The Worst Kind of First

According to the World Health Organization (WHO), Lithuania--at the head of a number of other post-communist countries in Eastern Europe--leads Europe in numbers of suicides. In 2001, more Lithuanians died by their own hand than died in car accidents.

And those recent figures even represent an improvement. In 1998, there were 51.5 suicides for every 100,000 people in Lithuania. That number decreased in the following years and has since stabilized at approximately 44 suicides per 100,000 people.

By contrast, suicide rates in Western Europe range from 11 to 36 per 100,000.

WHO has called on all countries to fight suicide as a preventable disease, but some health care professionals in Lithuania are skeptical that their government has even tried. Others, meanwhile, question whether the numbers are right.

Psychology professor Adolis Juodraitis from northern Lithuania's Siauliai University said that mental health has not been a priority in the Baltic nation.

"The government is worried about physical education, but what about psychological conditioning? There are no [suicide] prevention centers in Lithuania," Juodraitis charges. "Even in Soviet Russia in 1920 there were two such centers."

According to Juodraitis, suicide cannot be prevented without more societal attention to the problem. "People feel uncomfortable, unnecessary. Often they begin to use drugs or alcohol, which can also contribute. There are only a few people who are trying to prevent suicides at the moment."

Juodraitis described the way that the problem had been tackled in Hungary, another country with a historically high suicide rate. International and local organizations launched suicide-prevention programs, and some are beginning to bear fruit.

In one such research program, organized by the American Foundation for Suicide Prevention and sponsored by the Open Society Institute, health care practitioners in the Kiskunhalas region of Hungary learned how to better recognize, diagnose, and treat depression. Initial results indicated an 18 percent decrease in suicide mortality.

LOOKING FOR ANSWERS

There are nearly as many theories about the causes of Lithuania's suicide rate as there are cases of it.

The Lithuanian Catholic Church in July 2002 distributed a report blaming "moral crises" for the bulk of suicide attempts. According to the report, people who lose their beliefs begin to doubt their entire sense of the value of life and then lose hope. The report called on society to support all families and individuals who must endure "difficult situations."

Secondary school teacher Indora Savickiene from the northern city of Siauliai opined that modern Lithuanian society sets up many citizens for inferiority complexes.

"Society is divided into two groups: those who can afford everything and live a wealthy life, and those who have practically nothing," Savickiene said. "Besides, a lot of people had very high expectations after Lithuania's [1991] declaration of independence. Now they've lost hope--hope that they will receive what they were promised and hope for what they had faith in, a better future."

One sociologist, Lilija Kublickiene, even has a hypothesis about why it is that Lithuanian men are more likely to take their own lives. According to Kublickiene, the changing social status of men and women has left men unsure of their role. As women get better jobs and unemployment leaves more people without jobs, some men find themselves unable to determine their own worth.

"There is a problem when men think they are not who they have to be," Kublickiene said. "About 30 percent of men think they are not normal."

According to the Lithuanian nongovernmental organization (NGO) the Men's Crisis and Informational Center (VKIC), 72 percent of Lithuanian men think the main attribute of a "normal man" is to earn money.

"The situation in Lithuania has changed and men need to come to terms with that," said Algirdas Meskauskas, one of the founders of VKIC.

More than 80 percent of suicide victims in Lithuania are men. Most are unemployed.
 

LIES, DAMNED LIES, AND ALLEGED COVERUPS

During in the 21st Annual Congress of the International Association for Suicide Prevention (IASP) in 2001, German representative Annette Erlangsen presented specific cases of attempts by Lithuanian authorities to mask murders as suicides. Erlangsen found that most suicides were registered among middle-aged men, and in other countries middle-aged men are most likely to be murder victims. Deaths ruled to be suicides may not require additional police investigation, which can lighten the burden on law enforcement.

According to the main suicide specialist in Lithuania, Danute Gailiene, a report on the possible over-reporting of suicides was presented in the Lithuanian parliament, but lawmakers did not order any kind of investigation into the matter.

Until 1991, both suicide and murder numbers were almost the same in the three Baltic states. After the three countries gained independence, the number of suicides in Lithuania increased as compared with those in neighboring Latvia and Estonia, while the number of murders decreased by 
almost the same number.

"The Baltic countries are very similar in social and economic development as well as in their historical situations. The only reason I can think of for such a different number is the incorrect registration of suicides," said Vlada Stankuniene, the head of the State Demography Study Center.

But whether the numbers are a case of over-reporting or a symptom of larger societal malaise, the suicide rate is not a list that Lithuania wants to top again. Preventing that from happening in future surveys is another hurdle.