Uruguay reached its highest suicide figures on record in the last seven years. 705 people took their lives. Due to the Covid-19 pandemic and the elevated suicide rates, Uruguay’s government set up telephone lines to offer support to people during emotional crises.
Whenever the telephone rings it is usually a woman. This time is different. A man is calling. He is phoning from an inland town in Uruguay, one with no more than three thousand inhabitants. He is 43 years old and says he is a handsome swarthy guy, and that he likes his things neat and tidy. He speaks like people in the northern region of Uruguay, with hints of a Brazilian accent, an intonation similar to that of country folks. The man claims to be tarot reader and to be personally related to Uruguayan left-wing personalities such as José Mujica, Lucía Topolansky and Tabaré Vázquez. He adds that, before coronavirus got to Uruguay, he would travel to Montevideo every fifteen days to read the tarot cards for former presidents Mujica and Vázquez.
His depression symptoms had led him to call the support line hotline. The handsome swarthy guy was tired of life because people around him thought he was a bad person. In his call he claimed he had not felt hungry for three days on a row, and that he was only feeding off loneliness and the resulting angst he was experiencing.
That was the only call with specific death ideations that Amelia Miller had received. Amelia is a volunteer working as a telephone operator at the emotional support hotline. She works from her office in her house, three hours a week: one hour on Saturday mornings, and two hours on Sunday afternoons.
For two months, the four walls in Amelia’s office listened to the crises of 26 people from all over the country. She received, at least, one call per hour during her shift as a volunteer.
The project to establish a telephone line for emotional support was announced by Álvaro Delgado, the Secretary of the Presidency, in a nationwide press conference. Within the context of the non-mandatory social lockdown and, foreseeing an increase in the national indicators of mental disorders, the hotline started functioning on April 14, and it was implemented by the State Health Services Administration (ASSE) in an effort to provide psychological containment and support during the pandemic.
There are more than one hundred psychologists and psychiatrists who have volunteered to provide care and offer help. They operate the hotline, fill out data forms, listen to people, talk with them and assist them, and, if necessary, begin the proceedings to provide in-person appointments.
Since it was implemented, the volunteers’ telephones rang more times than what anyone would have expected. They received a large number of calls: in the first six days, the number of consultations was as high as 1,360. Most people made some reference to the current sanitary crisis but they mostly expressed deep feelings of loneliness and anxiety.
Two months after its creation, on June 22, the emotional support hotline had already recorded 8,100 calls, i.e. 14 per hour in the entire country. There was a much higher number of female callers than male ones, since as world-wide suicide statistics indicate, women attempt suicide much more often, but it is men who prove to carry it out more effectively.
Out of the total of calls received, 73% were made by women, and just 27% by men. That day,
when the handsome swarthy guy called, Amelia answered her cell phone in the same customary way she takes all calls:
–Hello, thanks for calling. I’m doctor Amelia Miller, I’m a psychiatrist. How can I help you?
Given that his own father had committed suicide and the fact that he himself had had a non-violent attempt to do so, the handsome swarthy guy’s case was major red flag. A history of suicide is one of the many risk factors that make up such a complex phenomenon.
She went to on ask him if he had already thought of how and where to kill himself. He did not know what to answer. Then Amelia asked him to give her the telephone numbers of his sisters and his doctor, all of whom live in the same town.
Next day, Amelia called every number the man had given her. None of them answered, not even his doctor. She tried again a little later, but she did not get any answer whatsoever.
Suspecting the handsome swarthy guy was a patient experiencing psychotic breaks and possibly, schizophrenia, Amelia phoned Línea Vida (which translates as LifeLine), Uruguay’s suicide prevention hotline. She was told he had already called Línea Vida exactly one year before.
The suicide prevention hotline did not start working just as from 2018. Before that, Último Recurso —an NGO that had also been historically devoted to preventing suicide in Uruguay— was in charge of providing this service.
The telephone line used to work exactly the same way as ASSE’s hotline: available 24 hours, for free, operating all along the country. The NGO had gained thirty years of experience in offering suicide prevention services before ASSE took over the hotline.
Something María José Di Agosto will never forget about is her first call while she was working for Último Recurso as an operator of their telephone line. Sitting in front of the telephone, she was waiting for it to ring for the first time. She had taken the training course and was completely prepared.
When she heard it was the time to handle and respond to a crisis or a self-killing attempt, she experienced fear. All she said was:
-Último Recurso, this is María José. Listening.
In time, she grew used to solving situations. The sound of the ringing phone eventually became more natural. She came to understand that people calling the line did not want to die: they just wanted to stop living the way they were living back then.
She recalls a day in which she picked up her phone and it was a patient of hers. She was intoxicated and it was hard to understand her words. While trying to assist her, she was looking through her data in order to send her face-to-face support. Such containment implied keeping her awake, preventing her from losing her consciousness, calling her doctor before she hung up.
This is what was done in Último Recurso during the calls: forms were filled out, the person’s suicide risk was assessed, and the assistance of the medical personnel was considered. Calls would last as long as it was necessary until the person felt alright: from ten minutes, to one hour, three, six, ten.
Towards mid-2020, the National Observatory on Violence and Crime (Observatorio Nacional sobre Violencia y Criminalidad) of Uruguay’s Ministry of the Interior revealed the figures regarding the number of deaths by suicide in 2019.
The latter substantially exceeded deaths by car accidents. Whereas there were 705 suicides, deaths associated to traffic accidents were 422. And those related to homicides, 391. It seems that Uruguayans die, mostly, because they lack the wish to live.
Sadness, depression, apathy. They are all ghosts that haunt the smallest country in South America.
The reason for such an elevated suicide rate in Uruguay is complex. It is a multi-factor phenomenon. That is, a person does not take his or her life for just one reason. Instead, there is a group of factors that lead one to that kind of decisions.
It is necessary to take into account individual issues which are personal and specific, such as a person’s family situation, his or her socio-economic level, the education level, whether there have been any suicide attempts of his/her own or in his/her family history. It is also important to consider social and cultural factors as well. Organizations such as Último Recurso even go as far as to conduct an analysis of the town and the kind of social logic predominant in the area.
Uruguay continues to be one of the countries with the highest suicide rates, a situation that has remained the same in its variables of age, sex, and self-killing methods. The most alarming figures, for example, are observed in rural areas than in those which have lately experienced a deruralization process. The highest suicide indicators are seen in the north-east part of the country. A quieter zone.
Therefore, there is a local logic, along with social and cultural components in every town, that clearly adds to an individual’s state of crisis which can lead to a person’s attempt to take his or her own life. Nonetheless, there are also personal factors in each case. Factors that have to do with every person’s outlook on the world, and how it will determine his/her moments of success and failure, their self-esteem, his/her amount of repression and expression, and life expectations.
In the year 2019 in Uruguay, for instance, an average of two people per day committed suicide. And if, on average, for every person who commits suicide there are 25 people who will attempt to do so, in Uruguay there are 50 daily attempts at self-murder. This means that, if those 50 daily attempts were to become actual suicides, in a year then, 19,750 people would die, that is 0.5 % of the whole population of the country.
Considering these hypothetical figures, reality is that if Uruguayans stopped procreating (a phenomenon which has been increasingly occurring), that together with the endless numbers of deaths related to other causes, in less than eighty years the country would only exist in recent history textbooks.
LATE es una red sin fines de lucro de periodistas que cuentan el mundo en español