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  • 1

    Community Suicide Prevention 2nd Revised Edition

    Jairo Osorno, Leif Svanström, Jan Beskow

  • Jairo Osorno Leif Svanström Jan Beskow

    Community Suicide Prevention 2nd Revised Edition

    With contribution from Joon Pil Cho Bo Henricson Lars-Gunnar Hörte Göran Melin Annika Petersson Yoshihide Sorimachi Thomas Wibble

  • ISBN 978-91-86457-06-8

    Community Suicide Prevention 2nd Revised Edition © Jairo Osorno, Leif Svanström, Jan Beskow (Editors)

    Photos: Joon Pil Cho (JPC) Conchi Gonzalez (CG) Bo & Margareta Henricson (B&MH) Johan Live (JL) Charlotta Munter (CM) Lena Nielsen (LN) Jan Rancken (JR) Yoshihide Sorimachi (YS) Guldbrand Skjönberg (GS + front cover: The Lone Biker) Leif Svanström (LS + back cover: Confidence) Kristoffer Thessman (KT)

    Graphic design: Cécile Everett Production co-ordinator: Moa Sundström Language review: Jon Kimber

    Order from: Karolinska Institutet Department of Public Health Sciences Division of Social Medicine Norrbacka, 2nd Floor SE-171 76 Stockholm, Sweden leif.svanstrom@ki.se

    Printed by: PAGROUP 2010

  • Community Suicide Prevention

    “How to ease the pain and prevent suicide at the local level”

    Its name is EXCLUSION: Ours, INCLUSION

  • Contents

    Foreword ........................................................................................... 9 The authors ..................................................................................... 10 Introduction .................................................................................... 13

    References ........................................................................................ 19

    Glossary of terms ........................................................................... 20 References ........................................................................................ 25

    Chapter 1. Emile Durkheim and the concept of anomie ............. 26 Émile Durkheim and the concept of ANOMIE .................................. 28 Anomic suicide ................................................................................. 29

    Chapter 2. The meaning of suicidality .......................................... 37 Bridging the gap between accident and suicide ................................ 39 Examples of suicide prevention interventions in Safe Communities . 50 References ........................................................................................ 58

    Chapter 3. Epidemiological issues related to suicide and self inflicted injuries ...................................................... 60 Costs ................................................................................................. 62 Family and community impact .......................................................... 63 Difficulties involved in interpreting statistics ..................................... 68 Suicide is difficult conceptually and technically ................................. 69 References ........................................................................................ 70

    Chapter 4. The community approach and the need to develop safety promotion .................................................... 72 Community ........................................................................................ 72 Safety and safety promotion ............................................................. 76 Main reasons to develop a safety promotion framework ................... 78 References ........................................................................................ 88

    Chapter 5. The “Safe Communities” Model in Suicide Prevention ................................................................. 89 Community suicide prevention within the frame work of “Safe Communities” ................................................... 91 The Manifesto for Safe Communities ............................................. 105 Safe Communities and suicide prevention: ................................... 107 Complex contemporary models ..................................................... 108 The levels ........................................................................................ 109 References ...................................................................................... 116

  • Chapter 6. Specific example I: Arjeplog, Sweden – an example of a true community approach with the Health Centre as initiator .............................................. 117 The Arjeplog experience in suicide ................................................ 119 Description of the actions taken in Arjeplog to prevent suicide ...... 126 How are things organized in Arjeplog around suicide prevention? 128 Reference ........................................................................................ 135

    Chapter 7. Specific example II: Aomori Prefecture, Japan ...... 136 Suicide prevention and the Safe Communities movement in Japan: the importance of central government and socioeconomic interventions .......................................................... 136 Characteristics of suicide in Japan .................................................. 137 References ..................................................................................... 154

    Chapter 8. Specific example III: The role of hospital and emergency department for suicide prevention in South Korea ...................................................................... 155 The suicide problem in South Korea .............................................. 156 Epidemiology ................................................................................... 156 Suicide prevention interventions in South Korea ............................ 165 Conclusion ...................................................................................... 170 References ...................................................................................... 172

    Chapter 9. Specific example IV: Jönköping in Sweden; a model for collaboration between community services to enable a more efficient response to suicide threats ..................... 173 Knowledge growth in relations ........................................................ 175 Threats of suicide – collaboration between police, healthcare, SOS Alarm and community rescue services. An example from Jönköping County ........................................................................... 178 Alarm routines in cases of suspected suicide ................................. 182 The role of community environment planning ................................. 185 Reference ........................................................................................ 188

    Chapter 10. Love is the best kick Suicide prevention among youth in Sweden: national, regional, and, community efforts.........................................189 National efforts ............................................................................... 194 Regional efforts ............................................................................... 197 Local efforts ..................................................................................... 200 References ...................................................................................... 205

    Chapter 11. Reflections ............................................................... 206

  • 9

    Foreword

    In the “Safe Community” movement there has been an increasing urge to not only work to prevent accidents and violence but last decade also suicide attempts.

    The initial contributors of this book on the community approach of preventing suicide were mostly physicians of different backgrounds working in public health/ social medicine. However, as the book matured, professionals from other disciplines or just people interested in suicide prevention joined. This helped us a lot since the book was never intended specifically for medical doctors or health professionals. Rather, this has been and will remain an attempt to share with others the “Safe Communities” approach as complementary to other views on suicide prevention, and the prevention of other forms of violence and injury. The positive aspect of this paradigm is that it seeks to promote inclusion in social life i.e. a shared social life of mutual respect, inclusion, and harmony in the midst of diversity that honours human rights and exalts kindness over brutality and exclusion.

    We also contacted some Safe Community and Suicide prevention program managers around the world to give us their concrete experiences. They are responsible only for their own chapters. We as editors are responsible for all other chapters and conclusions. However Jan Beskow has as editor above answering to one separate chapter also scrutinized all chapters from his view of being a world-wide known and experienced suicidologist. As you can see the three editors are presented here but the rest of the authors are introduced by their own contributions.

    Bogota, Colombia and Stockholm and Gothenburg, Sweden March 2010

    Jairo Osorno, Leif Svanström, Jan Beskow

  • 10

    The authors

    Editors

    JAIRO OSORNO Initially trained in neurosurgery. For more than two decades, he has worked in primary healthcare and health promotion. Since 2007, he has been interested in injury prevention, joining the Safe Communities movement, and translating the second edition of the book “Safety Promotion – an Introduction” published by Karolinska Institutet. He has lectured to postgraduate students in public hea