World Suicide Prevention Day: Young Brazilians’ mental health alarming
The World Health Organization estimates that over 700 thousand people take their own lives around the world every year. Considering unreported cases, this number can reach 1 million. In Brazil, approximately 14 thousand suicides are recorded every year—some 38 people a day.
September 10 is World Suicide Prevention Day. Experts point out that the majority of suicide cases are related to mental disorders, like depression. These problems, they say, are manifesting themselves at an increasingly early age.
According to psychiatrist Rodrigo Bressan, head of the Ame Sua Mente Institute, research indicates that 75 percent of adult mental disorders begin before the age of 24. In the case of teenagers, half start before the age of 14. “We end up seeing people who are depressed in their 20s and 30s, but in reality most of the illnesses started much earlier,” he said.
One of the problems occurring at an increasingly early age is self-injury. A study on the structure of the ego and personality of adolescents who self-injure, conducted by the Fluminense Federal University (UFF), looked at 61 students aged 10–16. As well as showing that 83 percent of the cases seem to stem from unresolved family conflicts, the analysis also revealed that most cases are associated with depression. “We found a 65 percent correlation rate,” said study coordinator Dr. Antonio Augusto Pinto Junior. He believes that further research is needed to better understand the ties between depression and self-injury.
This type of behavior, Dr. Augusto noted, is starting to appear earlier and earlier, around the age of 10. Such was the case with Clara (fictitious name), Gabriela’s daughter, who started exhibiting it when she was 11. “I noticed she was wearing sweatshirts. That’s when I realized she was self-mutilating. I was so worried. She also wanted to take her own life, saying everything was too difficult for her, that people didn’t understand her,” said Gabriela, who took her daughter to a specialist. The diagnosis was depression. Today, Clara pays regular visits to the doctor, is medicated, and lives a happy life, her mother says.
Like Clara, those who self-injure usually cover their arms and legs with long-sleeved clothes, like sweatshirts. According to the UFF study, the body parts chosen for self-injury in most cases are arms, hands or wrists: 94.1 percent. In 88.5 percent of cases, sharp objects such as razors, sharpeners, and utility knives are used.
A call for help
In the view of psychologist Karen Scavacini, from the Vita Alere Institute of suicide prevention, self-injury is most often a cry for help. Some young people will experiment with this behavior out of curiosity, she said, which also requires attention. If this happens repeatedly, the alarm must be sounded.
In these cases, she went on, the young person may be suffering from bullying, cyberbullying, or physical, sexual or substance abuse. Scavacini mentioned that teenagers may also be suffering from some unidentified or untreated psychiatric issue, such as mood swings, personality changes, eating disorders, anxiety, depression, or even issues relating to sexuality, social vulnerability, and family conflicts.
“What we’ve been seeing is a low tolerance for frustration. Self-injury is seen as a form of relief,” the psychologist stated.
Rodrigo Bressan said that when suffering is intense, self-injury may be linked with suicide. These cases are usually associated with depression. “Someone who is self-injuring is in great emotional distress. We have to remember that 90 percent of cases are associated with a psychiatric diagnosis, especially depression, and the most important thing is that we have to treat what’s behind it.”
A change in behavior, poorer school grades, constant isolation from friends, the appearance of cuts, burns, and bruises, and wearing long sleeves even in hot weather can all be relevant signs.
The role of parents and teachers
In most cases, teachers are the ones who identify self-injury. “This signals a need for teacher training. The school must be understood as a gateway for the early identification of various forms of psychological distress in childhood and adolescence,” Dr. Augusto argued.
Rodrigo Bressan affirmed that talking to adolescents in such situations is always a delicate affair. They cannot be treated with arrogance or labels. They should also not be told that what they are doing is wrong or that they are crazy. No further barriers should be built, but their behavior should be perceived and signaled as different.
“You let the teenager take the lead of the conversation. When they’re in charge, the chances of them opening up to talk are greater.” Bressan believes that “any judgmental comment, even insinuations, can alienate teenagers.”
To the judgment of psychologist Karen Scavacini, Yellow September—the month that marks the suicide prevention awareness campaign—is an opportunity for schools and parents to bring mental health under the spotlight. According to her, a talk can start by discussing a movie or a series. “If you realize this young person needs help, you should offer a listening ear, to take them in,” she said.
Psychological support for children and adolescents in schools is also one of the priorities for the Department of Mental Health of the Health Ministry, said psychiatrist Marcelo Kimati, technical adviser at the department, who talked about the expansion of the mental health care network in Brazil: “[We’re helping] clear a queue that was obstructed over the last year, when we didn’t have new services for children and adolescents.”
The Ministry of Health increased the budget for the psycho-social care network with an investment of over BRL 200 million in 2023. The funds earmarked for states total BRL 414 million in one year.
*Dayana Victor, from Rádio Nacional, contributed to this article.
