Suicide

The recent controversy surrounding the Sunday World’s decision to publish a picture of a man who had apparently committed suicide and the subsequent apology again highlighted the problem of suicide though whether it was an attempt to create a debate or simply sensationalism was of course open to question.

This is an updated version of a blog I did some time ago but now seems a reasonable time to mention it again.
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 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 showed 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 in past budgets may have some effect and also highlighting counselling and other services may bring benefits but is unlikely to abolish the problem.

How well those budgets will survive the economic stringencies now being imposed on the public purse is of course unclear. In addition a recent study suggested that during a recession although there is no consistent evidence that a rise in unemployment increased overall death rates across the EU population; there was an association between rising rates of unemployment and a rise in suicide levels among people under the age of 65.

In the relatively recent past there was the disturbing 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 spate of suicides a couple of years ago in Bridgend, South Wales the police reported no evidence of any link.

An additional previous hysteria drummed up by the media was that many suicides could be explained by a number of social networking internet sites frequented by young people and hence, stopping them would solve the problem. At one stage regulation or even closure of some aspects of these sites, was considered though such strategies seem 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 which is likely to worsen in the short term and loss of social and family cohesion which is prevalent throughout much of the Western world. These problems are vastly more difficult to address but all these issues need to be considered as this is a significant problem within society which merits serious discussion and examination of any possible solutions; incremental as any one of them will undoubtedly be and unfortunate as the circumstances which have again highlighted this issue are.

  • CW

    It was the Sunday World, not the Sunday Life, Turgon.

  • Turgon

    Sorry will fix

    Thanks

  • Turgon

    Indeed have fixed

    Thanks again

  • LURIG

    I live in North Belfast where the suicide rate is quite high and I know that there is quite a lot of despair in this area which cuts through both communiities. Why is this? Firstly I think the legacy of the Troubles is still deeply embedded in the psyche of many people and that does provide an excuse for some of the deaths.
    However there is also a benefit, ‘world owes me a living’ AND prescription drug dependancy culture that exists in these areas and a tendency by the media and Health authorities to over indulge those who wont take any responsibility for themselves. A doctor I know who practised in North Belfast told me that if he stopped prescribing anti-depressive drugs his surgery would be inundated with people demanding them and probably riots if they were refused. He stated that 80% of them didn’t need them and that many of his prescriptions and sick lines were SOLELY for benefit purposes for a lot of malingerers who refused to work. Secondly, and while I have totally sympathy with relatives of those who have died, there is a mindset in these areas that everything negative that happens is ALWAYS the fault of someone else.
    I have always said that children should be told at the earliest opportunity that it is a f**king hard life out there and that you only get out of it what you put in. I think that some young people feel that if life doesn’t deliver them an easy ride right away they throw the head up and take their own lives; they can’t accept that you have to put a bit of effort into existance on this earth. Suicide is awful but the sooner that people in ALL contexts of society are told that life isn’t easy the sooner they will realise that they have to work hard for success.
    I am sorry if I offend some but in my opinion there is too much indulgence of these individuals and mollycoddling when a hard dose of life reality would better prepare them for the pitfalls ahead. At the end of the day if you want a decent standard of life for yourself and family educate yourself, learn a trade AND get out and work for it like the rest of us. I have NO sympathy for the ‘so called’ lone parent or healthy 40 year old Incapacity Benefit receiver who demands a detached house overlooking Belfast Lough because he/she and their DLA receiving kids can’t sleep in the one they already live in. It’s a big bad world out and the sooner that people realise that the better. Much suicide is the last bastion of the self pitying brigade who won’t accept responsibility for their own lives.

  • borderline

    “Much suicide is the last bastion of the self pitying brigade who won’t accept responsibility for their own lives.”

    I think taking to decision to end it, and carrying out that decision is pretty much accepting responsibility for it.
    As any visitor to the Dignitas clinic would explain.

    And I doubt they need to be told life is hard.
    I imagine there are few enough poor bastards about to slit their wrists who are thinking, ‘hey, life’s a doddle.”

    I think what we need to do is try and increase happiness levels, for everyone, and particularly for those who are miserable and depressed. Sarkozy was on about this lately. It would be nice to see the suicide rate discussed as often, and analysed as often, as the GDP rate or the inflation rate.

  • Rory Carr

    I think what we need to do is try and increase happiness levels…

    Ken Dodd for Prime Minister!

    The very best that we can do is to be willing to listen to those in anguish and after that all that remains is to bury the dead and give comfort to those that mourn.

  • I wrote about this issue recently (albeit mostly about the South):

    http://forth.ie/index.php/content/article/killing_time/

    Response:
    http://forth.ie/index.php/content/article/healthy_money/

    For my money “copycat” suicide is a dubious idea. Additionally, I don’t think “suicide prevention” achieves anything positive.

  • Brit

    I think LURIGs comments show a failure of both compassion and comprehension.

    Some suicides are (to use a clinical phrase)full on loonies in the sense that they dont really know what they are doing. I had a good school friend that developed some form of schizophrenia and killed himself.

    Most others are those in such terror or suffering, such pain (psychological, physical or both) that they are prepared to kill themselves as the only way of ending the pain. Its not neccessarily a case that they are weaker than the rest of us who endure the pains of life without sucumbing but may be that they are suffering more than we have suffered and more than we (the ‘normal’ ones) can even imagine. Clinical depressives are not generally self-pitying wimps but are often robust, confident fighters,(think Churchill or Campbell) who suffer from a debilitating illness that is very difficult to understand.

    Neither case deserves any condemnation but many people in both situations can be the subject of intervention which may stop things going to the extreme act. It is such an extreme individual act that I am very dubious of drawing any broad conclusions from national suicide stats on the general mood or happinenss of the people.

  • Anon

    A brother of mine has atempted suicide a number of times in the last two years. It’s hard to understand because he would be considered a very jolly person by all, has lots of friends, a great girlfriend, has a loving and supportive family, financial security, no long term helth problems. It is very difficult at times, he will always say things are great no-matter what.

  • GasWorker

    I am keping this short due to lack of time but I think Brit is wrong to say that LURIG has a lack of compassion and comprehesion.

    I have read many of LURIG’s contributions over the last months and have both agreed and disagreed. His side swipes at management in the SSA are often too broad brushed for my liking as he paints all with the same brush and wrongly may I add although I do have a sense of where he is coming from in terms of certain people and it shows throughout that he cares about getting the job done which is getting the right benefits as quickly as possible to the right people who deserve them. LURIG I may have not met you but I have met many of your likeminded hardworking, stressed out colleagues who do a fucking hard job for little reward.

    But back to suicide. Lurig’s points on doctors, benefits, the world owes me a living, medication,life is hard,indulgence and mollycoddling are very close to being spot on from the perspective of someone dealing with benefits claimants. It doesn’t paint the whole picture obviously but it represents a large proportion of the problem amongst belfast benefit claimants and its East & West & North & South by the way.

    Please remember suicide is multi-factorial. Lurigs post hit upon a very painful truth and I hope that other commenters don’t distract from the particulars by going on about those in terminal illness going to switzerland etc. This is a local problem and there are those who choose suicide who unfortunately I and many others do not have a great deal of sympathy for in terms of their motivations but a lot of sympathy for why they ended up with the mind sets that they inherited and learned from their environment.

  • Brit Tracker

    Another ill thought out esay.

  • Gas worker

    @ Brit Tracker

    Just for clarification was that last post of yours aimed specifically at the post :

    ‘Brit on Nov 09, 2009 @ 11:37 AM’ ?

  • Brit

    There may well be a culture of dependency/malingering, of victimhood and people being less willing to work for the good things in life, whether it be working in a job, working at a relationship or working at being a good parent. I’m not convinced this is new.

    But even if true I think it is misleading to draw a line from the above to those people who are in such a hellish place that they are prepared to end their lives.

    Hello Brit Tracker xx

  • i wonder

    Brit says (Clinical depressives are not generally self-pitying wimps but are often robust, confident fighters,(think Churchill or Campbell) who suffer from a debilitating illness that is very difficult to understand.)
    Both Churchill and Campbell are were alcoholics with alcoholism comes its old friend the black dog or as we call it clinical depression.

  • Brit

    I think you are mixing up cause and effect. The alcohol use and abuse is a symptom not a cause (although ultimately an exacerbating factor).

  • i wonder

    Poor brit .You know somthing brit your like turgon and mick the brit there is just fuk all you dont know about everything also what amazes me is that you the trinity dont actually with all this knowledge do a Warren Buffy.

  • Brit

    No need to be rude mate. I’m not, and havent claimed to be an expert in this area – I’m no psychologist or psychiatrist.

    If you dont like my comments either respond or dont read them and if you have a point to make, make it.

    A mate of mine topped himself and I have always felt strongly that condemnation of those who commit suicide is wrong, in the moral and intellectual sense.

  • paddy

    these new groups that have sprung up talking about preventing suicide are jumping on the bandwagon.it wasnt that long ago these so called unelected community workers supported breaking peoples limbs that led to lots of people killing themselves. now there is alsorts of grants on the go they want a bit of it they love grants its their war cry theyre worse than peggy mitchell in eastenders shouting up the stairs GRaaaaaaaaaaNT