Malta is witnessing a rise in traffic fatalities and suicides, trends that, according to psychotherapist Kyle Matthew Attard, are deeply linked to broader societal pressures and emotional wellbeing.

Speaking in an interview with The Malta Independent on Sunday about his work at YMCA's psychotherapeutic services, Attard emphasised that while legislation and enforcement are crucial, addressing the root causes requires a cultural shift and robust mental health support.

"The rise in road traffic accidents has been ongoing for years, but the recent increase in fatalities is particularly concerning," Attard said. "While congestion and poor infrastructure are often blamed, the real issue lies in how we understand emotional regulation and stress behind the wheel."

Eighteen people have died in road accidents in Malta so far this year, compared to 12 in the whole of 2024 and 16 a year earlier.

Statistics provided when the National Suicide Prevention Strategy was launched in March show that from the 22 deaths by suicide in 2020, the numbers went up to 35 in 2021, down to 27 in 2022 and slightly up again to 28 in both 2023 and 2024. This year, until May, 14 people had died by suicide, Mental Health Commissioner Denis Vella Baldacchino had told this media house in an interview a few weeks ago.

Attard highlighted research showing that emotions like anxiety and anger play a major role in aggressive driving behaviours, commonly referred to as road rage. He explained that chronic stress and limited coping mechanisms amplify these internal states, turning frustration into aggression and increasing accident risk. "This reflects a broader societal struggle with emotional containment and the pressures of modern life," he added.

Cultural attitudes towards alcohol further compound the problem, according to Attard. In Malta, socialising frequently centres on food and alcohol, normalising excessive drinking and fostering an underestimation of associated risks. "Many people genuinely believe 'nothing bad will happen', especially given the short distances we drive," he said. In his clinical work, Attard has seen individuals who underestimate the dangers of drinking and driving, influenced by both denial and familiarity with risk.

Recent legislation tightening drinking and driving rules is a step forward, but Attard warned that legal changes alone are insufficient. "While stronger laws are essential, they are not enough. Real change begins with prevention and education, especially from a young age. If people are only motivated by fear of punishment, the change will be superficial and short-lived. We need to help individuals understand why certain behaviours are risky, not just tell them they are," he explained.

Legislation can affect public psychology in complex ways, Attard noted. "Laws create fear, awareness, and resistance all at once. Fear can initially motivate compliance, but without ongoing education, it often leads to apathy or resistance. When people feel policed rather than supported, they disengage. Public campaigns need to focus less on fear and more on empowering informed decision-making. Change is most sustainable when it's internalised, not imposed."

Education and awareness campaigns are therefore critical complements to legislation, he added. Effective prevention requires a multi-layered approach spanning schools, communities, and workplaces. Harm reduction strategies, such as teaching young people how to recognise intoxication, refuse drinks or intervene safely, are far more effective than fear-based campaigns. Attard emphasised the importance of building emotional literacy and decision-making skills from an early age to enable long-term cultural change.

The psychotherapist also drew attention to the connection between alcohol use, mental health, and suicide. "People experiencing high levels of distress - whether due to depression, anxiety, grief or social isolation - often turn to alcohol or other substances as a form of coping. Unfortunately, this temporary relief deepens emotional instability and impulsivity, increasing suicide risk," he said. Attard described the relationship between alcohol, mental health struggles, and suicide as "complex and cyclical but undeniable".

Social pressures, including stigma around mental health, exacerbate risky behaviours, according to Attard. When individuals feel ashamed of their struggles, they often avoid seeking help, turning instead to alcohol or other destructive coping strategies. At YMCA, anxiety accounts for approximately 12.2% of presenting issues upon referral, with many clients exhibiting harmful coping patterns. "When professional help feels out of reach, whether due to stigma, cost or accessibility, people turn to what's immediately available, even if it's destructive," he said.

Attard observed a link between stress, depression, and reckless behaviour such as drunk-driving. "Emotional distress can cloud judgment and increase impulsivity. For some, reckless behaviour becomes a temporary escape from pain. Alcohol dulls emotional suffering but also heightens risk-taking. Not everyone externalises their distress this way; others turn inward, isolating themselves or neglecting their wellbeing. Both patterns reveal how deeply emotional pain can distort one's sense of safety and control," he explained.

Families, schools, and communities play a crucial role in shifting attitudes towards alcohol and road safety, Attard said. Families can de-normalise heavy drinking and model healthy coping strategies, while open conversations about emotions and stress can break cycles of silence. Schools should integrate emotional literacy and stress management into curricula to help students recognise signs of distress in themselves and others. Communities must ensure accessibility to mental health resources and promote alcohol-free social spaces. Practical measures, such as improved late-night public transport, also help prevent impaired driving.

Despite these needs, Attard warned that Malta is still primarily reacting to symptoms rather than addressing root causes. "Public attention spikes after tragedies and then fades. There's also a persistent stigma surrounding suicide that prevents honest discussion. To make progress, we must treat reckless driving and rising suicide rates as interconnected outcomes of deeper social and emotional distress, not isolated incidents," he said.

Long-term societal change, according to Attard, requires viewing traffic accidents and suicides as public health concerns. Bridging the gap between mental health, substance use, and public safety is essential. "Universal access to affordable, high-quality mental health care must be prioritised, along with tackling socio-economic stressors like poverty, instability, and isolation. At YMCA, our donation-based system ensures no one is excluded from therapy, which has allowed us to reach hundreds of clients who otherwise would not have received timely support," he explained.

Attard also offered guidance for policymakers, stressing a balanced approach between legislation, enforcement, and mental health support. "Legislation and enforcement are necessary for safety but must be complemented by strong, well-funded mental health systems. Early support reduces the likelihood of crises that lead to reckless or self-destructive behaviours. Enforcement should not only punish but redirect individuals into care and education. The ultimate goal is prevention, building a society that nurtures emotional wellbeing before distress becomes danger," he said.

In summary, Attard argues that tackling Malta's rising traffic accidents and suicides requires a cultural and systemic shift, integrating education, emotional literacy, and accessible mental health care to prevent tragedies before they occur. "Change must be internalised at an individual and societal level. Only then can we hope to reduce the human and social costs of these intertwined public health crises," he concluded.

If you need help

• National Mental Health Helpline for suicidal thoughts, mental-health problems, loneliness, and emotional support. Call the National Mental Health Helpline 1579 Foundation for Social Welfare Services Supportline
• The Emergency Psychiatric Service: For emergency psychiatric reviews and assessments by doctors and nurses specialised in mental health. Accessible through the Accident & Emergency Department at Mater Dei Hospital, Msida
• Suicide Prevention Outreach and Therapeutic Services (Spot) provides support to people who have been affected by suicide (bereaved individuals), people who have attempted suicide three months prior to service intake, and people who struggle with suicidal ideation. Visit https://victimsupport.org.mt/spot/ for more information or contact Victim Support Malta on +356 2122 8333 or [email protected]

Source: National Suicide Prevention Strategy