Home' Trinidad and Tobago Guardian : June 11th 2015 Contents B11
Thursday, June 11, 2015 www.guardian.co.tt Guardian
• FROM PAGE B10
cautionary principle: "Today, we re
simply too scared to release emo-
tionally unstable patients---or those
suffering from what is known as
borderline personality disorder---
because there is this pressure to pre-
vent suicide at all costs, and so doc-
tors and carers are afraid of being
blamed if something happens to the
patient once he or she leaves the
"The result is that, today, our
institutional-care facilities are not
mainly filled with people suffering
from major depression, as was the
case two decades ago, but with peo-
ple who suffer from personality dis-
orders, a milder diagnosis."
Admitting such patients infringes
on individual autonomy, Eberhard
continued. But that s not all. For
patients who suffer from borderline
personality disorder rather than clin-
ical depression, in-patient care may
prove an inappropriate and even
Eberhard pointed to research
showing that patients are particularly
at risk of attempting suicide just
after being released from the hospital.
The experience exacerbates the
fear of abandonment that many of
these patients grapple with, since
they abruptly go from having 24-7
care to being sent home alone with
only occasional telephone contact
with medical staff.
Another psychiatrist, Herman
Holm, has drawn similar conclusions.
In a 2011 article, Holm noted that,
compared with 15 years earlier,
Swedish women aged 16 to 24 were
twice as likely to receive hospital
care following suicide attempts or
While many benefit from such
care, studies also show that many
continue to harm themselves inside
the clinics, which leads to more
severe interventions like forced med-
ication and the use of restraints.
(Last summer, two psychiatric-care
providers in southern Sweden
launched a campaign to end the use
of restraints by, of all things,
demanding a Vision Zero approach
to the practice, which politicians
have since taken up.)
The larger question at the heart
of the debate is whether Sweden s
innovative approach to road safety
can be grafted onto suicide preven-
While there are concrete ways to
steer drivers toward exercising more
caution on the roads and to pressure
car manufacturers into adding safety
features to vehicles, the underlying
causes of suicide are less tangible.
To prevent drivers from acciden-
tally killing pedestrians, you can
lower the speed limit or introduce
speed bumps. But what are the smart
solutions to the existential ailments
that lead people to harm or even kill
How do you engineer away the
anxiety, loneliness, social alienation,
trauma, or psychiatric disorders that
drive people to such extreme acts?
Alfred Skogberg of Suicide Zero
has faith in the Swedish govern-
ment s ability to do exactly that.
He argues that individuals do not
choose to commit suicide. Instead,
suicides are "psychological acci-
As such, they should be regarded
as just as unacceptable and prevent-
able as road or workplace accidents.
Evelius, the Swedish government s
psychiatric-health coordinator, made
"Critics say the zero vision is hard
to reach, but on the other hand it
is hard to see what other goal we
should have as a society," she
"I mean, how many suicides
should we say are acceptable?"
But Eberhard doesn t buy it, and
he warns against overlooking the
element of choice in such decisions.
He cited the effort to suicide-
proof bridges with fences.
"People don t try to kill themselves
because there are bridges around,
they kill themselves because they
feel bad," he said.
"So we can make it harder to
attempt suicide by jumping off
bridges, but that won t stop people
from trying to end their own lives.
They will likely do it some other
way instead---by throwing them-
selves in front of a train, for instance.
So does that mean we should get
rid of trains?" (theatlantic.com)
Swedish politicians seek to engineer away suicide
To prevent drivers from
pedestrians, you can lower
the speed limit or introduce
speed bumps. But what are
the smart solutions to the
existential ailments that
lead people to harm or even
kill themselves? How do you
engineer away the anxiety,
loneliness, social alienation,
trauma, or psychiatric
disorders that drive people
to such extreme acts?
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