כל העולם כולו גשר צר מאוד

1. כל העולם כולו גשר צר מאוד במחלקתך אירעו שני מקרים סמוכים של התאבדות ממגדל, המפורסם בעיר כמקום אטרקטיבי להתאבדויות. למחרת מנהלת המחלקה מעלה את השאלה האם יש מרכיב של "הדבקה" בהתאבדויות ואולי חולים נוספים יתאבדו כעת? האם על הפסיכיאטרים לדאוג כי לא תהיה נגישות למטופלים לגג המגדל- מה עמדתך? האם קיימת הדבקה בהתאבדויות והאם כדאי לאבטח מקומות פופלריים להתאבדות? מתמחים: אביבה כהן – הדסה נובלה דויטש – טירת הכרמל נועה קלמן – לב השרון ברוך שי נוישטטר – סורוקה נועה ורדי – מרכז קהילתי ע"ש בריל ת"א מנחים: פרופ' יורם ברק – אברבנאל דר' שמואל הירשמן – שער מנשה.

2. דודו

3. Cluster suicide – definition Point Cluster: A temporary increase in the frequency of suicides within a small community or institution, relative to both the baseline suicide rate before and after the point cluster and the suicide rate in neighbouring areas

4. Cluster suicide – definition Mass Cluster: A temporary increase in the total frequency of suicides within an entire population relative to the period immediately before and after the cluster, with no spatial clustering

5. Cluster suicide – definition Site Cluster: Specific sites and landmarks that become spots for repeated or frequent suicides . Highly publicized locations act as magnets for people suggesting that the mystique of particular locations adds to their attractions as sites for suicidal attempts

6. Social models • The Werther Effect - a massive wave of emulation suicides after a widely publicized suicide. The majority of the suicides will take place in the same or a similar way as the one publicized. • Herd Behavior (Social Proof) - When people are unable to determine the appropriate mode of behavior, they will deem the behavior of others as appropriate or better informed. (Cialdini:1993) • Social learning theory – Identification of the imitature with the model as a nesseciery prequisite of imitative behaviour (Bandura:1986)

8. Copycat vertical identification people are more likely to identify with individuals who are socially superior, such as celebrities. horizontal identification social similarity between imitator and model (e.g. same age group and sex) is an important factor in identification and in imitative behavior.

9. Media and Cultural Influence on suicide rates Niederkrotenthaler T, et. al. Copycat effects after media reports on suicide: a population-based ecologic study. Soc Sci Med. 2009 Oct;69(7):1085-90.

10. Positive Immediate telephone or online help Negative Suicide encouraging sites : suiciders’ chat rooms, instructions sites Media and Cultural InfluenceInternet & Press

11. What is the world most popularsuicide site?

12. Beachy Head LOCATION: East Sussex, England, United Kingdom BODY COUNT: About 500 suicides (approx. 20 per year) 3rd place

13. Golden Gate Bridge LOCATION:San Francisco, CaliforniaBODY COUNT: Over 1,500 (approx. 30 per year)

14. Aokigahara LOCATION:Mount Fuji, JapanBODY COUNT: Countless(approx. 70 per year)

15. Suicide at Famous Sites • Suicide magnet • Accessibility, lethality amplify suicidality in vulnerable individuals • Romantic final exit (Mystique) • Experienced transcendence - Egocide • Guaranteed notoriety Gunell D,1997,Acta Psychiatr, Scand Mel Blaustein,2009,AJP

16. Prevention Hawton, The Lancet, 2009

17. Do Suicide Barriers Help? Public survey answers: • Majority -74% said that they would have found another way. (Miller, 2006, Suicide and Life-Threatening Behaviour) In reality: • Only 6% of 515 people who were restrained from jumping actually committed suicide in future (Blaustein, 2009, AMJ)

18. Do Suicide Barriers Help? Bennewith, 2007, BrJPsych, Blaustein, 2009, AMJ

19. אסף גולדרינג מוני פאנן