From mental health to suicide: the interruption of this chain reaction by prevention

This article was exclusively written for The European Sting by Ms. Emilly Cardinalli, a 20 years old undergraduate student of Medicine at Universidade Potiguar in Natal, Rio Grande do Norte, Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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In Rio Grande do Norte, a state of Brazil, according to the data from Coordination of Statistical Information and Criminal Analysis (in portuguese, Coordenadoria de Informações Estatísticas e Análises Criminais – COINE) ¹, in the first four months of 2019, 99 suicide attempts were registered in Natal city. Given this scenario, it is understood that’s necessary to facilitate the access of individuals to care. Much is said about the prevention of diseases in society, such as diabetes mellitus and high blood pressure. However, little is known about the prevention of psychiatric illness. So, what happens is a chain reaction: the individual goes from a healthy mental state to a time of conflict that translates into an organic disease and, by not receiving the basic health care and proper treatment, finds the solution to his pain in suicide. This is a result of the lack of primary to quaternary prevention. The question that guides the challenge is: “What can be done to increase the access to health services in the region?”. For the answer, it is valid to rely on strategies that already exists today in Brazil, such as the Family Health Strategy (Estratégia de Saúde da Família – ESF), which aims to promote the quality of life of Brazilian population². This program is multiprofessional, involving the Community Health Agents (Agentes Comunitários da Saúde – ACS), which establish the link between the family and the neighborhood health center, through direct contact with population’s residence, where will have health promotion and the identification of diseases and its risk factors. To stop the chain reaction, a system is needed to reach the individuals who are in the different moments of this process. Thus, through the relationships established between the parts, the ACSs, after being properly trained to detect and approach mental problems, will be able to act in the various aspects of prevention. In primary prevention, evaluate the presence of triggering factors for psychic problems (such as family conflicts). In secondary prevention, to identify individuals who are already experiencing psychological hazards, in order to guide them to medical and psychological care, where they will be properly assisted and treated. With the aim to intervene in complications of the disease and rehabilitate the patient, comes the tertiary prevention. Finally, it is also up to the physician to perform quaternary prevention, in order to perform the correct management of the patient, to avoid iatrogenesis. Therefore, it is clear that what should be done is to interrupt the chain reaction that leads a healthy individual to disease and then to suicide. Thus, the strategy aims at the performance of trained professionals at each stage of the reaction, looking for maintaining a good mental state and the proper management of those who are sick, to give them a better quality of life, so that they do not seek in death the solution that a coherent and engaged health strategy can offer. References

1. RAFAEL BARBOSA (Rio Grande do Norte) (Org.). Dezenove pessoas cometeram suicídio em Natal neste ano, diz Secretaria de Segurança: Relatório. 2019. Disponível em:<https://g1.globo.com/rn/rio-grande-do-norte/noticia/2019/05/22/dezenove-pessoas-cometeram-suicidio-em-natal-neste-ano-diz-secretaria-de-seguranca.ghtml>. Acesso em: 24 out. 2019.
2. Ministério da Saúde. Política Nacional da Atenção Básica. Brasília: Ministério da Saúde, 2017. (Série E. Legislação em Saúde).

About the author Emilly Cardinalli is a 20 years old undergraduate student of Medicine at Universidade Potiguar in Natal, Rio Grande do Norte, Brazil. She is a member of the International Federation of Medical Students Associations of Brazil (IFMSA Brazil) and has been working at IFMSA Brazil's in the Standing Committee on Public Health (SCOPH) since 2018. She loves to help people and really believes that the knowledge and love can change lives.