The paradox of Uruguay: Suicide record in the happiest country in South America

Suicide is a significant concern in Uruguay, with experts and statistics confirming a gradual increase over the past two decades. In 2022, 823 Uruguayans, approximately two people per day, tragically took their own lives, resulting in a rate of 23 suicides per 100,000 inhabitants, more than double the regional average of nine per 100,000. This ranks Uruguay second only to Guyana and Suriname in South America. The Uruguayan suicide rate is rising, as it was slightly above 21 per 100,000 inhabitants in 2019, according to a global study by the World Health Organization (WHO).

Minister of Health Karina Rando presented this data on July 17, designated as Uruguay’s National Day for Suicide Prevention. During her speech before Uruguay’s Parliament, Rando pointed out the paradox of the nation’s high suicide rate despite being ranked as one of the happiest countries in the world by the United Nations (28th overall and fourth in the Americas after Canada, the United States and Costa Rica). Rando explained that the reasons are linked to personal and social factors that extend beyond the lingering impacts of the Covid-19 pandemic. “It is crucial that treatment encompasses more than just medical intervention, as suicide typically has more than one cause,” said Rando.

Official data shows that in Uruguay, eight out of 10 individuals who died by suicide were males (78% males, 22% females). The highest rates were observed among individuals over 75 years old and in the 25-29 age group. From October 2022 to June 2023, health services attended to 2,896 individuals who attempted suicide, with 50% of them being under 29 years old. In these cases, 71% were females.

“Suicide is a significant public health concern that reflects the distress within our communities,” said sociologist Pablo Hein, a researcher in understanding and preventing suicidal behavior at Uruguay’s University of the Republic. Hein says certain social institutions in Uruguay that historically fostered solidarity and community cohesion have weakened, including sports clubs, labor unions and political groups. Societal strictures frame suicide as unresolved emotions experienced by individuals. “Successes belong to the individual, and so do the failures,” said Hein.

Experts say older adult men in Uruguay, who are the most prone to suicide, face loss of emotional bonds, physical deterioration and the onset of chronic illnesses. This occurs in a society that no longer values its elders as it once did. Furthermore, these older men often struggle to seek help. Adolescents and young adults — another vulnerable age group — experience stages of existential crisis characterized by the emergence of sexuality and the transition into adulthood.

“Educational environments — primary and secondary schools — have the greatest power to prevent suicide,” said Yaravi Roig, a Uruguayan teacher and writer who started a suicide prevention organization called Resistiré in 2016 after the suicide of her only granddaughter. Resistiré works with survivors of suicide, including family members, friends, classmates and coworkers.

Suicide is the leading cause of violent death in Uruguay, surpassing both traffic accidents and homicides. Roig emphasizes the importance of prevention efforts targeting adolescents and young adults, considering the recent rise in numbers. “We have to listen and ask questions without judging,” said Roig.

The Uruguayan government has implemented three suicide prevention plans since 2011. These plans include comprehensive mental health care, mandatory registration of suicide attempts, and a toll-free helpline. Last year, a joint suicide awareness campaign by Uruguay’s National Youth Institute and UNICEF conducted 300 workshops in educational centers across the country. These workshops provided a platform for 14 to 19-year-old youths to share and discuss their emotions with peers and supportive adults.

Despite these initiatives, suicides have continued to rise in Uruguay, and the authorities are alarmed by the number of attempts. “We have over 270 suicide attempts every month,” said Health Minister Rando. Starting in 2024, all members of the national health system will have free access (with a medical prescription) to commonly used antidepressant medications. Individuals who have attempted suicide will be reimbursed for a portion of the treatment expenses, and psychotherapy coverage will be extended from 25 to 30 years. Additionally, teenagers will be entitled to an annual free consultation with a psychologist to assess signs of depression or mental disorder.

“Psychiatry and psychology specialists should be afforded the proper opportunity to intervene and address crises. It is important to avoid pathologizing everyday life problems,” said Hein during a presentation at Uruguay’s Parliament. Hein is involved in an interdisciplinary project on mental health at the University of the Republic that focuses on the country’s eastern region, an area heavily affected by suicide.

Hein says the project consists of three stages: suicide prevention (which involves the entire social fabric), specialist-led interventions, and post-suicide support for the relatives and loved ones of the deceased. “Uruguay has the human resources and data to tackle this issue, but it’s not something that can be resolved overnight. It will take time and effort — it’s definitely a long-term endeavor,” said Hein.

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