Suicide is a complex issue. The topic surrounding making the decision of ending one’s own life has been debated for millennia. Is the decision to end one’s life a product of free will, and therefore a rational action based off the Socratic method? Or is it an irrational mode of releasing oneself from the grips of impending disaster and deep seeded nihilism?
Since their inception, Judaism and Christianity have viewed suicide as a form of mortal sin – something that would not allow you to pass through the gates of Heaven. Western society’s legal and social frameworks are very much based on Judeo-Christian values, and this is arguably a major factor as to why policies akin to euthanasia are still very much seen in a negative light.
The Morality of Taking Your Own Life
John Stuart Mill, a British philosopher who lived in the 17th century, believed that since the condition of liberty is the power of the individual to make choices – then any choice that one might make that would deprive one of the ability to make further choices should be prevented.
He wrote, in his book On Liberty, “In this and most other civilized countries, for example, an engagement by which a person should sell himself, or allow himself to be sold, as a slave, would be null and void’ neither enforced by law nor by opinion. The ground for thus limiting his power of voluntarily disposing of his own lot in life, is apparent, and is very clearly seen in this extreme case.”
On the other side of the argument you have individuals such as Arthur Schopenhauer, a German philosopher who lived in the same time as Mills, explaining in his essays Studies in Pessimism, “They tell us that suicide is the greatest act of cowardice, that only a mad man could be guilty of it; and other insipidities of the same kind; or else they make the nonsensical remark that suicide is wrong; when it is quite obvious that there is nothing in the world to which every man has a more unassailable title than to his own life and person”.
According to Schopenhauer, moral freedom can only be obtained by relinquishing ones will to live. Suicide would then be an emphatic assertion of this will, for it is in fleeing from the pleasures, not from the sufferings of life, that this denial consists.
Suicide in Malta
The ever-present stigma on mental illness occasionally prevents people from speaking up, a challenge that further prevents individuals from receiving the proper care and support. A persons’ position in the socio-economic spectrum also plays a part because, as one can imagine, therapy is not a cheap process to undergo, and waiting lists for state-funded support may not be the most favourable in some cases.
With regards to actual numbers, Malta saw a drastic increase in suicide rates from the 1980s. A study by Finnish experts published in the Malta Medical Journal in 2014 showed that the suicide rates of men between 2005 and 2009 was 70 times higher than it was between 1980 and 1984. The suicide rate of females was only nine times higher when taking the same timeframes into consideration.
“Although the suicide rates in Malta remain at a considerably low level, they have exhibited a notable increase towards the present, whereas the European suicide rates are in decline. Becoming aware of this fact and the issue may help in building a suicide prevention program to mitigate the situation,” the Malta Medical Journal in 2014 reads.
Crisis Resolution Malta
Crisis Psychiatrist Mark Xuereb forms part of Crisis Resolution Malta team, a 24/7 crisis group founded in 2010 made up of various experts in the field who offer services to individuals who find themselves in difficult situations.
“WHO said that by 2030, depression is going to be the most common illness worldwide, then they said 2020, then 2017. Since February 2017 WHO has said that depression is the most common illness worldwide more than cancer and heart disease put together.
This is not about who deserves more - the cake is there, it is important that we take care of physical health, but we have to take care of our mental health because studies have shown that if you have a mental or psychological problem, then your physical problems are going to worsen, and vice-versa.”
With state-of-the-art service for physical health, Xuereb believes it is high time we need redress the balance, quoting the Royal College of Psychiatrists’ motto which states that “there is no health, without mental health”.
“We need to now grab the bull by the horns - we need to stop people in Malta and Gozo from killing themselves and from self-harming.”
According to recent statistics, between 20 and 40 people commit suicide every year in Malta, with another 1,000 thinking about it, so obviously this is a big issue. Not to mention that for every person committing suicide there are 20 people attempting to do the very same.
One must keep in mind that the victim is not the only one who suffers when an individual takes their own life, as for every person who has committed suicide, he emphasizes that there are six people who are directly put at an increased risk of suicide and mental health problems.
“You are talking about 3,000-4,000 who are affected by suicide every year in Malta. This is a whole legacy, a lifetime legacy.”
This also leads to difficulties after the fact, as statistics have shown that individuals close to the victim have a 60% chance of losing their job and remaining unemployed. And on top of that, an 85% chance of falling out of the educational system – “so we are talking about some pretty serious stuff here” he says, driving home his point.
Where do we go from here?
“One way of solving the issue is implementing a national suicide prevention strategy – something the government already has. It's been in a draft since I presented it in 2015.”
Crisis Resolution Malta suggested various ideas that should be implemented, the most urgent may be the nationalization of a suicide crisis line, coupled with the setting-up of a 24/7 crisis team in the public sector – something that already exists in the private sector.
“The police stations, rapid intervention unit, the vice squad, the victim support - all the entities will have our number so that if someone is having thoughts about killing themselves, is trying to do so, or there is a loved-one that is worried, then they can call us. We will then give them 3 consultations for free, and streamline them as necessary.
“Research shows that, like every other illness, the more you address things in the beginning, the better the overall outcome. The same applies to heart disease, diabetes, and cancer.”
In Malta and Gozo, 8 suicide spots have been identified by CRM, and a system has been suggested that is already in use outside of Malta. The system comprises of a telephone line with an LED saying, for example, “there is hope, friend”, as a last-ditch effort to catch the individual’s attention. There would be a professional from the crisis centre on the other end, and whilst they’re talking, motion sensitive, infra-red cameras would home in on what’s going on.
At the same time, the professional would alert the Crisis Ambulance Response Vehicle, and it would rush to the location of the call. In doing this, you are already de-escalating by talking to the person, whilst help is already on its way.
“We have to go from words to action. We are sick to the back of our teeth of words and awareness campaigns. They're important, but they are useless unless they are accompanied by the next step.”