Suicide or Survive?

Suicidal behaviour represents a global health problem and its prevention continues to provide a major challenge to health and social services at all levels of...

Suicidal behaviour represents a global health problem and its prevention continues to provide a major challenge to health and social services at all levels of Irish Society. More people die by suicide in Ireland each year than in road traffic accidents. Currently Youth suicide rates in Ireland are fifth highest in the European Union (World Health Organisation, 2005). Deliberate self-harm is also a problem. According to the National Parasuicide Registry, over 11,000 cases of Deliberate self-harm are seen in the accident and emergency departments of our hospitals annually and many more cases of deliberate self-harm never come to the attention of the health services.

Research.

Based on official suicide mortality data from the CSO, between 2000 and 2002 there were, on average, 494 deaths by suicide in Ireland annually, peaking at 519 in 2001. Of particular concern is the rate of youth suicide in Ireland, currently the fifth highest in the European Union at 15.7 pre 100,000 for 15-24 year olds. The rate is even higher in Ireland among those in their 20s and early 30s, with men under 25 years accounting for approximately 40% of all Irish suicides. Currently, the highest rate of suicide is found among young men in the age group 20-29 years (35 per 100,000). Ireland experienced one of the fastest rising suicide rates having doubled over that period. The rise was largely confined to men and has been most striking in young men. While the overall female suicide rate has not increased since 1980, the rate of suicide in young women (15 to 24 years) more than doubled in the 1990s, albeit from a low base rate.

Each year more and more Irish people are affected by the problem of suicide in some way. When a community sample of young men (aged 18-34 years) was asked about whether or not they knew someone who had died by suicide, 78% said ‘yes, 42% knew ‘more than one person’, while 17% knew a ‘close friend’ who died by suicide (Begley et al, 2004).

High Risk Categories.

Examples include young men an rural areas who no longer have a clear pathway into farming as a way of life due to the modernisation of agriculture, fathers who are isolated from the increasing number of single-parent families, teenage girls who struggle with the burden of unrealistic expectations about physical appearance and achievement propagated by popular culture and the media, or older people who no longer have the support of an integrated and extended family and community network to turn to. Improving access to quality health services is an essential part of any suicide prevention strategy (National Strategy for Action on Suicide Prevention, 2005).

The Way Forward.

Schools can play an important role in the promotion of positive mental health, building up resilience and in identifying and supporting students who may be vulnerable or at risk, including students who are bullied or who are suffering form low self-esteem. The school response in the aftermath of a student or staff suicide is also extremely important in order to minimise the negative and distressing impact on the school and the wider community. It is especially important to address myths and stigma surrounding mental healths, which, for many young people, are barriers to seeking help for emotional and mental health problems. It is important that there exists an independent counselling service that can be accessed through schools or in the community by school students and by early school leavers.

People who experience traumatic life events, in particular sexual and/or physical abuse, have a high risk in engaging in deliberate self-harm and suicide (Santa Mina and Gallop, 1998) In most cases these characteristics alone are not associated with a high risk suicidal behaviour, but in combination with other risk factors such as depression, the risk increases. Considering the relatively high prevalence of sexual abuse in Ireland-the SAVI study (McGee at al, 2002) identified that 16% of men and 20% of women had experienced sexual abuse as children. The risk associated with abuse is further compounded by the problem of non-disclosure, especially in the case of men that have been abused. It is vital that there be easy access counselling services to adults who have experienced childhood abuse.

It is difficult to ascertain the true number of people affected by each suicide death, also difficult to ascertain is the increased risk or likelihood of further suicidal behaviour following a suicide death in a given community. The aftermath of a suicide death is an extraordinarily difficult time for the bereaved and for the wider community. Whether related to genetic factors, social modelling or other reasons, an increased risk of further suicidal behaviour in the aftermath of a suicidal death is always a possibility. For these reasons, and because of the need to support those bereaved following a suicide death, it is important that as a society we respond in the right, supportive and helpful way when a suicide death has occurred. The role of the Bereavement Counsellor is vital in helping a person come to terms with their grief in a supportive and helpful manner. 

 
*Attracta Gill is an experienced and professional Counsellor and Psychotherapist. She is presently completing her M.A. Degree in Humanistic and Integrative Psychotherapy in Limerick University. For appointments please call 087 2382978.