Considering that mental health encompasses much more than just the will to live, and that suicide is a complex issue influenced by various factors, it’s overly simplistic to assert that a decrease in suicide rates equates to an improvement in overall mental health.

This insight was shared by psychiatrist Aleksandra Raznatović and medical psychology specialist Milena Raspopović while discussing statistical data from the Police Directorate (PD) with “Vijesti.”

According to the institution’s response to the newspaper, there were 83 reported cases of suicide last year, marking a considerable decline compared to earlier years.

“In 2024, 83 cases of suicide were documented, showcasing a notable reduction relative to previous years. Specifically, 108 suicides were noted in 2023, while in 2022 the count was 121, 120 in 2021, and 109 in 2020,” the response indicated.

They pointed out that the factors leading to such actions, which have profound social ramifications, are linked to various elements including family dynamics, socio-economic challenges, significant health issues, and emotional turmoil.

“A key factor in the decline of suicide rates may be the enhanced willingness to discuss mental health issues, which has certainly increased in recent years. This suggests that today, individuals are considerably more inclined to seek help—whether from professionals or trusted friends—after experiencing suicidal thoughts, and before contemplating suicide, compared to the past,” Ražnatović and Raspopović noted.

They clarified that suicide is never due to a single factor or incident; rather, it usually stems from a complex interplay of multiple influences.

“Elements contributing to suicidal thoughts and behaviors can include various mental health issues such as feelings of hopelessness, unbearable psychological pain, particularly when combined with poor impulse control and low stress tolerance. Additional risk factors can be a lack of social support, troubled family relationships, domestic violence, recent stressful life events, childhood trauma, unemployment, or a decline in living conditions, among others.”

In response to how factors like economic conditions, family dynamics, and social networks impact the decision to commit suicide, the “Vijesti” interviewees reiterated that lower socioeconomic status and troubled family relationships can significantly elevate suicidal risk, leading individuals to feel insecure and deprived of support, thereby increasing suicidal thoughts and behaviors.

“Conversely, a higher socioeconomic status and a nurturing family environment can provide vital emotional, social, and practical resources for overcoming suicidal tendencies. Regarding social networks, negative aspects can include information overload, unrealistic societal standards, isolation from the real world, while the positive aspects include the rapid dissemination of crucial information, including resources for suicide prevention,” they stated.

The proactive engagement of health institutions, educational systems, and media is invaluable for preventing suicide: “Educating the population from an early age about the importance of discussing these topics—that problems do not equate to weakness and that seeking help is acceptable—can significantly mitigate the risk of individuals experiencing loneliness and suffering in silence.”

“The media plays a crucial role in reporting on mental health, as stigma, misconceptions, stereotypes, and ignorance remain major hurdles in suicide prevention. Media can act as an ally by avoiding sensationalism, using appropriate terminology, and avoiding oversimplification of the causes and challenges faced by individuals. Conversely, media can provide vital information regarding available support services.”

Both experts advocate for the establishment of an SOS line dedicated to suicide prevention, along with interdepartmental programs and strategies. They also emphasize the existing availability of mental health services…

“Many Montenegrin cities have mental health centers within health facilities, alongside psychiatry departments in three general hospitals and one clinical center, as well as a specialist hospital for psychiatric conditions. The NGO sector is notably involved in suicide prevention, contributing significantly in this regard. Currently, citizens have access to a free SOS line for psychological counseling, staffed by experienced professionals. Developing an SOS line dedicated specifically to suicide prevention, along with additional interdepartmental programs and strategies, is certainly desirable.”

THE STIGMA PERSISTS

Ražnatović and Raspopović observe that the stigma associated with seeking professional mental health assistance, while diminished over the last two decades, still lingers…

“Many individuals endure prolonged suffering—months or even years—without seeking help, due to the shame associated with the stigma surrounding mental health issues. To mitigate suicide risk, more effort is necessary to combat ongoing stigmatizing attitudes towards mental disorders and suicide. Addressing stigma as a risk factor for suicide should galvanize greater collective action to challenge public stigma and support those affected by perceived or internalized stigma. Given the serious repercussions of stigma, specialized help and psychological interventions should be available for affected populations.”

They also highlight the importance of examining seasonal patterns in suicide rates as a means of identifying potential determinants and enhancing prevention efforts.

Most studies indicate a rise in suicides during spring, with a slightly smaller uptick noted in fall.

“There is no universal seasonal pattern concerning methods of suicide. Findings suggest that clinical, bioclimatic, sociodemographic, and biological factors may play roles in the seasonal fluctuations of suicide rates.”

“In 2024, 83 suicides were registered, marking a notable decline compared to earlier years. In 2023, 108 were recorded; in 2022, there were 121; in 2021, 120; and in 2020, 109,” the Police Directorate reported to “Vijesti.”

Don’t judge, listen and refer to a specialist

For individuals grappling with suicidal thoughts, the initial step is to confide in someone they trust. Following this, they should seek professional assistance and communicate openly about their feelings, according to the experts interviewed by the newspaper.

They recommend removing any means that could be used for self-harm, particularly sharp objects or weapons, and if medications are involved, to give them to a trusted person responsible for administration.

“During such periods, it is wise to avoid activities where the individual may feel inadequate or overwhelmed. Instead, setting achievable, small goals is preferable, along with reducing isolation—even when the individual may feel inclined to be alone. It’s also important to allocate specific times each day for activities they once enjoyed, as well as outdoors time. It’s essential to recognize that regardless of how dire their feelings may appear at that moment, this state can be temporary, with help available to navigate through the crisis. For those wishing to assist someone experiencing suicidal thoughts, it is crucial to avoid judgment, listen empathetically without offering immediate solutions, ask open-ended questions, refrain from making promises of confidentiality (which could provoke anger or withdrawal), and inquire about what has helped the person in the past, thereby enabling them to seek their own solutions. It’s vital to encourage the individual to pursue professional help and offer to accompany them to that specialist,” Ražnatović and Raspopović emphasized.

Risk groups and warning signs

Research indicates a heightened suicide risk among individuals undergoing treatment for various mental health disorders, including depression, bipolar disorder, borderline personality disorder, eating disorders, substance abuse issues, and schizophrenia, according to Ražnatović and Raspopović.

“This elevated risk stems both directly from the symptoms of these disorders and indirectly due to diminished self-esteem resulting from the illness and its effects on the person’s functioning.”

However, they point out that adolescents emerge as a particularly vulnerable demographic due to heightened impulsivity and a tendency to engage in suicidal actions, combined with a lack of awareness of the finality of such decisions. Additionally, the LGBT community experiences a notable number of suicides, primarily due to social rejection and lack of support.

They highlight warning signs such as a diminished interest in usual activities, withdrawal into isolation, preoccupation with death, and distress.

“Indicative signs include deep depression or psychological distress, changes in behavior, giving away treasured possessions, addressing unfinished matters, sleep disturbances, high-risk behaviors, increased substance use, and other self-destructive actions,” they outlined.

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