Successful suicide prevention in Estonia
Prof Merike Sisask
Estonian-Swedish Mental Health and Suicidology Institute (ERSI)
Tallinn University, Institute of Social Work
Nõmme Health Clinic
Standardized suicide rate per 100 000 in Europe
1994
2009
WHO/Euro mortality database
Standardized suicide rate per 100 000
(Estonia, Latvia, Lithuania, Finland, Hungary, EU)
WHO/Euro mortality database
Värnik A, Sisask M, Värnik P, editors
Baltic Suicide Paradox
Tallinn: Tallinn University Press; 2010
Baltic Suicide Paradox
 LITHUANIA In the Baltic States similar patterns of suicide trends during the transition
period, but disparities during the post-transition period – in Estonia and Latvia stable
decreasing trend, in Lithuania the rate remains high
 CAUCASIAN AND CENTRAL ASIAN REPUBLICS OF THE FORMER USSR Different
suicide trends in Baltic States and other regions of the former USSR – high rate with
remarkable fluctuations in Baltic and Slavic republics, in Caucasia middle rate without
fluctuations, and in Central Asia low rate without fluctuations
 SATELLITE COUNTRIES OF THE USSR Different suicide patterns in the Baltic States,
former satellite countries of the USSR, and EU-15 (before 2004) – in Baltic States high
rate with remarkable fluctuations, in satellite countries middle rate with decreasing trend,
and in EU-15 low rate with decreasing trend
 GENDER Overwhelming male suicide majority in the Baltic States – male-female ratio 6:1,
in most of the Western Europe roughly 3:1
 AGE Middle aged males as a risk group in the Baltic States, in females and in most
countries also for males the highest suicide risk is among the elderly (65+)
Suicides in Estonia (1970-2013)
80
70
rate per 100 000
60
Males
Females
Total
50
40
30
20
10
0
1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000 2003 2006 2009 2012
Prof Dr Airi Värnik
Prof Dr Danuta
Wasserman
Prevention and
rehabilitation of
attempted suicides
Practical
instruments for
mental health
promotion
Early recognition and
adequate treatment of depression
Prevention of suicidal and risky behaviours in youth
Mental health promotion
policies and strategies
Other projects
(networking, web-based solutions)
Collections of ERSI papers
2003  2008  2014
Värnik A, Wasserman D.
Suicide Prevention in Estonia.
In: Wasserman D, Wasserman C, editors.
Oxford Textbook of Suicidology and Suicide Prevention.
New York: Oxford University Press; 2009. p. 791-2
Successful suicide prevention in Estonia (1)
Overall socio-political stabilisation in Estonia after transition period
Establishment of ERSI in 1993, support from the National Swedish
Prevention of Suicide and Mental Ill-Health (NASP), Stockholm Care,
Stockholm County Council, Swedish Eastern European Committee
From rejection to appreciation of the subject in the Estonian society
Work has gradually shifted towards earlier stages of suicidal process
and towards promotion of mental health in general
Involvement in the WHO and EU projects (Public Health Programme,
FP7) and International networks on suicide prevention and mental
health promotion
Successful suicide prevention in Estonia (2)
Systematic initiatives implemented by ERSI:
Trainings on suicidology for different target groups (primary care specialists,
gatekeepers, volunteers, university students etc)
Establishment of Estonian Lifeline (Eluliin) in 1995 (currently independent NGO)
Consultations and supervision for medical staff and other specialists
Public relation activities and media work to increase awareness and to diminish
taboo and stigma concerning suicidal behaviours
Information to politicians and decision-makers, involvement in expert groups
Draft of national suicide-prevention programme and action plan in 2001
(although officially never approved)
Various international conferences and workshops on suicidology held in Tallinn
(the latest in 2014, ESSSB15, www.esssb15.org)
High-level research (epidemiological, clinical, community based interventions)
Thank you for your attention!
Merike Sisask, PhD
Phone +372 51 66 543
[email protected]
Estonian-Swedish Mental Health and Suicidology Institute (ERSI)
Executive Director and Senior Researcher
Õie 39 Tallinn 11615 Estonia
Phone/Fax +372 651 6550
www.suicidology.ee
Tallinn University, Institute of Social Work
Professor in Public Health
Nõmme Health Clinic
www.tervisekliinik.ee