The system of suicide prevention in Tyumen’ region (West Siberia)

In Tyumen region (West Siberia), the rates of suicidal mortality, starting from the 90s of the last century, were significantly higher than the national average, in some years passing to the category of superhigh (more than 40 cases per 100,000 population). Among the reasons for the low effectiveness of traditional measures of suicide prevention, the authors singled out: 1) the lack of systematic recording of suicidal attempts; 2) rendering assistance "on demand" - independent circulation of citizens; 3) depersonalization of records and provision of only final numerical indicators of total suicidal lethality. In order to improve the situation in the region, in 2012 the authors developed and proposed a model of the Center for Suicide Prevention, including besides the "Trust Phone", the offices of social and psychological care and a crisis hospital, the organizational and methodological structure - the suicide register. The organization of the register made it possible to: determine the frequency of suicide attempts in the region and identify areas with the highest suicide risk; to trace the dynamics of suicidal activity; give a more accurate and detailed description of the suicidal contingent by sex, age, individual social and national indicators, mental and somatic diseases; highlight the most important regional risk factors among the population of the Tyumen region; identify priority areas for the development of preventive and corrective measures. At present, based on these data, purposeful work is carried out to reduce suicidal mortality. An important element of the prevention system is the Commission for the Analysis of Suicide. The educational direction in the region is realized on the basis of the School of Preventive Suicidology and Deviantology. The School's tasks include organizing and conducting scientific and practical seminars on suicidal activity and related topics - deviant behavior. Educational programs are designed for different contingents of listeners (doctors, psychologists, teachers, etc.). It is shown that such an integrated approach allowed to obtain a significant improvement in the suicidal situation in the Tyumen region: a 2.4-fold decrease in suicidal deaths from 36.0 in 2010 to 14.8 in 2017 (per 100,000 population). With a view to improving and increasing the effectiveness of the prevention system, the authors identify a number of priority areas for its further development in the coming years: the development of a "suicidal passport" of the Tyumen region and its individual territories; opening of the offices of social and psychological assistance in the leading universities in the region; creation of scientifically grounded Internet resources for the prevention of suicidal behavior; improvement of joint work with the media; work to prevent stigmatization and self-stigmatization of suicides; development of volunteer movement; scientific research in the field of suicidology.