At Mike Emme’s wake, in September 1994, in the United States, family and friends distributed yellow ribbons with phrases of support for people who may be in emotional distress. The 17-year-old, owner of a yellow 68 Mustang, died by suicide.
One of the phrases on the tapes was “If you need help, ask for help.”
The motto is the same used by the ABP (Brazilian Psychiatric Association) in this year’s Yellow September campaign. The objective, according to the association, is to encourage people with thoughts of death to understand that they may be sick and that they deserve to receive treatment.
Studies carried out by the WHO (World Health Organization) indicate that 90% of deaths by suicide are linked to mental disorders, such as depression, bipolarity, schizophrenia, alcoholism and anxiety.
“They committed suicide because they did not have access to treatment or the treatment was bad. In other words, those who commit suicide are because they have an illness and therefore need to ask for help”, says the president of ABP, Antônio Geraldo da Silva, campaign coordinator.
Psychiatrist Ana Paula Werberich Lange, technical director of Hospital Francisca Júlia CVV (Center for the Valorization of Life), says that the first step in asking for help is accepting that it is okay to feel your own emotions.
“The person needs to recognize that it’s not their fault, it’s not weakness, it’s not that they can’t handle themselves. When the symptom invades the person, they can no longer make their own choices (for example: I’m sad, but I didn’t want to be there), and needs help”, says the doctor.
Lange says that before thinking about suicide itself, a person usually begins to have thoughts like “It would be better if I wasn’t here anymore”, “I wanted to put my head in a hole and never take it out again” or “I wanted to disappear”.
She compares the path to taking one’s own life to climbing a mountain. “The suicidal act is when the person reaches the top of that mountain,” she says. The journey begins with anguish or existential discomfort, evolves into viewing death as a way out and can then be structured with planning how to die and post-death arrangements. During all this time, the act can be interrupted.
“If the individual is able to recognize and seek help at this moment, we are talking about prevention”, says the psychiatrist.
The help that should be sought, according to experts, is, first and foremost, professional. Psychiatrist Daniel Kawakami, from the Institute of Psychiatry at USP (University of São Paulo), says that those with suicidal ideation should seek an emergency room with psychiatrists.
“Even if you don’t have hope and don’t see any solution, it’s the psychiatrist and mental health service’s job to help,” says Kawakami.
If there is no emergency room with the specialty nearby, the advice for people who have thoughts of death is to seek any health service, including Samu (Mobile Emergency Care Service), and report all their symptoms.
Suicide, according to the president of the ABP, is a psychiatric emergency. “If I have an accident and break my arm, I call Samu. If I have chest pain that radiates to my arm, I call Samu. The same should be done if you have psychiatric manifestations”, says Silva. UBSs (Basic Health Units) and UPAs (Emergency Care Units) are also options.
Silva defines psychiatric symptoms as behavioral changes that cause a decrease in quality of life. “Today you work normally, then you start to no longer arrive on time. You have difficulty sleeping and waking up. You begin to experience losses in interpersonal relationships.”
Isolation, disappearance from social media, sudden changes in mood, anxiety, irritability, changes in eating patterns, insomnia or too much sleep can be signs of suicidal ideation. This is when friends, partners, family and colleagues can help. The support network can alert the person to a change in behavior by identifying it.
Psychiatrists recommend that someone close to you offers to listen to how the person is doing, but do not offer advice and seek professional help. Calling CVV channels can help those who do not have a support network or do not want to seek professional help.
According to the WHO, an average of 39 people commit suicide per day in Brazil. This is the fourth leading cause of death among people aged 15 to 29.
The Yellow September campaign, inspired by the story of Mike Emme and his family, aims to raise awareness that this is a public health problem and encourage its prevention. September 10th is remembered as World Suicide Prevention Day.
“If you need it, ask for help. Don’t let it get serious, don’t let it become impossible to help,” says Silva, president of the psychiatry association.
Where to seek help
Psychiatrists recommend that the person seek any available medical service
NPV (Violence Prevention Center)
The NPVs are made up of at least four professionals within the UBSs (Basic Health Units) and other equipment in the municipal network. To welcome and protect victims, the centers work in partnership with the Public Ministry, the Public Defender’s Office, the Guardianship Council, the Municipal Department of Education and the Municipal Department of Social Assistance and Development.
Psychiatric Emergency Room
Suicidal ideation is a medical emergency. If you think about taking your own life, look for a psychiatric hospital and check if it has an emergency room. In the city of São Paulo, there are options such as Pronto Socorro Municipal Prof. João Catarin Mezomo, Caism (Integrated Mental Health Care Center) and the Dr. Arthur Ribeiro de Saboya Municipal Hospital.
Mental Health Map
The website, from the Vita Alere Institute, maps public mental health services available throughout the country, in addition to free reception and care services, as well as voluntary actions carried out by NGOs and philanthropic institutions, among others. It also offers booklets with mental health guidance.
CVV (Center for the Valuation of Life)
Volunteers answer free calls 24 hours a day on 188, via chat, via email or directly at a physical service point.
