Research on Suicide in Malta &
Evaluation of SPOT Service
18/09/2023
Author: John
In 2023, MAS was contracted by VSM to undertake research on suicide in Malta that included an evaluation of VSM’s SPOT (Suicide Prevention, Outreach, and Therapeutic) programme. The research was funded by the European Social Fund (Reference: ESF.02.161/01) and included both quantitative and qualitative components.
Objectives
The broad objectives of the study were threefold. First, to explore the relationship between adverse childhood experiences, alexithymia, and lifelong suicide ideation through the application of established psychometric tools (Adverse Childhood Experience questionnaire and Toronto Alexithymia Scale) and surveying a representative sample of the Maltese population.
Second, to identify gaps in knowledge, practice, and policy with respect to how the phenomena of suicide and suicidal ideation are represented, navigated, and treated in contemporary Malta. Both the ‘individual’ and ‘public’ approaches to suicide and self- harm were relevant to this objective.
Third, to evaluate the effectiveness of VSM`s SPOT service in preventing suicide and mitigating its short-term and long-term impacts on those who have experienced it directly (ex. ‘survivors’ who have attempted suicide, individuals with suicide ideation) and indirectly (ex. family members of those who have died by suicide).
Methodology
Seven-hundred and fifty-four (754) valid responses were collected through the survey that was used to address the first objective. Ten (10) in-depth interviews with mental health professionals who work with persons who are impacted by suicide and suicidal ideation were conducted to address the second and third objectives. A further five (5) in-depth interviews with SPOT professionals were conducted to collect more specific data and insights towards the third objective.
Conclusion
In sum, three conclusions were drawn from the results of the study. First in Malta, the phenomena of suicide, suicidal ideation, and self-harm are both pervasive and underreported. Pervasive because – due to the smallness of Malta and familiarity between members of local communities – cases of suicide and suicidal ideation impact both the actors and those who are and become close to them (ex. friends, relatives, and members of their communities, but also medical and other professionals who respond to these cases) in significant ways. Underreported because suicide retains a ‘taboo’ property that discourages public debates about it, and therefore, even though it is not uncommonly dealt with privately. As a result, it becomes ‘invisible’ and is often absent from public narratives, including those that have to do with mental health.
Second, the simultaneous pervasiveness and invisibility of suicide in Malta complicates its prevention and treatment. Not only because in this context it becomes a source of shame and stigmatization for the actors and their kin, but also because it is considered ‘exotic’ or ‘alien’, and as a result, one is often unprepared when impacted by its occurrence.
Third, given the previous two points and as confirmed by all professionals who were interviewed during this study, SPOT constitutes an indispensable service to a growing number of clients who are impacted by suicide and suicidal ideation. The service is necessary for two reasons. First, it provides free access to unique support, treatment, and prevention services within a contained and adequate environment in a non-institutional setting. Second, these targeted services are long-term, with SPOT professionals following and supporting clients over extended periods through their trajectories of treatment and recovery.
This research shows how the mitigation of the suicide phenomenon in Malta involves specialized, complex, and long-term operations at both public/cultural and private/psychological levels. Given SPOT`s unique competencies and services in this respect, any abrupt suspension of SPOT services (ex. through lack of funding) would pose a serious risk to hundreds of clients who are currently benefitting from these services and who by all accounts would be unwilling and/or unable to receive the same services through other organizations.
