The island has, over time, one of the highest numbers of suicides compared to the rest of Greece. And that may be the fear of the “crazy” rant. Mental health experts explain to “K”
It happened in 2008. He didn’t hear voices like he used to. At that time he felt restless. He wasn’t sleeping well. Sometimes he took the medicine, sometimes he didn’t. One night he woke up and decided he didn’t want to live anymore. Inside the closet he saw his rifle. He filled her. He rested the barrel under the chin. He pulled the trigger. He was 20 years old.
“My bad. The only mistake I’ve made in my life.” This is how F. describes in “K”, sixteen years later, his suicide attempt in Moires, a town in southwestern Crete. He underwent 12 operations. His face remains disfigured, but, miraculously, he lived. In 2017, his brother committed suicide. He was hanged.
“I found him,” he says to “K”. It was one of 49 suicides that year in Crete, which for the last 25 years has been consistently at the top of the list of suicides in Greece, often finishing first. The number of suicides in the country is so far this year, according to Kyriakos Katsadoros, scientific director of the “Klimaka” Suicide Observatory.. Recently, in less than two weeks, at least four people took their own lives on the island. Why are there so many suicides in Crete?
“It has kept me busy since I came here,” he tells “K”. Alexandros Vgontzas, Emeritus Professor of Psychiatry at the University of Crete, and Penn State University in the USA. Since 2009, when he moved from Pennsylvania to Heraklion, he started investigating the issue of suicides. According to a publication by him and other researchers in BMC Psychiatry in 2018, from 1999 to 2013, the number of suicides per 100,000 people of the population was 2.4 for Greece, and 5.2 for Crete.
The rates were worse in the male population, for which the average suicide in Greece was 5.3 per 100,000 people, while in Crete the number was more than double, 10.8. This particular trend does not seem to be changing. According to ELSTAT data, published by the “Klimaka” Suicide Observatory, in 2021, when Crete had the second highest rate of suicides in the country, per 100,000 people, 6.6 took their own lives. The following year, according to the “Scale”, it finished first, with 97 suicides.
From 1999 to 2023, there were an average of 45 suicides per year in Crete – “one of the highest numbers was 61, and it happened in a time of prosperity for Greece, in 2001,” emphasizes Mr Vgontzas, who is scientific manager of the Mobile Mental Health Unit of Heraklion, adding that usually the reasons are not financial.
“Our experience shows that most suicides in Crete are linked to mental illness, with serious cases that are often undiagnosed, and even if they are diagnosed, strict follow-up is not followed.”
The whispers
“She’s not well, she’s going to see a psychiatrist.” “To the mad doctor he goes.” “He’s on medication.” “He hears voices.” The whispers, from acquaintances, neighbors, relatives, are deafening – this is what members of the “En plo” group, of the Day Center that started in Moiras in 2014, together with the Mobile Mental Health Unit of Heraklion, and the last five years is hosted in the cultural center of the metropolis. “Since we were kicked out by the municipality,” says the psychologist and head of the Center, Vasiliki Galanopoulou, to “K”.
Most members come to the Center, which provides both psychiatric monitoring and psychological support, from the surrounding villages – Faneromeni, Petrokefali, and Zaros, among others. They suffer from various mental illnesses – from severe depression to bipolar disorder – and all of them tell “K” that in addition to their health issues, in Crete they also have to manage the stigma that the disease carries.
They hear people talking about them when they pass by – “they say we’re not normal to go to the group,” says 73-year-old E., which made them initially reluctant to seek help from public structures, where and other villagers would see them, and then be reluctant to go out in public with other members of the group.
“I feel bad that they don’t understand that it is a treatment for the good of our soul, so that we can be well too, not to be fingered,” says the 61-year-old Vasiliki. “I think about the stigma, but I try to look at it positively – it’s better to be told I’m not well, to live with the taboo, than to lie in bed. I have been hospitalized in the psychiatric hospital for nine years – since the mobile unit started,” says 50-year-old A.
The stigma, of course, does not exist only in Heraklion, although in recent years most cases of suicide have occurred here, a fact that Mr. Vgontzas links to the fact that “eastern Crete lacks necessary psychiatric services”, more so than the western one. For example, the Child Psychiatry Clinic of PAGNI is permanently closing. Even the mobile unit has funding until July.
Christos Mokkas, director of the Mental Health Center of Agios Nikolaos and responsible for the prefecture of Lasithi, tells “K” that there are three psychiatrist positions at the Center, but for the last three and a half years he has been alone. The stigma was stronger in the past, but it still exists. “You also see it in educated people, they come very hesitantly,” he emphasizes. Twice a month he goes to Ierapetra and once a month to Sitia. “But patients prefer to travel many kilometers to meet them in Agios Nikolaos, than to be seen by someone they know.”
Things are better in Chania than in Heraklion in terms of people’s familiarity with mental health services, comments the scientific manager and head of the Mental Health Center, Anna Georgoudaki – “perhaps because the psychiatric hospital existed here until 2005” – , where they also face understaffing problems. “We used to be eight, now we are three. Each of us has 700 cases, we are exhausted,” he emphasizes. In the villages, however, the taboo remains.
“In closed societies, in small villages, we will see people who have a disorder directly acquire the stigma of the “village madman”. There are cases where the relatives themselves hide their people at home, so that the problem does not come out”, says Michalis Printezis, head of Social Welfare of the Municipality of Phaistos.
“tough boys kill themselves”
The second factor that is “blamed” for the large number of suicides has to do with the culture, with the identity of the Cretans, especially the men. “One view, not based on data, attributes the high suicide rate to cultural factors, to the Cretan temperament, to pride,” says Mr. Vgontzas. According to Mr. Mocca, men, in particular, see mental problems as a sign of weakness. “Cretans are very proud, they do not accept the defect, the disease – we have seen them diagnosed with cancer and kill themselves because they cannot accept that they are suffering”, emphasizes Ms. Georgoudaki.
F.’s brother also faced psychiatric problems. As is often the case, according to psychiatrists, there is a history of mental illness in their family, as their father is psychotic. But F.’s brother refused to take medicine, refused even to admit that he was sick. “He was ashamed”, explains F. to “K”, “he didn’t go to the appointments with the doctors”. People who knew him describe him as “a bunch”. He pushed hard, he drove fast, he liked the image of being strong. “He could not accept his condition, unlike F., who whenever he was not well, he came to the emergency room,” Katerina Tsikala, who was the director of the Moira Health Center from 1994 to beginning of the year.
“Crete presents a highly competitive social way of life,” says anthropologist Michael Herzfeld, professor emeritus of Social Sciences at Harvard University, who has done many years of research in Crete, having written two books about the island. “In such an environment,” he continues, “the fear of failure plays a dangerous role in male identity, and this phenomenon has taken on serious dimensions under pressures arising from consumerism.” Cretans constantly feel the need to demonstrate their masculinity – “a man who doesn’t like to behave like this, or isn’t able to express himself like this, will feel condemned by society”, he points out to “K”.
Cretan society is open, but it has some red lines, says Aris Tsantiropoulos, associate professor of Social Anthropology at the University of Crete. “Shame and honor are together; there is still in Crete what is transferred as selfishness, duty, blood,” he says.
In Galia, a quiet village about 10 minutes from Moiras, someone committed suicide. About two weeks ago, he was found hanged. Most residents don’t want to discuss it. They say they went to the funeral, but they don’t know anything. Some report that it was not suicide. Those who recognize her as such say that she was a romantic disappointment. “Very often, residents attribute them to romantic disappointments,” comments Mr. Vgontzas. In the village, the self-made man was not seen. He was not circulating, he was not appearing. “It didn’t give a goal,” says a Galian woman, “the village wonders how it got to this point.”
This is not the first suicide in Gaul. One resident says his uncle and cousin had both committed suicide – “it must be hereditary”. And another fellow villager had hanged himself a few years ago, and his father and mother had also committed suicide – “they had no financial problems”, he emphasizes.
In the cafe of Kostas, where there is a large green canvas with a photo of Andreas Papandreou, and in the forecourt cats sunbathe undisturbed even when small children pass by on motorbikes, some residents of Galia gather in the early afternoon. He brings out raki, most people want coffee.
“If you are not strong”, Kostas tells “K”, “they might eat you – there is ego in Crete, society is difficult”. It has happened that they make fun of people with mental problems in the village, he says, “teasing” them. But things are changing. A friend of his tells us that he takes anti-depressants. He calls them “pills”. Kostas shakes his head condescendingly, his friend has had a hard time. Even self-handicap, he does not see it as a weakness. In Crete, this concept does not seem to exist. “Those who kill themselves”, he tells “K”, “are strong boys”. “Tough boys kill themselves.”
kathimerini.gr
