Joan Carles March: "The person who commits suicide does not want to die, they want to stop suffering"

PalmaJoan Carles March Cerdà (1960) is a Doctor of Medicine and currently a professor at the Andalusian School of Public Health, of which he was director. He is one of the most media-friendly island doctors. This resident of Pollença, based in Granada, has just published Más de 11 vidas, a collection of testimonies from people with suicide attempts, their families and survivors, as well as experts in the field.

The book is a tool to break the taboo surrounding this reality and give voice to experiences, often silenced by prejudice, delving into the complexity of this world. It was a personal episode that led him to delve into this area and, since then, he has argued that the key to prevention necessarily involves communication. "Silence kills, but talking about it helps," he has reiterated on several occasions during the interview.

What prompted you to write Más de 11 vidas and talk about such a complex topic as suicide?

— Has writing this book changed your understanding of suicide, even on a personal level?

Has writing this book changed your understanding of suicide, also on a personal level?

— Yes, very much. Above all, it made me understand the level of suffering behind it, because I was not aware of the emotional and psychological disorder that the suicidal death of someone close, whether a family member or a friend, generates in people. What I have discovered is a world I did not know, the world of survivors, because I had a more professional view of it, from psychology and psychiatry, but I had not had such direct contact with this pain. I have found very affected people, people who have had a very bad time, but also people who explain that one can move forward, that life can be rebuilt, even if what has been lost is not always fully recovered. It has also made me see and value, even more, grief and support groups. Although at first talking about it again makes them relive the pain, it is an environment where they see that they are not alone and that there is a way out, a light at the end of the tunnel.

Suicide continues to be a major taboo. Why is it still so difficult to talk about it openly?

— I believe there is something we must keep very much in mind, and that is that silence kills and talking about suicide helps and heals. People who have gone through this often feel guilt, shame, and rejection, and this weighs heavily. Suicide is a taboo subject for many centuries; there is a historical and cultural component. For centuries, religion prohibited talking about it openly, which has been passed down from generation to generation and has remained in society, even though it is now detached from the religious world. Even today, it is an uncomfortable and painful topic. Over time, I have learned that one of the keys is not to judge, because if someone feels judged, they will not speak. That is why we must normalize talking about suicide and create safe spaces. There are very hard stories, like people who cannot touch the belongings of a deceased family member, or a mother who did not make her son's bed because she had the feeling that he would return one day.

What are the main myths or misconceptions about suicide?

— There are many myths, such as thinking that all people who commit suicide have a mental disorder, when this is not true, or that someone who commits suicide wants to die, when in reality what they want is to stop suffering. It is also false to think that someone who tries it once will try it again, or that someone who says it won't do it, when in reality, when someone verbalizes these ideas, they should always be listened to. Cries for attention regarding suicide do not exist; if someone verbalizes it, it is because they have the idea in their head, not because they want more attention. Another myth, and one that has deeply ingrained itself in society, is that talking about suicide incites it, when in reality, if done well, it helps. And it is also false that it is always an impulsive and unpredictable act, because in many cases it can be prevented.

Can suicide be prevented?

— Yes, it can be prevented, and the first key is to talk about it and the second is to listen to the person, make them feel that they are not alone and that there is someone nearby. It is also important to facilitate professional help, create support networks and have accessible resources in times of crisis, such as phones and trusted people. Another key thing is that the person has a social or family circle with whom they can talk when they are feeling unwell. It also helps to take care of physical health, nutrition, and maintain social relationships, because all of this protects. In any case, for me, one of the most important things is to avoid attitudes that judge or trivialize suffering, because when someone expresses these ideas, it is real and must be taken seriously.

What role should the media play?

— The media play a fundamental role, one of the most important if we talk about suicide in general and not about a specific case. Suicide is a very important public health problem, with thousands of cases every year in Spain. The media can help or harm depending on how the information is presented, and therefore they must be responsible, avoiding sensationalism, not explaining methods or places, and not simplifying the causes. Moral or romanticized explanations should also be avoided, such as saying that he committed suicide for love or for dignity, and it should not be presented as a way out or a solution. The media must play an informative role, both to make public that it is a reality and a public health problem, and to offer tools and publicize the helplines for vulnerable people in this regard.

How can we detect warning signs without falling into alarmism?

— There are various signs such as social isolation, behavioral changes, expressions of hopelessness, feeling like a burden, expressing intense emotional pain, and not finding meaning in life, among others. Also, alcohol or drug consumption or a drop in usual performance are important indicators. Normally, drastic changes in people's lives and substance use and abuse are key indicators. When these signs appear, they cannot be ignored and action must be taken.

Which groups are especially vulnerable?

— Men have a higher risk of completed suicide, this is an objective and statistics-based fact. If we talk about groups, I would mainly highlight the elderly who live in situations of unwanted loneliness, people in social exclusion, those who have suffered abuse, bullying or violence, in addition to immigrants in precarious situations and people with economic or relationship problems.

Do we live in a more emotionally fragile society?

— What have you learned personally after writing the book?

What have you personally learned after writing the book?

— I have learned above all the importance of social interaction and not leaving people all alone. When someone says they can't find meaning in life or that they are very bad, we cannot look the other way, but rather we must truly listen, be close, and help seek professional support.

What message would you send to someone going through a moment of great fragility?

— I would tell him not to face it alone, to talk about it with someone, with a friend, a family member or a professional, because there is always someone nearby who can help.