As for liberals, they are often overwhelmed. Certainly, President Emmanuel Macron has just announced the hiring of some 800 additional professionals in the CMP, but this hardly represents a new position in half of the 1,780 centers in the country … Therefore, the monitoring of people at high risk suicide rate is not likely to improve significantly. Memona Hintermann knows something about it, she who searched in vain for a psychiatrist for her husband: “Our GP did not know of any available specialists. It was also impossible to get an appointment at the local hospital. Nurses specialized in psychiatry. Finally an association told us. a social worker. Lutz gets along well with her, but I wish she could seek treatment … “.

In the absence of means, at least we know what to do with suicidal people, who are at high risk of making other attempts. But how can we act higher, to prevent them from tipping over and reaching the stage where they want to end? “When someone shows signs of discomfort, we still do not collectively have the reflex to go to him or her. ‘To care about others”, explains Professor Michel Debout, a great specialist in suicide prevention, author of the first official report on the subject in France, in 1993. This expert advocates a pedagogy of benevolence and care for the other from an early age: “This culture is not sufficiently developed in our country,” he laments. For this psychiatrist, prevention must be seen in a broad way, attacking evil at its roots: among the unemployed, to restore their confidence; in the workplace, to avoid devaluation or failure situations; at school, to better combat bullying, etc. Extensive program, also in view of the lack of resources for school medicine and occupational health services …

(1) I couldn’t see or hear. How to deal with the suicide attempt of a loved one? by Mémona Hintermann, Hugo “? Doc?”, 262 pages 16.95 euros

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(2) If you or a loved one is having suicidal thoughts, you can call 3114 beginning Friday, October 1. You can also contact your doctor or call 15.

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