Moderator of 3 Sessions
Presenter of 5 Presentations
EPA Pascal Boyle Prize announcement
COVID-19 and Suicide in the World
Compulsory Admissions of Patients with Mental Disorders in Europe: State of The Art on Ethical and Legislative Aspects
Abstract
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Globally, mental health legislation has been changing and evolving throughout time. Compulsory admission is when patients with mental disorders are admitted to a psychiatric unit against their own will to receive treatment. In Europe, as public attitudes and practices shifted, compulsory admission procedures were reformed to ensure patient rights and safety. Differences however exist for compulsory admission procedures between countries. In 2018, a survey was created and disseminated by the European Psychiatric Association Ethics Committee to National Psychiatric Associations within 40 European countries to learn more about the legislation, key actors involved, and reasons for admission. Results showed that approximately half of the responding countries required an independent medical expert, typically a psychiatrist, to be involved in the procedure. Most countries by law required the involvement of a court-appointed judge in making the decision about compulsory admission and to review the case after a certain period of time. All but one country have time limits on legal decisions for compulsory admission. Further, patients have the right to obtain legal counsel to assist them through the process of appeal or the decision in most countries. The primary reasons for admission were the patient being a danger to themselves or others. Despite continued efforts, stigma still surrounds mental health disorders. Public awareness and increased knowledge are needed to improve the perception of compulsory admissions. Moving forward, it is necessary to create educational courses, as well as written guidelines for key actors, to stimulate good practice and promote voluntary treatment (Wasserman et al. 2020; https://doi.org/10.1192/j.eurpsy.2020.79).
Has Suicide Really Increased After the COVID-19 Pandemic?
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Despite being preventable, approximately 800,000 people die by suicide each year worldwide. Evidence suggests that suicide rates decrease during crises, but once the immediate threat passes, suicide rates are expected to increase. The COVID-19 pandemic likely affects risk and protective factors for suicide. Studies show mixed results regarding whether suicide behaviours have increased among adults during the pandemic. The results are however different for young people. An increase in suicidal behaviours has been identified in some countries among young people after lockdown period and when returning to schools. Data also suggests that there may have been a rise in deaths by suicide among those younger than 18 years in China, and during the first phase of lockdown in the United Kingdom. Studies have found significant decreases in hospital admissions for suicidal behaviours and visits to emergency departments both for adults and adolescents. Suicide can be prevented if evidence-based methods that exist are implemented in a systematic way. Wasserman, D., Iosue, M., Wuestefeld, A., & Carli, V. (2020). Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World psychiatry: official journal of the World Psychiatric Association (WPA), 19(3), 294–306.
Suicide in the COVID-19 Pandemic
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A literature search using PubMed and Google Scholar identified 64 articles assessing suicidal thoughts, suicide attempts and suicide during the COVID-19 pandemic in comparison with the pre-pandemic period in the six WHO regions of the world. Most studies come from high- and middle-income countries. There is a scarcity of data from South America, and no studies from the African and East-Mediterranean Regions. Compared to trends in previous years, suicide rates remained largely unchanged globally or declined in the early phase of the pandemic. However, increased suicide rates were reported among non-white residents and Afro - American groups in the US, as well as among adolescents in China. Japan and India showed a statistically significant increase in suicide rates after an initial decline. Similarly in Peru, after an initial decline, suicide rates increased among men during the course of the pandemic. This is in line with previous findings in the context of natural disasters and other epidemics where a similar increased suicide trend can be expected in the post-pandemic period in other countries. Among adolescents, there were no significant changes in suicide rates during the period of school closure, but an increase has been observed in the period after coming back to schools. The assessment of suicidal thoughts and attempts during the pandemic was mostly conducted through online cross-sectional surveys and showed significant increases, particularly in females and the young. Suicide can be prevented if evidence-based methods that exist are implemented in a systematic way (Wasserman et al. 2020; https://doi.org/10.1002/wps.20801).