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Who will make the
most of warning signs and of risk factors?
The warning signs may be described as behavior changes.
Changes like flights into drugs, absenteeism, hazardous
conducts or shutting oneself up are not specifically warning
of a suicide. Those flights may be interpreted as calls
for help, urging the near relations to seek more specific
warning signs: the onset of a depression or of making oneself
cheap, a mood swing in a depressed person, and the signs
of a suicidal crisis.
The warning signs are frequently hidden to the psychiatrist
whereas they were disclosed to the company the person keeps
everyday.
The risk indicators
classically include a past suicide attempt, mental disturbances,
an addiction, personality traits, an environment. Most
of those risk indicators are better known and detectable
by a health professional and a gatekeeper than by the
near relations, provided the opportunity is found.
An event felt as
a loss is also regarded as a risk indicator but is best
observed by the near relations. Usually, such an event is
followed by behavior changes. Among these, it is up to the
near relations to discern the warning signs. It requires
more people really motivated (wondering “Around me,
is life pleasant?”) and trained (at least, in French,
using this website).
The calculations
published by Rosenman, 1998 as well as the observations
on black females by Nisbet 1996 and on friends’ role
by Salleh, Osman & Maniam 2003 previously showed that
preventing suicide is “everyone’s business”.
Prevention based on warning signs depends on exchanging
observations and informations between trained near relations,
gatekeepers and health professionals. Could that be evaluated
by randomising? Meanwhile, the near relations would be
able to report upon what happened to the warning signs.
- Besançon F:
Warning signs for suicide: everyone’s business.
Suicide & Life-threatening Behavior 2004; 34 (2): 197-198
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