Suicide Patterns in Malta: pathways for prevention

Abstract Background Suicidal behaviour is the result of several risk factors, such as acute stress, severe depression, violence, sexual abuse, etc. A mental public health approach to suicide prevention needs to look beyond the demographic characteristics of deaths by suicide and to take into account specific country determinants. Available clinical information can help identify and quantify risk, analyse patterns of behaviour, explore links between risk and behaviour and generate possible suicide prevention pathways. Methods 162 deaths by suicide for the period January 2015 - June 2021 in Malta are analysed against available clinical information. Major sources of detailed clinical information include obligatory notifications to the Commissioner for Mental Health of all cases of persons involuntarily admitted to acute psychiatric services and other medical records held within the Maltese public mental health system. Results 81% of 162 deaths by suicide for the period under study were males, two-thirds of them between 25 and 54 years. The preliminary findings have confirmed that less than 50% of these deaths had previous contact with the public health system. The two main diagnostic criteria among deaths with recent psychiatric admission/s were acute stress reaction to personal life events and very severe mood disturbances, particularly depression. There seems to be increased risk among migrants and foreign workers residing and working in Malta. The frequency of prior admissions, age-related issues, the time-event relationships, and relevance of elicited clinical findings are still being evaluated and will be presented in more detail in the workshop. Conclusions Exploring risk factors within the history of cases of suicide through available clinical information can contribute to the development of suicide prevention pathways, relevant to the specific context of local communities.


Background:
Suicidal behaviour is the result of several risk factors, such as acute stress, severe depression, violence, sexual abuse, etc. A mental public health approach to suicide prevention needs to look beyond the demographic characteristics of deaths by suicide and to take into account specific country determinants. Available clinical information can help identify and quantify risk, analyse patterns of behaviour, explore links between risk and behaviour and generate possible suicide prevention pathways. Methods: 162 deaths by suicide for the period January 2015 -June 2021 in Malta are analysed against available clinical information.
Major sources of detailed clinical information include obligatory notifications to the Commissioner for Mental Health of all cases of persons involuntarily admitted to acute psychiatric services and other medical records held within the Maltese public mental health system. Results: 81% of 162 deaths by suicide for the period under study were males, two-thirds of them between 25 and 54 years. The preliminary findings have confirmed that less than 50% of these deaths had previous contact with the public health system. The two main diagnostic criteria among deaths with recent psychiatric admission/s were acute stress reaction to personal life events and very severe mood disturbances, particularly depression. There seems to be increased risk among migrants and foreign workers residing and working in Malta. The frequency of prior admissions, age-related issues, the time-event relationships, and relevance of elicited clinical findings are still being evaluated and will be presented in more detail in the workshop.

Conclusions:
Exploring risk factors within the history of cases of suicide through available clinical information can contribute to the development of suicide prevention pathways, relevant to the specific context of local communities.
Abstract citation ID: ckac129.530 Self-stigma in suicide prevention of mental health professionals

Introduction:
Stigma is one of the main factors hindering help-seeking, which can have debilitating effects on mental health and even lead to suicidality. Stigma can affect the general public but also mental health professionals. In this study we examined mentalillness and help-seeking self-stigma as well as public stigma of suicidal behavior among suicidologists.

Methods:
Invitation to participate in the study was sent to 518 member of the Internat.l Assoc. for Suicide Prevention. 89 participants (55 female, 34 male; 17% response rate) completed the survey. We gathered sociodemographic data, data on personal history of mental illness and suicidal behavior and on different types of stigma. We hypothesized that help-seeking self-stigma is predicted by sociodemographic attributes and personal history of mental illness and that self-stigma related to mental illness and suicide act as mediators.

Results:
Personal experience with mental illness predicted mental illness self-stigma. There was no significant predictive value of other variables (age, gender, years working in suicidology) for self-stigma of mental illness and suicide behavior. Both types of self-stigma (mental illness and suicide behavior) were correlated. Mental-illness self-stigma was shown to be a stronger predictor of help-seeking self-stigma than selfstigma of suicide behavior, though the effect did not reach statistical significance. Self-stigma of suicide behavior showed no independent contribution to help-seeking self-stigma.

Conclusions:
Mental healthcare professionals represent a particularly vulnerable group for developing mental health issues and suicidality. However, due to fear of being perceived less competent by colleagues and the public, they often disguise their mental struggles and are reluctant to seek help. These pilot findings warrant further research to better understand self-stigma and its impact on help-seeking behavior in order to prevent suicidality in this population.
iii214 European Journal of Public Health, Volume 32 Supplement 3, 2022