Suicide

This is not going to be a fun or light hearted blog. I hope I can address this issue in as serious a fashion as it behoves. Can I say at the outset that I personally have never had a close friend or relative commit suicide and as such I cannot fully understand the personal emotions and trauma that this produces. If in any way I offend anyone I am truly sorry but I do feel this is an issue which is not addressed as much as it should be. I will very deliberately talk only in general terms about this and will not mention any local events.
Many years ago I was at a course in Scotland; a respected psychiatrist from Scotland stated that suicide was rare in Northern Ireland and claimed that this low rate was common in societies in conflict. There is certainly some data to back up this suggestion. Historically, however, the only deaths recorded by the coroner as suicide were those where the victim left a note; otherwise the death was recorded as accidental. This was in part (and I would suggest appropriately) to spare the family the trauma and indeed shame and opprobrium attached in the past to such a death; with at times difficulties having a burial in consecrated ground. As such it may be difficult to compare historical figures with current ones.

The reality now is that the suicide rate in Northern Ireland is actually quite high, in 2001 it was not quite double that for England and Wales though for the period 2002-2004 the rates in Northern Ireland were lower than Scotland or Wales and little higher than England.

The Investing for Health document shows an increase in suicide rates over the period 1987 to 2003 albeit with significant yearly variation. The variability of suicide rates amongst different groups and different localities is interesting. Suicide rates are highest amongst young men aged 15-34, which is a fairly typical finding word wide. At the risk of being controversial; suicide is more common in predominantly Roman Catholic areas, however, the report stresses that this may not reflect a significant difference due to the number of people living in mixed areas and does not take into account economic deprivation in different areas. It is also modestly more common in urban than rural areas and significantly so amongst those in socially deprived areas. The highest risk employments are own account workers and small employers closely followed by long term unemployed and never worked groups.

Groups at particular risk of suicide include, unsurprisingly, the mentally ill. Those with schizophrenia are notorious amongst psychiatrists for very rarely being a danger to other people (contrary to some popular myths) but a significant danger to themselves. Clearly psychiatric care can help but apart from detaining people indefinitely in mental institutions as we used to there is little way of completely preventing this problem. That of course leaves aside the inappropriateness of making people stay indefinitely in the old “lunatic asylums” and the fact that not infrequently they managed to kill themselves there. Persons with personality disorders also have high suicide rates. Unfortunately such people are extremely difficult to treat and although they may make many attempts before a successful suicide again there is little obvious way to completely prevent this. The provision of increased mental health services after the latest budget may have some effect and also highlighting counselling and other services may bring benefits but is unlikely to abolish the problem.

Amongst the most disturbing recent developments has been the occurrence of spates of suicide amongst teenagers and young people, sometimes in clusters. Concerns have been expressed that sometimes these episodes have a “copy cat” element which is a truly awful concept. However, despite sensationalist claims in the tabloid press over a recent spate of suicides in Bridgend, South Wales the police report no evidence of any link.

The hysteria currently being drummed up by the media could imply that many suicides can be explained by a number of social networking internet sites frequented by young people and hence, stopping them would solve the problem. Whilst regulation or even closure of some aspects of these sites, which currently seems to be being considered, might have some effect; it is unlikely to solve much of this problem. Clearly improved mental health services and the provision of counselling have considerable merit and sound like common sense solutions though acquiring clinical evidence of their efficacy is not especially easy. However, there are other problems related to economic deprivation and loss of social and family cohesion which are prevalent throughout much of the Western world. These problems are vastly more difficult to address but I would submit that all these issues need to be considered as this is a significant problem within our society which merits serious discussion and examination of any possible solutions; incremental as any one of them will undoubtedly be.

  • George

    There is an all-island campaign called ‘Your Mental Health’ which was developed by Ireland’s National Office of Suicide Prevention and launched in Northern Ireland three months ago.

  • Mark McGregor

    Great blog, apart from the unneeded feed para.

    There has been and continues to be a suicide spike mostly concentrated in areas that would be defined as Republican. I feel this is due to the removal of community cohesion during an intense and endorsed uprising that has not been replaced when former revolutionaries joined/endorsed/run state structures.

    Previously, everyone knew and cared about everyone else’s’ business, that caring is now handed over to state structures that never did and don’t care about the marginalised.

    Communities based on socialistic principles of mutual reliance are now being run on a selfish capitalistic basis. The spirit of volunteerism replaced by grant chasing and those at the bottom of the pile seeing no option but ending their own lives.

    All the wee badges in the world won’t save a single life. And god do the establishment love those wee badges.

  • Unfortunately the government’s attempts to address the issue of suicide and self-harm have been, to date, pathetic. In Northern Ireland the recommendations of the Bamford Review of Mental Health and Learning Disability have been languishing on the shelf of shame that so many good ideas wallow. Statistics be damned though.

    As someone with first hand experience, how can a polemically astute MLA or wearied civil servant comprehend the parental or personal agony of finding a loved one dead by their own devices? The reality in the budget announcement is that it is civil servant double speak – many of the announcements are repeats of Direct Rule promises that were never followed through.

    They have never stood in front of the dead body of a child, siblng or partner and wondered, as they cried, if they could have done more.

    The social networking sites are such a red herring that they only divert the fools and web illiterate advisors and political pygmies. That there are 500,000+ unique users in NI of one of these social networking sites could suggest to these idiots that a storm of self-inflicted deaths awaits, when the evidence is that they supply an important support mechanism in times of crisis.

    Oh how I wish for rational debate on this issue, but importantly I wish for what one emminent psychiatrist said: “It’s not interfering to ask what’s wrong, it’s not interfering to ask if everything is all right. By doing so you might have helped that friend, that person, live for another day. Is that not a great gift to give with a simple question?”

  • lapsedmethodist

    In an article in the Observer a couple of weeks ago a woman said of her talented but troubled son who committed suicide…
    …” he stayed as long as he could ”
    Which is as dignified and insightful a comment as you’re likely to hear. And which also points to the uselessness of commities and projects and whatever.

  • George

    From my own experience, the more it’s talked about the more it happens. When you are young if it is thought to be out there as an option it will be considered and sometimes followed through.

    There is no answer for despair and there are none more despairing than the young. The highs are high and the lows, low.

  • cut the bull

    Mark, I beleive that you have made a great anology that certainly rings true in working class areas which would be seen as republican in their political beliefs.

  • Miss Fitz

    It’s really only fair to mention the great work being done at multiple layers on the ground in Northern Ireland to address the suicide issue and the contributing factors to the rise in the rates. As with other such areas, you cannot point to one single factor and label it the single causation.

    For anyone interested, I would direct you to:

    http://www.dhsspsni.gov.uk/phnisuicidepreventionstrategy_action_plan-3.pdf

    I ran a suicide awareness semiar just before Christmas, and was very impressed by the commitment, dedication and awareness being demonstrated. A lpt of good work is going on and should be acknowledged.

  • aquifer

    The decline in apprenticeships and manual labour, demands for a more highly educated workforce, and pressure to achieve and conform with consumerist norms, put young men under immense stress.

    Global Competition means that our young people can be made redundant by other workers thousands of miles away, threatening social cohesion.

    There are also subcultures among the young of alcohol abuse and violence which are very destructive for them, and which are going unchallenged. Alcohol is often a gateway drug to other drugs which are getting cheaper each day.

    The wonder may be that most young people behave so well.

  • Dewi

    Terrible stuff here – Police now seem to accept that this cluster is linked. Heartbreaking.

  • dadoffour

    It’s hard to comment on this as I don’t know a lot about it. As a man who is of an age where I’m more likely to have a mid-life crisis, I wonder if there’s a combination of things bringing the apparent incrase in young peoples suicides about.

    e.g. Are there as many youth clubs and other opportunities for young people to socialise together as there was in my youth? There we could congregate without any of the pressure that the socialising they now do seems to bring. I have young ones who have to have the latest thing in clothes shoes and other goods like phones or else they’re thinking they’re not good enough.

    I also think we’re all scared of letting our children explore and be responsible for themselves when they’re younger (e.g. walking to school alone where it’s practical to do so) and so the sudden expectancy that they have to actually have to look after themselves seems too demanding.

    There’s also been great changes in personal relationships with the idea of a lifetime committment not even getting a mention. Sex is ‘pushed’ to all of them from a very young age.

    As I say I don’t really know anyhting about it, but these are the thoughts of a father trying to do the best by his kids. I feel it’s a conmbination of things leding to our children never being ready to live ‘alone’.