In 2007, the last year for which complete figures are available, 984 people took their own lives in Flanders – 681 men and 303 women. The World Health Organisation rates Belgium as a whole at 21.1 suicide deaths per 100,000 people. That’s far below Lithuania, which leads the world on 38.6, but places Belgium at fifth place in Europe, behind Slovenia, Hungary and Latvia. Greece is Europe’s least suicidal country, with only 3.5 deaths per 100,000 population.
The suicide rates in Flanders, in fact, are not much different from those in Wallonia, according to Grieke Forceville, director of the Centre for Suicide Prevention (CPZ). The centre is based in the Jette commune of Brussels and sponsors a telephone helpline manned by about 50 trained volunteers in Brussels and Leuven, as well as an internet chatline with 15 counsellors.
In addition, the CPZ offers training packages for outside agencies, such as the psychology staff of the detention centres for asylum seekers, the Post Office and Belgian railways, and staff employed by rest homes and youth centres.
What is it about Flanders, or about Belgium, that accounts for the high suicide rate? “Research is under way, looking at the differences between Belgium and the Netherlands,” explains Forceville. “But the results are not expected until the end of 2010.”
The answer will probably be a combination of factors. “It could be a matter of willingness to seek help, openness to talking about emotions, the ability to recognise suicidal behaviour, the way health care is organised, or all of those things together,” Forceville says.
According to the Ghent University-based Unit for Suicide Research, studies focusing on young people show that Flemish youth are less likely to discuss their problems with adults. The unit’s coordinator, Dr Gwendolyn Portzky, reports that they are instead more likely to turn to drugs and alcohol than to trying to find solutions to their troubles.
This results in twice the suicide rate as Dutch youth. The chatline run by the CPZ is, Dr Portzky says, “is absolutely a good idea because it’s a medium of communication that’s tailored to the young people themselves.”
Suicide line 02.649.95.55 (calls are free)
Gender and age can determine how people end their own lives
Men: The vast majority of suicides among men in Flanders – 61% of all cases – involve hanging or strangulation. In 10% of cases, a firearm is used, and in 7% of cases poisoning, including death by overdose of medication. Most of those cases involve prescription drugs, including psychotropic medications. But in 1% of cases, pesticide is the poison of choice.
Some 6% of suicides take place in traffic, including deaths under a tram, metro or train, while 16% come under “other” and include jumping from a height, fire, drowning, gassing and sharp instruments.
Suicide is the leading cause of death for men aged between 35 and 49, accounting for nearly one-third of deaths.
Women: The number one suicide method for women is the same as men: hanging or strangulation (36%). Poisoning replaces firearms as the second largest method (19%), followed by drowning. Three times as many women as men use drugs to commit suicide. Fewer than 3% use firearms, while 19% use “other” methods, and 7% die in traffic.
Suicide is the leading cause of death among girls aged 15-19 (21% of deaths) and for women aged 30-39 (12% aged 30-34, and 14% aged 35-39). Above age 39, breast cancer takes over as the leading cause of death. Younger men and women alike are more likely to throw themselves under a train, while older men and women are more likely to drown themselves.
Signs: Conventional wisdom has it that someone who talks about ending it all is the least likely to do it. Experts disagree: suicidal ideation, or the act of thinking about suicide, is considered an important danger sign. So are withdrawal and emotional fragility – the tendency to overreact emotionally to minor stimuli. On the other hand, there may be increased aggression or other attention-seeking behaviour.
The major “cry for help” is, of course, the suicide attempt, but just because it fails, even if it is half-hearted, doesn’t mean it isn’t a danger sign. About half of all successful suicides, according to Gwendolyn Portzky of the Unit for Suicide Research in Ghent, have been preceded by one or more failed attempts, and suicide experts don’t differentiate between an attempt that had no chance of succeeding and one that was a narrow escape: intent is more important than success or failure. Suicide, in the mind of the subject, is not a matter of death, it is a matter of escape from suffering.
A potential suicide victim may know nothing about anatomy or pharmaceuticals, leading to a failed attempt. But the desire to escape will still be present, and the next attempt could be successful. It is important, therefore, to take all attempts seriously and seek qualified help for the depressed person. “A suicide attempt remains the most important risk indicator of a fatal suicide,” says Dr Portzky.
The hanging death of singer and TV presenter Yasmine is probably the most famous case of suicide in Flanders in recent years. The 37-year-old was not only a prominent figure in the media, as an openly gay woman, she was also a role model for many young people in precisely those age groups where suicide is a leading cause of death.
According to Flanders’ Centre for Suicide Prevention (CPZ), the weeks following Yasmine’s death by hanging saw a threefold increase in the number of calls to the suicide line, and eight times more visitors to the website than usual. In the week immediately following the death, the number of calls from relatives of potential suicides increased tenfold, an effect which CPZ director Grieke Forceville attributes to the reporting in the press of the number and web address of the organisation.
But the press coverage also had a negative effect, Forceville says, as twice as many callers expressed a desire to kill themselves by hanging. “That increase is certainly due to the reporting in the media of details of the method used. After Yasmine’s death, the suicide line noticed a very clear imitation effect.”
Suicide-prevention organisations have drawn up a set of guidelines for the press and media in covering suicides, in an attempt not to overdramatise or normalise the practice.
Do
• stress the complexity of suicidal motivation
• provide information on sources of aid
• provide context by quoting experts on suicide
• respect the privacy of families and avoid affixing blame or responsibility (both of which rules were broken in the case of Yasmine)
Don’t
• report unnecessary details
• dramatise the circumstances, especially regarding images
• romanticise or idealise the dead person, to avoid imitation
• sensationalise the report in the case of a famous person
• Suicide workers in Flanders, finally, prefer the word zelfdoding (self-killing) to the more common word zelfmoord (self-murder), which they think carries more negative and blaming connotations
The Community Help Service in Brussels provides professional counselling in English and runs a confidential 24-hour help line: 02.648.40.14
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