Yucatan, the safest area with one of the highest living standards in the country, has five times more suicides than murders.
Paulina is fed up. She is tired of pretending that she is well and feeling that everything inside crumbles. It has been a fight of 11 years, of comings and goings, against the desire to die. “The others are going to be better without me.” “I’ve sunk again and I can not get out.” “My family thinks I’m sick, they do not understand why I do not want to live.” The thoughts rush one after the other, squeeze her chest, paralyzing her. Five other members of the La Esperanza support group sit in a circle and strip their life stories. In the psychiatric hospital of Yucatan, the fight against suicide is fought every day. In that battle, 246 people died last year, the historical maximum and a figure five times greater than the murders in the state, until becoming one of the states where people take more life in Mexico.
In a country stifled by the most acute crisis of violence in the last 20 years, Yucatan has emerged as a peaceful oasis. In 2018 there were 48 intentional homicides , a number that in other regions was exceeded in two days. Merida, its capital, has been recognized by the United Nations as the most livable city in Mexico and each year attracts 1.5 million tourists. Eight of every 10 inhabitants say they are happy with their lives, according to the National Institute of Statistics and Geography (Inegi) . His Government is the best evaluated in the country, says a recent survey . In a sea of good news, Yucatan seeks a lifeline to decrease a rate of 11.2 suicidesper 100,000 inhabitants, more than double the national indicator (5.1). “It’s an emergency,” says Arsenio Rosado, the local Undersecretary of Mental Health.
Paulina wipes her tears with a disposable handkerchief. Try to contain yourself. Anxiety makes her right foot move up and down when she recalls an argument with her mother, the trigger for her latest crisis. Victor, on his left, came to the group for debts. Yadira, in front of her, came for an infidelity. Greece, on his right, wanted to kill himself for the abuses of his ex-husband. “I need to rest, I can not do it anymore”, repeats Paulina, a thought that sneaks over and over in the group’s stories and that opens the way to a disturbing mystery about daily despair. Why does a person decide to end his life to avoid an overwhelming reality and another not? “People tend to attribute suicide to a single and immediate cause, it rarely happens,” says Guilherme Borges, a researcher at the National Institute of Psychiatry Ramón de la Fuente.
The search for answers extends throughout Mexico . In Chihuahua, the Mexican state with the highest rate of suicides – 11.4 per 100,000 inhabitants – there has been an attempt to associate the phenomenon with the violence provoked in the war against drugs. There is also a high incidence in Aguascalientes, one of the regions with the highest economic growth, and in Campeche, one of the most peaceful and secluded areas in the country.
Mexico is still far from Uruguay, the Latin American country with the highest incidence with 18.4 cases per 100,000 inhabitants. There are 20 countries on the continent with a deeper problem in relative terms, according to the World Health Organization (WHO) . But the phenomenon has exploded in the last decade. In 2017, the latest data available, 6,559 people took their lives in the North American country, the historical maximum and almost 50% more than 10 years earlier. Without clear patterns and as a result of a public health problem that is little talked about, the number of suicides has increased fivefold in the last three decades despite the fact that the population increased by only 50%, according to the Inegi.
The silence of the victims
A long scar is drawn on Eduardo Armenta’s right wrist. Swipe your finger for other marks: at the level of the left elbow, the forearm, the hand. The wounds are the testimony of his past as a stepson of a religious minister who beat him as a child, of his time in prison when he was 17, of a depression that marked his youth, of a man living with HIV for six years. years, of a survivor of 10 suicide attempts. Trapped in an emotional whirlwind, taking his body to the limit, Armenta tells that he tried almost everything to escape from reality. I could not die nor live. He survived himself. “I needed to punish myself for feeling bad, I needed to feel pain,” says Armenta, 38, his eyes clouded. “, were my desire to live and die. “
“We have a serious problem of alcoholism,” says Víctor Roa, local director of the Center for Youth Integration, one of the mainstays of the national strategy against addictions. Alcohol is present in 65% of suicides in Yucatán, the national leader in alcohol abuse. In 2018 he had more than 10,300 cases of poisoning. Jalisco, the second site, registered 3,686, according to data from the Ministry of Health .
Armenta knows that it could have been part of the statistics. In Yucatan, eight out of 10 suicides are men. The same proportion suffered or exerted sexist or sexual violence. Six out of 10 had expressed their desire to die, most were less than 40 years old when they committed it, and more than half had tried before. Those warning signs were not heard. These are some of the red hot spots that the authorities have identified when analyzing the clinical history and sociodemographic conditions of the victims, what they call psychosocial autopsies. “It is said that suicides do not speak, but there are all the signs and it is the people who do not want to see,” accuses Armenta. This type of autopsies are unusual instruments in the rest of the country, more stigma towards psychiatry , according to the WHO.
“Say yes to life”
“If I’m alive, it’s because of them,” says Armenta about Salvemos una vida, the state’s largest specialized network. The association has a 24-hour telephone line, gives free consultation to thousands of people each year through volunteers and claims to have loaded the slab of the problem for years. “Historically, the local government has not done anything, efforts have failed,” says José Vales, the network’s coordinator.
“Say yes to life” and “Worth living” are some of the phrases that can be read in the office of Save a Life, where patients come from all corners of Yucatan. In the Vales office there is a postcard of Jesus and a small statue of a saint. The association has a strong religious inclination and asserts that the wave of suicides comes from family disintegration and spiritual uprooting.
The organization has a catalog of actions to reduce the problem ranging from workshops to stop eating your nails to talks against abortion and divorce, which has earned them criticism. “We receive people of all religions, but everyone knows that we are Catholics, if they do not like it, not at all,” says Vales. In a society with an overwhelming Catholic majority (80%) and in which priests are the second most consulted source to suffer a mental disorder after family and friends, local authorities do not look with bad eyes on the participation of religious actors. “If they want to do their bit, we are delighted,” says Rosado, who as a psychiatrist has been an advisor and collaborator of Save a Life.
Ixtab, poverty and inequality
“Death is seen as a culturally accepted exit in Yucatan,” says Gaspar Baquedano, director of the Comprehensive Program for Suicide Care. The psychologist argues that the Yucatecans are a historically repressed society, in which it is not well seen to talk about emotions and in which suicide has become normalized as an escape from everyday problems. Baquedano stresses that since the time of the Maya, Ixtab, the goddess of suicide, was represented by a rope around her neck, and that there are a number of historical and cultural features that combine with current problems that can give many answers about the Suicide crisis in the State.
“They talk about our ‘good’ living conditions, but it’s an appearance,” says Baquedano. In his opinion, alcoholism and suicidal tendencies are chronic symptoms of the inequalities and lack of encrypted opportunities in the Yucatecan society. While the north and center of Mérida are filled with luxury shopping centers and subdivisions, the south of the capital suffers the presence of gangs and is a reflection of the precarious conditions of life in the rest of the state. In Yucatan there are almost 42% poor and a high degree of social backwardness. It is the State with the highest percentage of indigenous identification, but about 75% of the population considers that there is discrimination against the Maya. This sum of factors is synthesized in an argument. Baquedano is about to publish a study with the Autonomous University of Yucatan in which he affirms that eight out of 10 suicides had at least one surname of Mayan origin.
Although it is a problem that affects all sectors of society, dichotomies such as poor-rich, urban-rural or mestizo-indigenous are also reflected in infrastructure, resources and access to health. And they are difficult to ignore. The State has 74 psychiatrists, but 72 work in Mérida and another 105 municipalities have to make do with two specialists. The capital also houses the only psychiatric hospital and most of the medical staff is not trained to care for the population at risk, authorities admit. “We did not work hard enough,” says Rosas about his predecessors. In the last five years, 2017 was the only year in which suicides were reduced thanks to a temporary campaign that worked, but inexplicably, there was no follow-up. The budget for Mental Health used to be around 1% of state spending on Health,
An invisible crisis
Between daily pressures and heartrending life stories, secular and conservative explanations, in privilege and poverty, with public policies and private actions, in light of recent phenomena and an ancestral heritage, Yucatan seeks outlets for its own crisis of violence . The State approved in June its first Mental Health Law, in which a 7% budget is set for the sector and from which it promotes monitoring policies and zero rejection of potential cases. “We could not continue like this,” laments Manuel Díaz, the deputy who pushed for the law. The goal is for cases to fall by 15% by the end of 2019. Until February there were 30, 21% less than the same period last year. March began with three suicides in a weekend, according to local press. “The fight is one day at a time”,
Like them, Yucatan falls and goes on, but he is one of the few who recognizes the problem. Only 19 of 32 states have legislated on psychiatry. In the rest of the country, suicides remain invisible. Without a national hotline, without a federal law on Psychiatry, without prevention strategies, without sufficient infrastructure or budget. “We see it throughout the country,” says Baquedano, before returning to his office. “It gets under the carpet until it starts to stink.”
Source: El Pais
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