1. SUPERIOR HEALTH COUNCIL 1 2 nd EuSANH meeting 29-30 November 2007 - Luxembourg Depression Depressiveness Suicide Prof. Isidore PELC

2. SUPERIOR HEALTH COUNCIL 2 FPS MISSION Together with our highly trained and motivated team, we develop and issue a transparent, dynamic and scientifically-based policy through dialogue. This policy aims at ensuring and improving the quality of life (humans, animals and plants), food and the environment both today and in the future.

3. SUPERIOR HEALTH COUNCIL 3 SHC MISSION In order to garantee and improve public health, the Council draws up scientific advisory reports that aim at providing guidance to policy-makers and health professionals. Thanks to its network of experts and its members of staff, the Council issues impartial and independent advisory reports that are based on a multidisciplinary evaluation of the current state of the art of science. The Council writes and publishes its reports either on its own initiative or at the request of the health authorities.

4. SUPERIOR HEALTH COUNCIL 4 Fields of activity Area 1: mental health: behaviour, psychosocial factors, social inequality, addiction, … Area 2: physical environmental factors: ionising radiation, non-ionising radiation, noise, … Area 3: chemical environmental factors: chemicals, pollutants, biocides and pesticides, … 6 areas

5. SUPERIOR HEALTH COUNCIL 5 Area 4: food: healthy food, additives, food safety, wrapping, novel foods, contaminants, microbiology, … Area 5: biological problems 1: blood and derivatives, cells, tissues and organs … Area 6: biological problems 2: infectiology, vaccines, hygiene issues, …

6. SUPERIOR HEALTH COUNCIL 6 Types of advisory reports : input Ad hoc Routine Urgent Own SHC projects “Open consultation”

7. SUPERIOR HEALTH COUNCIL 7 DEPRESSIVENESS DEPRESSION SUICIDE and SUICIDE

8. SUPERIOR HEALTH COUNCIL 8 Identifying the risk and protective factors plays an important role in preventing suicides and depressions. An overview of these factors could be provided to any health professional who is likely to be faced with the issue of suicide or depression.

9. SUPERIOR HEALTH COUNCIL 9 The conclusions drawn on the relation between mental disorders and suicide clearly indicate that an efficient strategy of suicide prevention is the early diagnosis and adequate treatment of mental disorders, also to consider some “less classical diagnosis” so as “depressiveness” with a high level of suffering and risk for suicide

10. SUPERIOR HEALTH COUNCIL 10 The promotion of mental health The use of health services for mental disorders The fight against the stigmatising of these disorders The access to care are the cornerstones of a policy that aims at reducing the prevalence of depression and suicide.

11. SUPERIOR HEALTH COUNCIL 11 With attempted suicides, to avoid fatal suicidal behaviour, particular attention should be paid to providing adequate care and follow-up. This is especially true in view of the fact that the actions aimed optimising the quality of the care and follow-up provided for attempted suicides turn out to be particularly efficient. In our country, systematising the psychosocial care provided to those who have tried to commit suicide, is of crucial importance.

12. SUPERIOR HEALTH COUNCIL 12 General practitioners are the health professionals who are most frequently consulted, even for emotional reasons. As a result, they play a key role in : – the early diagnosis and treatment of depression and other mental disorders – preventing suicides – the follow-up care provided after attempted suicides. Yet they have to be given the means to perform this function properly (continued training, easy access to mental health network, making medical and psychosocial consultations more financially attractive…).

13. SUPERIOR HEALTH COUNCIL 13 Over the last few years, certain emergency services have considerably improved the quality of the manner in which suicidal individuals are received and taken care of. Micro-networks between general practitioners and mental health specialists have been formed in an informal fashion. Nevertheless, it is necessary to generalise and systematise these practices in order to prevent these patients from simply being sent home after their attempted suicide, on the ground that their physical health has been restored. One could also consider organising training, raising emergency service staff consciousness, and providing support to relieve the stress involved in such situations.

14. SUPERIOR HEALTH COUNCIL 14 After this report has been commented by the general board of the SHC and transmitted to the Ministry of Health who decided to improve identification, support, acute care and psycho-social follow-up of these patients with high risk of suicide. Implementation of three pilot programs and their evaluation show as a result, better knowledge and use of good practices.