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Suicide Becoming Disease in Russia

March 16, 1998

MOSCOW (AP) _ First his health went, then his job, then his wife. After watching his life dissolve, Vladimir tried to take control in the only way he could imagine: killing himself.

It’s long been a solution all too common among Russians when life becomes too painful. And suicides, already high in Soviet times, have soared in the 1990s, cutting across age, gender and class to claim thousands of victims each year.

Even more fail in their attempts, ending up in emergency rooms, psychiatric wards or _ like Vladimir _ in suicide crisis wards of public hospitals.

``I don’t even remember what it was that I swallowed,″ Vladimir said, his fingers fiddling nervously with a neon-orange plastic watch hanging off his bone-thin wrist. ``I just remember feeling like I’d lost everything.″

Suicides shot up 67 percent from about 39,200 in 1990 to 61,900 in 1994, the peak year. By 1996, the number had edged back to 57,900, and preliminary estimates for 1997 point to a further decline, to 54,900, the State Committee on Statistics says.

The level remains extraordinarily high _ weighed against population, Russia’s suicide rate is triple that of the United States and Canada.

Suicides are especially high among Russian men. Russia is the world leader in male suicide, along with Latvia, according to the U.N. World Health Organization.

Psychologists blame the instability this decade has brought, including the fall in standard of living, growth in unemployment and politically or economically motivated migration to other regions.

Vadim Gilod, deputy director of the 60-bed suicide crisis ward at Moscow’s Hospital No. 20, said the ward was a reflection-in-miniature of the stresses Russians face.

``People used to try to kill themselves to solve purely personal problems,″ Gilod said. ``Now the despair is magnified by social failure.″

Vladimir, who asked that his last name not be used, has a history of alcoholism _ an illness that predisposes its sufferers to suicide. Hunched over in a small, sparsely furnished consultation room in the suicide watch ward, he spoke haltingly of one setback after another.

A broken leg. A lost job. Cancer surgery.

Then came the crowning blow, one that still causes his large green eyes to cloud over and his voice to drop to an almost inaudible whisper. His wife announced last year that she wanted a divorce _ though the couple would continue to share the apartment. Her lover moved in, rubbing in Vladimir’s loneliness and humiliation every day.

``I’m not a monk. I need a soul mate,″ mourned Vladimir, 49. ``I couldn’t live just with `hello and good-bye’ each day, seeing and hearing what’s going on but not being able to touch her.

``I couldn’t stand it anymore.″

And so on New Year’s Day he swallowed a bottle full of pills and landed in the hospital, surrounded by others who had likewise decided the only way to cope with misery was to end it all. But they failed.

Now they are getting intensive counseling, in individual and group sessions. Many are on medication. They live in single- or five-bed wards decorated with the patients’ posters and stocked with fruit, cookies and other food brought by visitors.

It could be any other ward in the hospital, except the doctors don’t wear white coats, and patients eat around tables, family style, instead of off wheeled-in trays.

Staff members encourage patients with pats and hugs. The doors are not locked; patients can walk out any time.

However, many don’t feel ready to re-enter the world when their maximum one-month stay in Hospital No. 20 is up. Vladimir had no idea what he would do next.

Most of the ward’s 60 patients are trying to cope with crises in their private lives: grief, abandonment, low self-esteem. Some were brought from emergency rooms; others were referred by Moscow’s crisis hotline or by counselors at walk-in clinics, where increasing numbers of people facing crises are seeking help.

A few of the patients are recovering from drug abuse and alcohol-related psychoses. Most addicts don’t seek help, however, and some experts blame the country’s widespread drug and alcohol abuse for the high suicide rate.

``There’s the constant search for a high, and then the withdrawal symptoms. If they can’t get their dose, they kill themselves,″ said Vladimir Voitsekh, deputy director of the suicide center at Moscow’s Psychiatric Institute.

``So far, we haven’t found a way to reach these people.″

Counselors have also lost touch with many people suffering from chronic mental illnesses since a 1993 reform freed psychiatric patients of mandatory visits to clinics.

All of that has stretched Moscow’s suicide prevention network to the limit.

There is a continual waiting list for Hospital No. 20, which despite its mismatched furniture and peeling linoleum is regarded as the best equipped of the 16 city hospitals that have unlocked suicide wards.

The seven lines at Telephone of Trust, the only crisis hotline for Moscow’s 10 million people, are jammed day and night. Counselors can handle only about 300 calls daily, said Sergei Trofimov, director of the city-financed hotline since its founding in 1982.

``It’s very little,″ Trofimov conceded.

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