US embassy cable - 05VILNIUS972

UNCLAS SECTION 01 OF 02 VILNIUS 000972 
 
SIPDIS 
 
SENSITIVE 
 
STATE FOR EUR/NB 
 
E.O. 12958: N/A 
TAGS: ECON, PHUM, PGOV, KPAO, LH, HT35 
SUBJECT: WHY DO SO MANY LITHUANIANS COMMIT SUICIDE? 
 
REF: 03 VILNIUS 643 
 
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SUMMARY 
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1. (U) Lithuania, a dramatic success story in so many 
ways, is the suicide capital of Europe, with 40 suicides 
per 100,000 residents each year.  Teens and middle-aged 
men are most at risk.  The bustling economy and expanded 
social protections have failed to lower the suicide rate, 
which has been steady for the past 10 years (reftel). 
The GOL has developed promising strategies to attack the 
problem, but they remain unimplemented because of a lack 
of funding and intragovernmental coordination.  End 
Summary. 
 
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WHO COMMITS SUICIDE AND WHY? 
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Youth Face High Rates of Institutionalization and Crime 
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2. (U) Thirty-eight per 100,000 boys commit suicide in 
Lithuania, the highest rate among the 35 European and 
Eurasian countries surveyed by the WHO.  Lithuanian State 
Mental Health Center data indicate that 33% of school 
pupils consider committing suicide, and 5% attempt it. 
The number of suicides among adolescents 15-19 years has 
fluctuated but remained high (56 in 2001, 66 in 2002, and 
49 in 2003). 
 
3. (SBU) According to the State Mental Health Center, 
suicides among youngsters are driven by conflicts at home 
and school.  A study notes that 33% of pupils complain 
that they are being bullied and teased, 20% that teachers 
tease them, 13.4% that they are beaten up or abused at 
school, and 12% that teachers abuse them.  Schools offer 
lectures on the harm associated with drug use, but not on 
bullying and intolerance.  Boys develop aggressiveness 
towards society at large as well, which results in 
juvenile crime.  Fifty-five percent (55%) of juvenile 
offenders surveyed by the Ministry of Interior live in 
broken families. 
 
4. (U) Currently about 14,000 children live in state 
institutions such as orphanages, giving Lithuania one of 
the highest rates of institutionalization in Eastern 
Europe.  The problem manifests itself when these children 
reach the age of 17 years and enter society.  Having no 
family and no societal support, they often become 
criminals or victims. 
 
5. (U) A lack of societal tolerance and increasing drug 
use also appear linked to suicide.  According to a WHO- 
funded study, only 42% of Lithuanians think tolerance in 
marriage is important.  Children, seeing intolerance at 
home, don't exercise tolerance at school.  Some of them 
succumb to depression and resort to suicide.  The 
increased availability of narcotics in Lithuania 
(imported and domestically produced) combined with socio- 
economic problems has led to the increased consumption of 
narcotics and to alcohol and chemical substances abuse by 
adolescents.  Surveys completed in 1995 and 1997 (in 
Vilnius among students aged 15-16) showed a rise in 
illicit drug use from 3.2% to 26%. 
 
Rural, Middle-aged Men Need Work 
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6. (U) The second group at risk for committing suicides 
is the rural male population of Lithuania.  High poverty 
in rural areas fosters social problems including 
alcoholism, drug addiction, suicide, and crime.  In 
Lithuania, the suicide rate in rural areas is double that 
in urban areas (59 to 31 per 100,000 in 2004).  Rural 
males are particularly vulnerable, killing themselves at 
an annual rate of 104 per 100,000, versus the female rate 
of 18 per 100,000. 
 
7. (U) The main reason behind the rural suicide rate is 
unemployment and poverty.  While the economic situation 
in Lithuania has improved dramatically -- from 1996 to 
2004, real GDP per capita doubled -- poverty remains, and 
regional disparities have increased.  Overall poverty in 
Lithuania peaked at 18% in 1996 and has remained fairly 
constant, standing at 15.9% in 2003.  The poverty rate in 
rural areas was 27.4% in 2003 compared to 10.3% in urban 
areas. 
 
8.(U) The rural poverty rate primarily reflects the 
transitional farm economy that, according to the 
Statistics Department, employs 17% of Lithuanian 
workforce.  Based on respective employment statistics, 
there are more farmers in Lithuania than in the United 
Kingdom.  In Lithuania, agriculture provides only 6.1% of 
GDP.  Transitioning this workforce to more productive 
sectors is a difficult and resource-intensive task, 
complicated by alcoholism, a lack of training, and 
minimal employment opportunities in rural areas outside 
of agriculture.  The migration of young and skilled 
Lithuanians from rural to urban areas also hampers 
economic opportunities for at-risk populations.  Health 
officials estimate that 50% to 80% of suicides are 
committed under the influence of alcohol in rural areas. 
 
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LACK OF FUNDS, COORDINATION HAMPER GOL RESPONSE 
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9.(SBU) The GOL has developed numerous strategies to curb 
poverty and the abuse of alcohol and narcotics, which all 
contribute to suicide.  In April 2003, the Suicide 
Prevention Program 2003-2005 was approved by the 
Government of Lithuania.  While identifying the problem 
and broadly setting goals, the Suicide Prevention Program 
obtained no GOL funding and failed to specifically assign 
new tactics to specific government agencies.  The Poverty 
Reduction Strategy's Implementation Program 2002-2004 
achieved no measurable reduction in the rural poverty 
rate or decrease the urban/rural income disparity.  While 
setting goals for progress, the strategies often fail to 
merge programs with real funding, coordinate the response 
and responsibilities across agencies, and measure 
results. 
 
10.(U) The GOL's Mental Health Policy 2005-2010 is a 
departure from previous strategies. (The policy is under 
development, with signing anticipated this fall.)  The 
policy reassesses the GOL's approach to mental health 
from the ground up, giving equal wait to the five basic 
care components for mental health: (1) treatment with 
drugs (pharmacotherapy), (2) psychotherapy, (3) 
counseling, (4) job training and reintegration, and (5) 
supported housing.  While the WHO in 2001 approved of 
Lithuania's approach to pharmacotherapy, it rated the 
other components as inadequate.  Balancing 
pharmacotherapy and institutionalization of patients with 
counseling and vocational training could conserve 
financial resources.  The policy also provides for a 
community-based approach to health services and evidence- 
backed programming not unlike in the United States. 
 
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COMMENT 
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11.(SBU) Minister of Health Padaiga has been a key leader 
in pushing for extensive reform of health institutions 
and hospitals, a task his predecessors avoided.  In order 
to reduce the suicide rate, GOL institutions will need to 
improve coordination, since reforms are not only needed 
in health services delivery and public education, but 
also in finding jobs for an aging and largely unskilled 
rural workforce.  This rural population is also a key 
voting bloc, responsible for the rise of the Labor 
Party's popularity.  If their economic and social woes go 
unchecked, rural voters will remain receptive to populist 
promises in future elections. 
 
KELLY