We Need to Talk About Suicide

IN IRELAND close to 600 people die by suicide annually – three times the number of people killed on our roads. What can we do as a nation to help end this endemic? Órla Ryan talks to those who dedicate much of their lives to providing support for people dealing with mental health issues and the repercussions of suicide.

Image c/o Pieta.ie

There were 525 deaths by suicide reported in 2011, an increase of seven per cent on the previous year.

It is all too easy to become immune to hearing such statistics, but, as a community, we must remember that every figure masks a face; a human life. Those gone were a best friend, a child, a parent, a lover, a classmate.

Many factors contribute to a person ending their own life. Bea Gavin, Head of Counselling at NUI Galway, believes the recession has led to a sense of purposelessness for many.

“Thinking about suicide is much more common than we realise . . . you cannot know who will and who won’t go on to make an attempt, so it is important to offer support,” she says.

Ms Gavin notes that the number of students seeking guidance at the university’s counselling service “increases every year”, with almost 1,000 people attending in 2012.

Greater levels of communication and information on mental health are vital to help those in need. “Public campaigns have a big role to play. It is important to create an environment where these issues can be talked about,” Ms Gavin maintains.

She lists alcohol as a possible “trigger to a suicide attempt”, adding, “The culture of binge drinking is also significant in that a very high rate of suicidality is associated with alcohol use.”

Sandra Hogan, who works with Aware, echoes these sentiments. “Alcohol . . . is a disinhibitor, it can also impact on levels of self-anger and self-aggression,” she states.

“We need to be careful about the way we talk about suicide – it has become such a commonplace word that it is perhaps being viewed as an option by some people who are vulnerable,” Ms Hogan adds.

Self-mutilation is also an issue of immense concern. "There is a huge fear around self-harm with people being quite ashamed of their actions. Families are in deep distress and they need more help to manage," Pauline Bergin, a senior psychotherapist at Pieta House, affirms.

Like most suicide related charities, the volume of people contacting Pieta is increasing steadily. Over 3,000 people attended their Dublin and Longford centres in 2012 alone.

Ms Bergin advises people “to recognise when their loved one or friend is becoming more isolated, not interacting, not eating or sleeping.

“I would encourage them to seek help with either their local GP or counselling service . . . sooner rather than later.”

Young Men and Suicide

The Young Men and Suicide Report, compiled by the cross-border Men’s Health Forum, states that Ireland’s rate of suicide among young males is among the highest in the European Union. Some 165 and 72 young men killed themselves in the Republic and Northern Ireland respectively in 2011.

The report attributed the recent increase in suicides in this demographic to the economic downturn and unemployment.

The National Office for Suicide Prevention (NOSP) 2011 Annual Report shows that suicide is much more common among men than women. This rate has steadily increased from 8.4 per 100,000 in 1980 to 20 per 100,000 in 2009. NOSP works closely with the HSE to provide suicide prevention training and resource packs.

‘Mind your Man’ is a soon-to-be-launched campaign headed up by Pieta House that will encourage people to take action when a man shows signs of distress or suicidal tendencies. The charity’s CEO Joan Freeman will appear on The Late Late Show on February 8 to discuss the venture.

John Buckley, Youth Engagement Officer with SpunOut, believes we need to gain a greater understanding of how young Irish men think and learn what supportive factors work for them.

“In Ireland there has traditionally been a distinct lack of dialogue around suicide and this has potentially impacted on how young men perceive help-seeking and speaking up.

"Problems such as financial and relationship-related issues were seen as a weakness and reaching out was at times seen as 'not manly',” Mr Buckley states.

He is a firm believer in early intervention; prevention is always preferable to cure.

“We need to understand that positive mental health starts in the early years, not in a fire fighting battle when the problem is endemic.

 “It’s an extremely tough fight, but fighting stigma is something that has been successful in many areas, such as cancer, so it's a fight we can win,” he asserts.

The Scotland Model

Mary McTernan set up the GRASP (Greater Responsibility and Awareness in Suicide Prevention) Life Foundation four months ago. In 2004 she lost her only son Garry to suicide at the age of 24.

The charity aims to provide a full time suicide prevention, intervention and postvention service through training and counselling. It also facilitates support groups for those who have been bereaved through suicide. Since its inception, the organisation has worked with 43 crisis situations in the North West.

“Suicide is a permanent solution to a temporary problem – there are ways around everything,” Ms McTernan states. 

She feels the Irish government should follow Scotland’s lead of increasing funding in the area of mental health.  Based on three-year rolling averages, there was a 17 per cent fall in suicide rates in Scotland between 2000 - 2002 and 2009 - 2011.

The Government has earmarked €35million for spending in this sector in 2013 – the same amount as last year.

Last week Kathleen Lynch, Minister of State with responsibility for Mental Health, spoke of the Government’s future plans in this area. As part of their bullying action scheme, a programme that promotes positive mental health in secondary schools has been launched.

At a practice-based level, two specialist nurses are to be stationed in each suicide unit in Ireland. A joint initiative with the Irish College of GPs that will increase doctor training on the subject has also been introduced.

In December, Minister Lynch promised that the 414 community mental health posts announced in the 2011 budget would be filled by the end of January. So far this figure stands at less than half. The Government cannot make empty promises when so many lives are at stake. Now is the time for action; not lip service.

More needs to be done – both in terms of public information campaigns and financial assistance from the Government. Those in rural areas should have the same level of access to support as those in cities and large towns.

Ireland has made some steps in the right direction where mental health is concerned. However, this is largely due to independent, non-State funded organisations. A collective effort is needed make real progress.

To reduce the stigma that often surrounds mental health issues, honest and frank discussions are needed at family, local and national level.

If you are feeling depressed or suicidal – or want to talk about any aspect your mental health – speak up. For anyone who is concerned about a loved one, listen and show your support.

And for the Government, as Ms Bergin put it; “Recognise that suicide is not going away."

Aware: 1890 303 302; info@aware.ie	GRASP Life: 087 4188053 / 086 6824760; www.grasplife.ie	National Centre for Youth Mental Health: www.headstrong.ie
National Office for Suicide Prevention: 01 6352139 / 01-6352179; info@nosp.ie	NUIG Counselling Service: 091 524411 (ext. 2484); counselling@nuigalway.ie	Pieta House Midwest: 061 484444; mary@pieta.ie
See Change (National Stigma Reduction Partnership): 01 8601620; info@seechange.ie	SpunOut: 01 675 3554; info@spunout.ie	Your Mental Health: www.yourmentalhealth.ie

Me, Myself and Mental Health

"March?," I cried.

"How could the next available appointment be in March? It's only early November."

I collapsed onto my bed in a fit of tears, virtually inconsolable. I had finally plucked up the courage to seek professional help and the soonest appointment with a psychiatrist was nearly five months away.

I should state that I am speaking about a personal experience that took place couple of years ago - although I'm not sure whether or not waiting lists have decreased significantly in the interim.

At the time, I decided to go through the public health care system for financial reasons. My parents had paid for me to go to a counsellor in the past and, I'm certain, they would have done so again had I chosen to tell them I had fallen back into the clasp of depression.

To be honest, I had never come fully out of it. I didn't feel as though I was making any progress with therapy the previous year so I stopped going and pretended to be OK again. I chose to keep my mental state a secret this time around - I'm not sure why. Partly due to shame I think.

Luckily, a cancellation meant I was given a new appointment in late January. Not so luckily, it didn't seem to make any difference. I was prescribed more medication and still at a loss of what to do next.

For me, depression started off as a tiny black dot inside my gut. It would increase and decrease in size sporadically. There were times when I could push it away and ignore it; there were times when it impacted on every single action I made.

Since I was quite young, I remember experiencing periods of deep sadness. This feeling was heightened during my teenage years - something put down to angst and hormones (which no doubt did play a role). During my worst period of depression, there were many factors involved. I felt like a huge disappointment in every way: I was unhappy at college; had my heart broken; failed to make a lot of new friends. I felt completely isolated.

At its peak - or rather depth - my depression was almost unbearable. I had lost all hope and saw no way forward. For a period of my life, I thought death was the only way I would find relief from what was now an all-consuming black mass. It had taken my identity; I no longer felt like a person with depression, rather depression itself. The blackness was not in me; it had become me.

I found solace in the face that, even if I didn't go through with it today or next week or next year, suicide was my 'get out of jail free' card. The main reason I didn't end my own life was the realisation of what the repercussions would be on those closest to me.

People often say that suicide is the ultimate act of selfishness, but, to someone in that mind-set, this is not the case. If a person is suicidal it's safe to say that they are not thinking clearly, so don't be so quick to judge.

I became extremely reclusive when I was depressed - I couldn't face being around people. In retrospect, this is one of the worst things I could have done. Engaging with people was one of the reasons my condition started to improve. I know this is easier said than done. I found Aware's anonymous online support group very helpful in this regard - it was a safe, kind place to talk.

When in the throes of depression, there is little, if anything, someone can say that will ease the pain. You may have heard this a thousand times before but PLEASE TALK: to a friend, a family member, a teacher, a doctor, an online support group. Seeking help may seem possible at times but you have the strength to do it. It might be a long road ahead but it does get better. You will feel better and you can be happy.

I don't pretend to know a lot about mental health. Professing a lack of knowledge in this area may, in itself, be the height of understanding some of us can achieve in this regard.

I don't recall why, or exactly when, I began to feel better; but I did. For me medication or therapy didn’t seem to help, interacting with others did. Every person is different, but by reaching out you will find something that works for you.  

Every now and then, I have my bad hours or days or weeks, but I am happy to be alive and to be able to experience life – the good and bad.

If you feel down, talk. Help is there. Life will get better.


This article was also published on Headsup.ie and in Student Independent News, NUI Galway's student newspaper.