Rome, Italy - Giuseppe Sopranzi threw himself into the sea off the coast of central Italy in April, after the 73-year-old discovered his sister and brother-in-law had hanged themselves in their home that morning.
The couple, Annamaria Sopranzi, 68, and Romeo Dionisi, 62, had long been struggling to survive on a pension of a few hundred euros a month. The triple suicide in Civitanova Marche in eastern Italy was widely attributed to the family's insurmountable financial burden.
Italians were shocked. In response, the president of the Italian Chamber of Deputies, Laura Boldrini, visited the town. Although the triple suicide was deemed a unique tragedy, growing economic difficulties in Italy are making suicide a growing phenomenon.
The recent Report on Global Rights 2013 found that financially related suicides increased by 40 percent in the first three months of the year, compared with the same period in 2012. Half of those deaths were attributed to the "precarious" economic situation in the country, and 28 percent because of loss of employment.
Male entrepreneurs worst hit
The figures mirror a worsening economic situation across the country: According to Italy's National Institute for Statistics (Istat), in 2012 a quarter of Italians lived in "deprived families", up from 16 percent in 2010. The unemployment rate also reached 12.2 percent in May - a record high for the country.
Financial hardship is having a tangible impact on people's mental state, says Maurizio Pompili, director of the Suicide Prevention Centre at the Sant'Andrea Hospital, Sapienza University of Rome.
"We have been observing that some suicidal individuals are reporting economic troubles, failing in their job, unemployment or a lot of debt," Pompili told Al Jazeera.
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"One of these patients is an entrepreneur that, at the first meeting, said the main problem was an enormous debt of €36m ($48m)... He was determined to commit suicide," said Pompili.
The Italian state owes about €40bn to private companies, which the newly appointed government aims to pay back by the end of 2014.
Nicola Ferrigni, director of Link Lab, found that there were 14 economic suicides by entrepreneurs and 16 by unemployed people in the first quarter of 2013. "The increase in suicides is because the economic crisis seems to leave no more hope, especially among entrepreneurs," he said.
"There are also more men, partly because in Italy men are more likely to be entrepreneurs and business people," Ferrigni added. Men accounted for 30 of the 32 suicides Link Lab recorded from January to March 2013, based on national and local media reports, and all of those recorded for the first quarter of 2012.
Correlation or causation?
However, Carlo Dell'Aringa, undersecretary at Italy's Ministry of Labour, said that the suicide rate may have been overstated. "People say that there has been an increase but it is not as bad as one might imagine. When there is an economic crisis, the news of a suicide is something which hits public opinion; this news comes out more frequently during an economic crisis than at other times," he said.
Pompili said he could not be certain that the economic crisis was the main cause of a rise in suicides, although he said that an entrepreneur forced to fire staff due to financial difficulties would suffer greatly. "Especially in the north of Italy, where there are a small number of people working for one entrepreneur, probably friends, relatives and so on. When the entrepreneur is forced to fire them, they feel it inside their bones, because various families are getting into economic troubles," he said.
We can imagine that the crisis can have an influence on suicide rates, but we are not sure. Greece has fewer suicides compared to Italy, but the economic situation is worse than Italy.
The Link Lab research found 12 economic suicides in the northeast of Italy in the first quarter of 2013, twice as many as in the south. "It corresponds to the distribution of companies; the majority of companies are in the north-east and Veneto [a region in the north-east]," said Ferrigni.
Despite Istat reporting that the economic decline is more pronounced in the south than the north of Italy, with "severe deprivation" affecting a quarter of southerners in 2012, suicide has been higher in the north since well before the financial crisis began. The suicide rate in the south fell from 5.3 to 4.9 per 100,000 inhabitants between 1993 and 2009, while during the same period rates in the northeast of Italy fell from 10.5 to 7.9.
Alessandro Solipaca, a researcher in health economics at Istat and scientific secretary at Osservasalute, said that the Italian suicide rate was low. "We can imagine that the crisis can have an influence on suicide rates, but we are not sure," he said, as Istat only records the cause of death rather than the reason for a suicide. "Greece has fewer suicides compared to Italy, but the economic situation is worse than Italy."
Struggling to prevent suicides
An increase in Italy's national suicide rate was recorded between 2006 and 2009, although, as more recent data is unavailable it is difficult to determine how the economic crisis has impacted the total number of suicides. This increase is "not significant from a statistical point of view", according to Solipaca, although the Osservasalute 2012 report says that it may be a sign of growing social problems. The suicide rate should be monitored carefully, the report says, and measures should be taken in the areas of health and social care.
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The Ministry of Labour currently has no strategy for dealing with economic suicides, Dell'Aringa said. People facing financial difficulties are supported by municipalities and voluntary associations with government backing, although "at the moment, municipalities are complaining that they don't have enough money to assist the poor," said Dell'Aringa.
The role of the Ministry of Health in preventing economic suicides is unclear. The ministry referred questions from Al Jazeera to the Ministry of Economy and Finance.
Much more needs to be done, said Pompili. "We need a national strategy to prevent suicide; every region should have a suicide prevention centre," he said. A helpline he helped set up at the Sant'Andrea Hospital is unable to cope with the volume of calls, he said, showing the need for more support.
An awareness campaign should be launched, Pompili said, to help people realise that suicide stems from an "unbearable psychological pain" that may arise from job loss or failure as an entrepreneur.
"I believe that unbearable psychological pain is the main ingredient in determining suicide," said Pompili. "When you have hopelessness, and you don't have expectations about what good can come in the future."