Youth suicides lower, in Estonia

Photo: Peeter Langovits / Postimees

According to Suicidology Institute data, suicide has been attempted by two percent of Estonian school children aged 14–15. Suicidal thoughts are harboured by ten percent.

Airi Värnik, psychiatry professor and head of Estonian-Swedish Mental Health and Suicidology Institute (ERSI), admits: even with numbers of youth suicides in Estonia declining, there’s no reason to rejoice.

On world scale, are Estonia’s youth suicide numbers the «usual»?

On world scale, the frequency of suicides greatly varies. In Europe, the numbers are low in the Mediterranean countries, while especially high in Lithuania and Russia. Also, youth suicide is high in Ireland. Estonia may be considered quite average.

Youth suicides follow the adult suicide curve. With youth aged 15–19, suicides are in decline, in Estonia; the tendency is the same among adults. It also needs to be considered that in the middle of the stormy 1990ies, suicide rate was unprecedentedly high, especially in territory of the former Soviet Union, so the decline was to be expected as the society stabilised and spiritual assistance options improved as well.

How does that feel, compared to earlier statistics in Estonia?

Nothing to rejoice about. Over the past ten years, we have lost 170 young people, averaging 17 a year i.e. one or two each month. Imagine effect of that on family members, relatives, kids at school-mates.

At that, suicide death is the tip of the iceberg, preceded by a longer or shorter and painful period during which the intentions ripen, so to say. Luckily, only a small percentage goes the whole way. Sadly, youth share their plans with peers mainly, or anonymously over the Internet; therefore, the help needed may be late.

Suicidality is combined with other forms of risk behaviour, often with intentional self-mutilation which, according to our study, is frighteningly prevalent. A third of students have cut, pierced, scratched, burnt or otherwise damaged themselves.

This is a way a young person, by inflicting pain on himself, desires to recover inner peace, to calm the anxiety. To this, scars on body bear silent witness. This is more prevalent than the average of European countries studied.

What leads youth to thoughts of suicide, some following through? Who’s in risk group?

Talking of reasons, there’s three areas of course – home, school and peers – on which depends a young person’s quality of life. Clearly, a wholesome growth environment is a harmonious home with biological parents.

Regrettably, it is often the home where children catch the alcohol consuming habits, these in turn leading to other behavioural disorders. As confirmed by data: having seen a member of family intoxicated even once, it is the more likely that he will be an alcohol consumer, even a problematic alcohol consumer in the future.

What to do, at home and at school, to avoid these problems?

In schools, spiritual health and even lives of children are endangered by bullying, mainly by peers, but teachers are not guilt-free either. The school reform should definitely reflect the topic of spiritual health of children, so they wouldn’t lose their joy in life while still in their teens, and would stay themselves while fitting in the society; possessing a healthy dose of criticism while learning tolerance; learning to value and understand both themselves and the others.

Troubling statistics

•    According the international SEYLE study of 2010, two per cent of Tallinn school children aged 14–15 feel a very strong desire to leave this life or have already tried to take their lives.

•    A third of Estonian youth, mainly girls, have at least once intentionally mutilated themselves.

•    As found in other studies, over 10 per cent of all Estonian students aged 13–15 have suicidal thoughts. Such ideas are more frequent with youth who consume alcohol, smoke, participate in fights or are related to school violence, be it as victim or bully.

Sources: SEYLE study (2010) and other studies

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Children’s psychiatrists increased receptions

As recalled by Inna Lindre, senior physician and teacher at children’s department of psychiatry clinic at Tartu University Hospital, they used to have some thousand plus receptions with children’s psychiatrists, in 1995. The last year but one, the number was over 6,300.

«Indeed I may verify that, year by year, this is added,» said Ms Lindre. As reasons, she underlined poverty of families and parents working abroad.

«All situations affecting parents’ subsistence and health situation will immediately affect kids depending on them as well. Also, the kids’ spiritual health is impacted by the school environment, relationships at school, and the requirements at study,» she said.

As evidence to the seriousness of the situation, waiting lines for children’s psychiatrist stand at two-three months. 

«Right now, they are registering for receptions in March. For in-patients also, over these past four-five years, the waiting list is up to three months, constantly,» said Ms Lindre, adding that since 2006,  intensity of work at the children’s department has ever increased. 

Ms Lindre doesn’t doubt the SEYLE showings that a third of Estonia’s youth have intentionally mutilated themselves. «In our daily practice,  we run into self-mutilating behaviour quite often,» she noted.

Depression starting at primary school

According to Lemme Haldre, a clinical psychologist and head of Tartu children’s support centre, spiritual problems hit at ever younger ages.

«We are having quite many kids with suicidal thoughts and self-mutilating behaviour. During the past couple of years, we have seen the disorders are moving towards the younger children – while earlier we used to deal more with school-aged, especially those in puberty, then now the problem area has shifted towards the pre-school years,» she said. The other age group with lots of spiritual problems are children aged 8–11, said Ms Haldre.

Before going to school, the kids are mostly plagued by fears and mood disorders; those slightly older may already be depressed.

«While psychic disorders used to be related to puberty, rather, now children aged 8–11 have trouble like that. Anxiety, inability to concentrate, depressive thoughts, declining academic achievement...,» listed the psychologist. According to Ms Haldre, the increased numbers may be due to the troubled kids noticed more often, contacting the specialists – for instance, kindergarten teachers are calling the support centre, advice is asked much more frequently than five years back, for instance. 

Thoughts of repression and suicide are more frequent with kids at specialised schools, as well as kids whose parents are divorced and who live in combined families. «They cannot understand blood relationships, are growing apart from biological parents, and feel deep loneliness, rejection,» said Ms Haldre.

Risk group also includes children whose parents have gone to work in other countries. According to Ms Haldre, primary class children do not understand that a parent is earning money abroad for their wellbeing, they just feel that a loved one is away; also, parents tired from work and occasionally visiting home are not good at listening the kids’ joys and sorrows.

Doctors lacking to help the young

According to Anne Kleinberg, psychiatric clinic heat at Tallinn Children’s’ Hospital, depressive youth in Estonia are not getting sufficient help as there are not enough doctors to cure them. In her opinion, Estonia’s SEYLE study results – two per cent of youth acutely suicidal and a tenth thinking the thoughts – is global average and nothing unusual, definitely.

Ms Kleinberg says there’s no earlier statistics to compare; even so, with even increasing numbers of youth showing up for treatment, she sees the SEYLE data to be relevant, rather.

While numbers of youth in need increase, Mr Kleinberg says the doctors are scarce. «The fact is: youth with psychic disorders aren’t getting enough help,» she said. «Due to limited human resources, out-patient psychiatric treatment of children and youth is insufficient.»

Meanwhile, depression left uncured is risk factor for suicide. «Suicidal thoughts walk hand-in-hand with depression i.e. limits on treatment of depression definitely has an effect on suicidal thoughts with the young people, and on persistence of such thoughts,» said Ms Kleinberg.