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The Depression and Suicide Prevention Program has been successfully launched in South Africa. South Africa has become the first country outside the United States to implement the program, which addresses the very serious need for education and information about depression and suicide.

The program was originated by the US-based Global Alliance of Mental Illness Advocacy Networks (GAMIAN), which has made the program available for use by support groups and healthcare professionals around the world. The program is designed to combat the immense impact on society of depression and the most serious consequence, suicide. With depressive disorders constituting approximately eight percent of the global economic burden, the new program will address a desperate need, and should have marked effects in lowering suicide rates throughout the world. The Depression and Suicide Awareness Program is funded by a grant from Eli Lilly and Company.

In South Africa, the Depression and Anxiety Support Group is implementing the awareness program in both urban and rural areas around the country, as part of its commitment to mental health care issues affecting the lives of all South Africans. The program is particularly relevant to the local context, since estimates predict that in South Africa, between six and 19 people out of 100,000 successfully commit suicide each year, with up to eight times as many completing unsuccessful suicide attempts. Over 40 presentations will be conducted throughout the country during 1999, and will be presented by senior psychiatrists and members of the Depression and Anxiety Support Group’s Scientific Advisory Board.

Dr Franco Colin, a prominent Pretoria psychiatrist, launched the first Depression and Suicide Prevention Program in Benoni in early April. The meeting was sponsored by Eli Lilly, and was attended by 26 medical professionals, including psychiatrists, a gynaecologist as well as a district surgeon. Dr Colin stressed the importance of being alert to depression, emphasising that “early recognition of mental disorders in general is vital to detecting signs of suicidal behaviour”. During the course of the ninety minute program, he illuminated upon the latest developments in depression and suicide and then presented an overview of depressive symptoms and key indicators of suicide. “Educating both professionals and the public to behaviour indicative of suicide is necessary to alleviate the problem and reach out to those who are suffering”, he commented regarding the importance of the program. Aspects of the case history which may suggest suicidal behaviour were highlighted, and appropriate interventions discussed.

“Surgeon’s patients bleed to death, patients of Psychiatrists commit suicide” was one of the strong comments made during the course of the evening. Common consensus among the audience was that there was a lack of knowledge and understanding of depression and particularly suicide among doctors in South Africa (doctors commented that training at Medical School had never included specific attention on suicide and that suicide is only once discussed in lectures at Medical Schools in South Africa). The use of specific and appropriate case studies further benefited the understanding of all present. According to Dr Clare Berman, a medical doctor specialising in counselling, “The program was very interesting and informative, and was very well presented”. “As a result”, she added, “we have been given insight into the seriousness of depression and suicide, and are better equipped to deal with these conditions”. Dr Fazeela Meeron, a Benoni General Practitioner, added that South African doctors generally do not take Psychiatric illness seriously enough : “The presentation has addressed a very worthwhile topic, and has highlighted awareness necessary for depression and suicide to be taken more seriously”. Zane Wilson, Founder and chairman of the Depression and Anxiety Support Group, believes the talks (and the program in general) “make a tragic topic very interesting and informative, allowing the audience to gain maximum benefit from the wealth of information presented”.

Several important questions and points were raised at the very successful presentation in Nelspruit, which attracted the participation of 45 doctors. Questions centred on the very difficult treatment of suicidal patients who resist intervention. According to Dr Annemarie Potgieter, who presented the Nelspruit program, much concern was raised regarding the insufficient and inappropriate treatment given to suicidal patients by medical aid companies. As a whole, Medical aids in South Africa do not fund treatment for suicide attempts until the patient’s condition has stablised. This is a particularly disturbing obstacle in the way of affording patients improved access to medical resources, and is an area in which the Depression and Anxiety Support Group will be aggressively working to bring about change. “Most of the audience were particularly surprised to learn that suicide is the second greatest cause of death among women, after tubercolosis”, said Annemarie.

Questions were raised regarding the treatment of depression in the elderly, particularly at the Stellenbosch venue, where Dr Peter Oosthuizen fielded many such enquiries. Several audience members elaborated on the difficulties in distinguishing between senility and depression in the elderly, and enquired about treatment interventions and medication dosages recommended for the treatment of the elderly. The potentiality for suicide among adolescents was also discussed. Another aspect of the Depression and Suicide Prevention program in South Africa will focus entirely on adolescents during the second half of this year [schools and institutions interested in hosting such talks should make contact with the Depression and Anxiety Support Group - further information can be obtained by calling the Support Group at (011) 783-1474/6 or (011) 884-1797]. There was interest expressed as to the extent that psychotherapy should be included in the treatment of suicidal patients.