Welcome and Opening Remarks
I am delighted that once again the Pan American Health Organization and the World Federation for Mental Health have joined forces to observe World Mental Health Day. Our collaboration with the Member-States can advance more rapidly if done in partnership with other institutions. Today, several PAHO partners are present here and it is my pleasure to welcome you all. This is your house and not only ours.
Today's theme unites two of our areas of concern, mental health disorders and suicidal behavior. Mental disorders are affecting 1 in 4 of all people at some time during their lives and the figures are higher among patients in primary health care. These are universal problems affecting people of all societies and countries, women and men at all ages, the rich and particularly the poor, from rural and urban environments. Studies have shown that mental disorders impact adversely on the quality of life of individuals, their families and communities.
PAHO has published studies showing that the burden of mental disorders in the Americas looms too large to ignore. Indeed, the epidemiological picture compels us into action. The life-term prevalence rates for non-affective psychoses (largely schizophrenia) reach an average of close to 1.0% in studies conducted in this Region. The average 12-month rate of major depression is about 5%, and of alcohol abuse or dependence is over 6%. But beyond their magnitude the problem is that the unmet needs are extremely high. Although we have the means of intervention and control of these three groups of disorders, the gap between those in need and those that receive care is worrisome. For non-affective psychoses the gap is 34%; for major depression is 59%; and for alcohol abuse or substance the gap is 71%!
We need to reduce the gaps. To reach such an objective, PAHO is working with many countries in the Region to upgrade their capacities. In addition, the public should become more aware with regard to the mental health burden and to demand better services. As for the governments, they should allot adequate resources for mental health and social programs. Lastly, the health services ought to become more able to identify, treat and manage the people affected by mental disorders and their families. There is no doubt that mental health action, to be successful, should take place in many fronts.
The celebration of World Mental Health Day 2006 offers the opportunity to focus the attention on suicide as a major health public problem and its link to mental disorders. It is thus necessary to underline the role that mental illness and alcohol and drug abuse has in suicide behavior. Often, suicide represents the tragic path stemming from a failure in the diagnosis and treatment of the disorder. An important message is arising from the Day: "mental disorders are treatable and suicide is preventable." We have the necessary scientific knowledge and the means to helping the people with mental problems. We can thus be optimistic about the outcome of our efforts if we apply them wisely. But let us make no mistake, we may not move forward if the public falls to learn that mental illness is not a personal failure, nor it is something "only happening to other people," and keeps suicide-risks a family secret. This is what we must achieve through this DAY… and beyond.
It is estimated that around 1 million suicide deaths each year, representing 1.4% of the total global burden of disease. Also, there is evidence that in some places, suicidal attempts are between 10 and 40 more frequent that the consummate suicides. In many countries of the America Region, suicide is among the ten leading causes of death in adolescents and young adults.
The causes of suicidal behavior are multiple; there is a combination of biological, psychological and social factors. Suicide is a complex problem that also involves philosophic, ethical and cultural aspects. What is paramount, however, is that prevention is possible and includes activities such as: appropriate information to the population, proper education of young people and children, early treatment of mental disorders and the control of the risk factors. Fortunately, we have scientific evidence that adequate prevention and treatment of some mental disorders, such as depression, can reduce suicide rates.
Suicide is perhaps the most tragic form to die. Important to note those that attempt to suicide are, often, ambivalent, and may not be certain that they do want to die. Thus the early identification of the risk conditions increases the possibilities of thwarting the suicidal behavior.
I need to highlight the role of the media in suicidal behavior. It is a truism to state that the media plays a significant role in society. It has a strong influence on attitudes, beliefs, and behavior. Therefore, the media can play an active role in the prevention and control of mental disorders and suicide. For example, there is evidence that publicity given to cases of suicide might correlate with the number of later suicides, particularly suicides of significant personalities.
Special attention requires that some forms of journalistic information on suicide that might adversely impact young people. More recently, the Internet has introduced new modalities: There are sites that assist people to commit suicide, and even collective plan of suicides. Fortunately, other sites attempt to prevent them or help persons with suicide ideas.
This subject is complex and the solution is not easy. Yet we should all strive to persuade the media to play a more positive role in reducing stigma and creating further understanding of mental health without renouncing to their specific role of informing the public.
Let me conclude by adding that the loss of a life by suicide leaves a family that has to face the loss and continue living. We expect from the services to help the survivors to reach the highest possible quality of life. Obviously, the overall responsibility for action is not only of the health sector but of society at large. Health workers, educators, communities and leaders, the media and others can make the difference.
PAHO is pleased to collaborate with the World Federation Mental Health to jointly promote World Mental Health Days. We encourage all mental health stakeholders to seek opportunities to join efforts in reducing suicidal behavior across the Region.
Panel Presentations addressed at the meeting:
Mr. P. Garrison, WFMH SG/CEO. The Global Mental Health Awareness Campaign of the WFMH.
Dr. B. Mishara, IASP President. Improving the Public’s Awareness and Understanding of Suicide and Mental Illness.
Dr. J. Pearson, NIMH Acting Deputy Director. Mental Illness & Suicide: Research & Interventions.
Mr. J. Reed, SPAN,USA. Perspectives on Mental Health and Suicide. Advocacy.
PAHO Press Release (Spanish). Número de muertes por suicidio supera las causadas conjuntamente por guerras, terrorismo y asesinatos.
