Suicide in Belgium

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Erwin Ringel, Austrian psychiatrist and neurologist, 1988: “suicide is a eternal solution for something that it´s often a temporal problem”.

“My friend Marÿke suffered borderline and lived in a menthal institution for more than 2 years. Then, she had an apartment in Bilzen with a therapeutical program. A few weeks before her bithday she had already told me and another friend that she was feeling really bad, she used to drink a lot, and fight with her boyfriend and sometimes even was aggresive without having a lot of control of her own feelings. But still we never expected her to take an overdose of pills on the evening of her birthday. When they looked through her belongings they saw that she had a note, saying how she wanted her funeral arranged. And she had written it in August. So she had been planning this for two months and she kept all the pills somewhere so she could take them when she thought she needed them.”- Claudia Stienaers (23), friend of a suicider from Houthalen. 
    
This is just one of the cases of suicide in Belgium, a country with a extremely high rate on self-killing (21 per 100,000 people). Why? What makes Belgium so vulnerable to suffer this patology that brings more deaths than wars or homicides? What might have in common this girl from Hasselt, Yasmine and Frank Vandenbroucke?

World chiffres
There are more deaths from suicides than from wars, terrorists attacks or homicides, according to Brian Mishara, Doctor in psicology and teacher of the University of Montreal. There are some exceptions like China, but in the wold there are three times more suicides of males than females.
World Health Organisation (WHO) estimates that each year approximately one million people die from suicide, which represents a global mortality rate of 16 people per 100,000 or one death every 40 seconds. It is predicted that by 2020 the rate of death will increase to one every 20 seconds. Belgium case Belgium is the fith country in Europe with more suicides: 21.1 per 100,000 people. That´s far bellow Lithuania, wich leads the world on 38,6. Behind are Slovenia, Hungary and Latvia. Greece is Europan´s least suicidal country, with only 3,5 deaths per 100,000 habitants.

In Belgium suicide is the leading cause of death for men aged 35 and 49, accounting for nearly one – third of deaths; also for girls aged 15-19 and women aged 30-39 (above age 39, breast cancer takes over as the leading cause of death). About 90% is younger than 30 years old and 50% is younger than 18. Death rates continue to be highest among older adults ages 65 years and over. Hanging or strangulation is the largest suicide method. Younger men and women alike are more likely to throw themselves under a train, while older men and women, to drown themselves.

Signs
Experts disgree with the convencional belief witch says that people who talk about ending are the least likely to do it. According to them, suicidal ideation, or the act of thinking about suicide, is considered an important danger sign. About half of all successful suicides, according to Gwendolyn Portzky of the Unit for Suicide Research in Ghent, have been preceded by one or more failed attepts. “A suicide attempt remains the most important risk indicator of a fatal suicide”. Suicide attempts are up to 20 times more frequent than completed suicides. The american Centre of Disease Control and Prevention reports that males are four times more likely to die from suicide than are females. However, females are more likely to attempt suicide than males are.

Witch is the reason?
On one hand sociologists put the blame only on the social environment: isolation, adaptative failure, anomia, changes in the net of social relations... Emile Durkheim (1897) considered that suicide is only influenced by the social environment. Positivistic sociologist Albert Bayet (1922) discovered that suicide is strongly correlationated with the life cycle of the societies and cultures, and that´s why it´s more often in those moments of maximun power and progress of a culture and less common in those cultures which are starting to develop and build-up. On the other hand, cognitive theories found those psychological aspects that the most part of the suiciders have in common: fault, dependance, despair, defencelessness and neglect. Other phenomenons of the inconscient are autodestructive tendence, willing of killing, of diying or of being killed or attemps of manipulation. Since the earlier years of XX century, suicide is considered a pathology, an illness.
Experts from all over the world state that there is never only one reason for comitting suicide, there are many factors that influence it.

Factors
Being a male, celibataire and without strong familiar tights. Living in a city instead of the country. Being more that 65, unemployed or retired. Having a high educative level. All this demografic factors increase the possibilities of comitting suicide.
However, suicide results from many complex sociocultural and psychological factors and is more likely to occur during periods of socioeconomic, family and individual crisis and less common during wars. We cannot forget that most of the suicides are caused by a psychological pathology. An study made in 1990 by Black and Winokin demonstrated that mental health disorders (particularly depression and substance abuse), are associated with more than 90% of all cases of suicide.
It´s also significant the genetic influence: having a suicide in the family increases the possibilities of having a second one. Post-mortem studies found that suiciders had low levels of serotonine, a mood-elevating hormone called “hormone of pleasure”.

Why Belgium?
It is said that climate and weather have a lot of influence on suicide, and people tend to believe that the typical rainy and frozen Belgian weather is the cause... but this is just a myth. In fact, we can only say that suicides from all over the world are more common in spring and summer.

Victoria Delvaux, florist from Meertkerke :“I live in a little village near Brugges and last year three neightbours of my street committed suicide between March and August. The were all less that 30 and nobody knew why they did”.

According to some studies of the Unit for Suicide Research based in the University of Gent, Flemish youth are less likely to discuss their problems with adults. The unit´s coordinator, Dr. Gwendolyn Portzky, reports that they are instead more likely to turn to drugs and alcohol than trying to find solutions to their problems.

Pieter Demeulenaere, social worker from Gent: “Belgians aren't very eager to visit psychiatrist…. Also our familytighs aren't that strong, we're more individual which means as well that we try to solve our problems alone”.

Furthermore, you can see in Belgian-comunication-style that they normally avoid at all costs arrogance and boastfulness. If you talk with a Belgian and then with an American you will notice better the difference: in general, Americans are more self-promotional and Belgians more modest and even self-deprecating. In Belgium it´s said that you need to have a good job, a house, kids... to have a full life. However, in Spain there is a saying witch states that you need to “write a book, plant a tree and have a baby before you die”. It sounds less stressful, isn´t it? Most of the Belgians are very exigents with themselves.

Sam Lenaerts, ingeneer from Geel (Antwerpen): “There is so much pressure on people. It starts when you are a kid: school is very important and you must get good scores. Outside of school you play sports in a club and you have to be good at that too... Later on you need to get a diploma, a good job, buy a car, meet a girl/guy, buy a house, be able to pay the rent every month, have children... Many Belgians think that you haven´t if you don´t have done all this stuff...”.

As well, many people work under stress in this productive and efficient country. A national survey reports that many Belgians are affraid of losing their job. This might bring emotional instability and anxiety. To be aware of how affects this people, you just have to take a look at what happened in France Telecom. In this French company of 100,000 workers, 25 of them committed suicide in only 19 months. Why? France Telecom began a massive re-organization three years ago, cutting one fifth of its workforce. The notes left by most of the suiciders put the blame on the company: constant pressure to resign, impossible goals, frequent forced relocations and chaotic reorganization.
Here there is a noteworthy figure: Belgium has the double of suicides than Netherland, despite it borders to Belgium and there they speak the same language as Flemish people (Dutch).

Gudrun Leemans, medical analyser from Brugges: “I lived and worked in the Netherlands and they are more open and less introvert and negative. Belgians we are so much more on ourselves compared to them”.

Belgium has a mixed private/public health care system. The consultations are relatively long (18-20 minutes, average) Even thought, “less than 60% of patients who present sychosocial symptoms in Belgium are diagnosed”[1]. On the other hand, Netherland used to have a mixed system, but it turned to be more private since it is a must to buy a basic healthy insurance. Netherlands doctors have more time for their clients than Belgian ones. So that could influence on it.

Claudia Stienaers (23), friend of a suicider from Houthalen: “I think that the Belgian mental care system is really bad and needs to be approved. If they had checked up on her more regularly and had more controls about the pills the suicide of my friend could not have happened. But maybe then she would have found another way to do it. It is hard to say that it was somebodie´s fault. But the parents, afterwards made an outcry to improve mental care and especially the care for people with borderline”.

Grieke Forceville, director of the Flander´s Centre of Suicide Prevention (CPZ) in Belgium consideres that the answer of the high suicide rate will probably be a combination of factors. “It could be a matter of willingness to seek help openness to talking about emotions, the ability to recognise suicidal behaviour, the way health care is organised, or all of those things together”.

Also well-know Belgians...
...commit suicide or at least attemp it
These are some of the names of a too long list: cyclist Frank Vandenbroucke, Pierre Lano, CEO of Lano Carpets,the singer from the 60´s Jeanine Deckers, TV presenter Yasmine...
Unanswered death of a cyclist called “God”
Famous Belgian cyclist Frank Vandenbroucke died the night of 11th of October in strange circustances during his holidays in Senegal. His best friend Nico Mattan explained: “He went to Senegal, so far away. I couldn´t stop him, but I had a strange feeling about it”. This hard rider had a stormy carreer. He turned professional in 1993 with the Lotto team, and soon developed his prodigious talent, winning 51 races in the next six years. But his tranfer to the French team Cofidis in 1999 on a contract worth 740,000 euros marked the start of a downward spiral: doping controversies, drug taking, depression and relationship problems... His ex wife Sarah Pinacci (italian model), acussed him of being a cocaine addict.
This father of two has tried to commit suicide on two occasions in the past, once using insuline. During the attempt, he left a note explaining what he was doing and asking not to be cut open as he explained in his autobiography “Ik ben God niet” (“I am not God”). He also dressed himself in his champion´s jersey before injecting the drug.

Yasmine´s death and his copycat effect
After a big public difusion of a suicide by the media, the number of suicides increases. But it only influenced those with a strong predisposition to commit suicide. It is called “epidemic suicide” and was exacly what happened after the suicide of the singer and tv presenter Jasmine. The hanging death of well-known Yasmine (real name Hilde Rens), the 25th of June freaked out Belgium. She was a 37 years old openly gay woman also well-known for her 2003 marriage to Marianne Dupon, which was the first high-profile celebrity lesbian wedding in Belgium after same-sex marriage was legaliced there. The couple separated in April, which appears to have been a significant factor in Yasmine's suicide. This prominent figure in the media was also a role model for many young people in precisely those age groups where suicide is a leading cause of death.
Acording to Flander´s Centre for Suicide Prevention (CPZ), the weeks following Yasmine´s death by hanging saw a threefold increase in the number of calls to the suicide line, and eight times more visitors to the website than usual. In the week inmediately following the death, the number of calls from relatives of potencial suicides increased tenfold, an effect which CPZ director Forceville attributes to the reporting in the press of the number and web address of the organsation. But the press coverage also had a negative effect. Many press and media who covered this suicide, didn´t respect the privacy of families and neither avoid affixing blame or resposability. Some of them also sensationalise the report, dramatising the circumstances. Forceville says, as twice as many callers expressed a desire to kill themselves by hanging. “That increase is certainly due to the reporting in the media of details of the mothod used. After Yasmine´s death, the suicide line noticed a very clear imitation effect”. 
                                                                                                                        
[1] according to an European study of the Netherlands Institute of Health Services Research.