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"We are not tackling the problems as we should do, simply because authorities have failed to accept the fact that suicides are a contributing factor," Tatyana Dmitriyeva, director of the Serbsky Social and Forensic Psychiatry Research Center, a state medical research center in Moscow, told IPS. "There have been on average 60,000 suicides in Russia every year over the last 12 years, and all of them could have been prevented."
About 20 percent of suicides are by mentally ill people, but social and economic factors create a state of mind in which a person is more likely to take the final step, she said.
"It simply shows the extent of the crisis in the health system and the inability to bear economic difficulties that is driving people into a difficult mental state," she said.
Dmitriyeva said Russia ranks second after Lithuania in per capita suicide rate.
She said people aged 45-55 and teenagers are at greatest risk. The Koryak autonomous region in the far east, the Komi republic in northeastern Russia and Udmurtya in the Volga region in central Russia had the highest rates, she said. Suicides are rare in the Caucasus region despite the violence around Chechnya.
Dmitriyeva attributes such regional variation to religion.
"The Orthodox Church does not have deep influence in the republics of Komi, Mari El and Udmurtya, where pagan beliefs have persisted and crossing the threshold between life and death is considered a proud and brave act," Dmitriyeva said.
Suicides can be cut by reducing alcoholism, the head of the Moscow Protestant Chaplaincy, Pastor Robert Bronkema, told IPS. Legislative measures are needed to increase the cost of alcohol and discourage drinking, he said.
People also need to be able to talk more about their suicidal thoughts, he said. "In the United States, suicide is also a real problem, but not even close to the level of what we see here in Russia. There is a real awareness of suicide in the United States, and it is not an issue that people are afraid to mention."
But national comparisons can be tricky.
"I do notice that people in European and former Soviet countries are liable to commit suicide much more than those from poor countries," said Bronkema. "But in fact it is very difficult to find suicide rates for poor countries because there is not much reporting from those countries in that field."
Iosif Diskin, co-chairman of the Center for National Economic Strategies in Moscow, said Russia is lagging behind in providing economic security and adequate health and welfare services, leading to high death rates.
"People are not acknowledging the reality or analyzing the situation," he said. "We hear of industrial and traffic accidents, among the soaring number of suicides which are part of the key reasons for the decades long demographic crisis."
Dr. Raphael Quartey from the State Medical Academy in Krasnodar in southern Russia, about 2,000 kilometers from Moscow, said there appeared to be fewer suicide cases during Soviet days, although the economic situation was no better.
But here, too, there is some concern over official under-reporting. "We know that not everybody can cope with the new capitalism that has emerged in the country, and could as a result end up in depression leading to suicide," Quartey said.
But suicidal behavior is not easy to explain through such factors, he said. The biology of the brain, genetics, psychological traits and social forces can all contribute to suicide. People commonly attribute suicide to external circumstances such as divorce, loss of a job, or failure in school, but medical psychologists and sociologists believe these events are triggers rather than causes in themselves, he said.
"The majority of people who kill themselves suffer from depression that is often undiagnosed and untreated. Because depression so often underlies suicide, studying the causes of depression can help scientists understand the causes of suicide," Quartey said.
Mikhail Zurabov from the Russian Health and Social Protection Ministry told IPS that "the ministry is taking measures to solve the country's health crisis including growing suicide among the population, and the government plans to support low-income families under priority projects."
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