Dialogue with Alexandra Fleischmann

Dr. Alexandra Fleischmann, is a scientist from the Department of Mental Health and Substance Abuse at World Health Organization (WHO), specialized in suicide prevention strategy​.

In 2012, 800 000 people die by suicide every year. It’s more than e.g., malaria, breast cancer, dementia. Is that number evolving these past seven years ?
The number of suicides has been quite stable around 800 000.

For each suicide, there are likely to be more than 20 others making an attempt. Could you explain how this phenomenon appears to be contagious ?
Suicide is death by suicide (mortality). Suicide attempt is when someone attempts to take their life, but they do not die. Suicide deaths can be estimated from death registration. However, suicide attempts are rarely registered. Therefore it is a rough estimate that suicide attempts are about 20 times more than suicides.

Clusters of suicide is when there are more than one cases in the same geographical area in a short period of time.

Imitation is often used in the context of reporting of suicide by the media when the reporting of it leads other people to take their life.

Contagion is less used and would be related to clusters and imitation.

75% of suicides occur in Low and Middle Income countries. Wich countries are the most concerned ?
WHO does not rank countries. Suicide happens in all populations around the world, there are more people living in low and middle income countries, hence there are more suicides in these settings, most populous countries like India and China have most suicides.

How is it that Guyana, Korea, Sri Lanka, Lituania, Surinam, Mozambic and are in the top 6 of the most suicidal countries ?
Suicide is complex and there are various risk factors involved, from easy access to means, mental and substance use disorders, violence, loss, economic factors, discrimination, disasters, and one would have to look which are the factors most at play in a given setting.

Why is suicide so massive masculine in Russia or India, and feminine in China ?
The male to female ratio is higher in the Russian Federation than in India and China. One hypothesis is that when in self-poisoning highly lethal poisons like pesticides are used, there are more women who die who would otherwise live after having self-poisoned with medication.

Pesticides, hanging and firearms are among the most common means of suicide globally. Could you explain why pesticides account for an estimated 1/5 of the world’s suicides ?
They are easily accessible in households of agricultural areas in low and middle income countries.

Suicide accounted for 1.4% of all deaths worldwide. 15th leading cause of death in 2012. Is this number also evolving since the past 7 years ?
Still around the same.

About the Author
Alexandre Gilbert is the director of the Chappe gallery since 2005. He lives and works in Paris.
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