Suicide Prevention and Awareness

Sinn Féin banners outside Belfast's Waterfront Hall where the party will be holding its Ard Fheis this weekend.

Yesterday was the start of International Suicide Prevention Awareness Week. It runs until next Saturday, World Suicide Prevention Day.

Regrettably in my years as a public representative I have spoken to people at risk; to their families and the bereaved families of suicide victims; and to health professionals working on this issue. It is clear that this is a problem which is getting worse.

The World Health Organisation estimates that “Every year, almost one million people die from suicide; a "global" mortality rate of 16 per 100,000, or one death every 40 seconds”.

That’s equivalent to a population the size of Dublin dying each year from suicide.

WHO also calculates that in the last 50 years “suicide rates have increased by 60% worldwide”, and that it is now among the three leading causes of death among those aged 15-44 years.

Recently Pieta House, a suicide crisis centre based in Lucan, Dublin, reported that in the first half of this year it has seen a 40% increase in the number of people coming to it for help in respect of suicide and self-harm.

Pieta House said that 486 people - 386 men and 100 women - died by suicide in the south of Ireland last year.

In the north the situation is equally bad. The Public Health Agency (PHA) has reported that since 1999 rates of suicide there have increased by 64%. And in many instances these were deaths of young people, many of whom came from disadvantaged areas. North and West Belfast have been especially hard hit. In 2009 260 people died by suicide in the north.

A report last June by the Institute of Public Health in Ireland (IPH) examined the connection between the economic recession and male suicide.

Facing the Challenge – The Impact of the Recession and Unemployment on Men’s Health in Ireland concluded that male suicide is on the increase as a result of the dire economic situation. It revealed that in the south 379 male suicides occurred in the year up to June 2009. The following year that number had risen by 48 to 427.

In the north the report said that there had been 240 male deaths by suicide in 2010. When combined with the 73 female suicides in that period the 313 deaths by suicide in the north for last year, was the worst figure ever for that region. It is an increase of 100 on the 2005 figure of 213 deaths by suicide.

There has also been a significant increase in the numbers of people self-harming, again particularly among young men.

One year ago Prof Kevin Malone of the School of Medicine and Medical Science at University College Dublin and St. Vincent’s University Hospital gave evidence on suicide to the Dáil Joint Committee on Health and Children. He explained that a study he carried out into suicide in 23 countries concluded that suicide levels are significantly higher than the official statistics suggest.

It is easy to get lost in the statistics and to forget that this is an issue of life and death for hundreds of citizens and of huge trauma to many families.

The reality is that suicide prevention needs more resources, more money and more trained personnel than ever before. How to organise and put in place preventative strategies is well known.

What is required is a properly funded all-island based multi-agency intervention approach which brings together training and support for family doctors; a public information campaign; and a co-ordinated strategy involving all of those who are working on this issue in community, the voluntary sector and the health professionals.

At a time of cutbacks in health budgets it makes sense that the two health departments co-operate in providing effective and efficient health services for citizens.

The failure by the health service in the south to meet the psychiatric needs of young people has been highlighted in recent days by 17 year old Cíara Molloy from Dublin who in desperation wrote an open letter to the Dublin Minister of Health James Reilly.

Cíara suffers from depression and anxiety and has difficulties with food. In her letter she begs the Minister for help, describing the state’s current psychiatric care for teenagers as a “disgrace”.

Her decision to go public came after she was told that instead of an appointment with a psychologist she was being offered a place on a six week lecture course dealing with ‘stress control’. The course is entitled: “Think Clearer. Learn to control your eating. And control your drinking.”

Ciara told one journalist: “I’m 17 and I don’t drink.”

“I just broke down crying then,” she said. “The HSE were saying that they do not care.”

Cíara published her open letter on her blog and emailed it also to the Department of Health, the HSE and some media outlets.

In her letter she wrote:

“An Open Letter to Minister James Reilly, TD:

Dear Minister Reilly
My name is Cíara Molloy, and I am a 17 year old teenager. For the last few years, I have struggled with anxiety and depression. My local hospital, Connolly Hospital, was unable to treat me, as they didn’t have the funds or manpower to do so. Nor were they able to let me see a dietician for my difficulties with food. Instead, I’ve languished on a waiting list for over a year.
Thanks to my GP, I have been sent a letter by my local primary care team, to attend a ‘stress control’ course. This is not helpful in the slightest. To my mind, this course and letter is simply a way for the HSE to wash their hands of me. The course itself isn’t suitable for me, because, as the letter states, it ‘is NOT group therapy’. Secondly, it is on a Wednesday morning from 10 – 11.30. Minister, I am going into sixth year, and wish to study Law in college. I cannot afford to take that much time off school, because by the time I get out of the course, go home, get my schoolbag and get the bus to school, it will be 1.30.
Minister, I am begging you to help me. Nobody else seems to want to, and the HSE appear to have washed their hands of me. Psychiatric care for teenagers in this country is a disgrace. There are no facilities. Unless you’ve attempted suicide, you can’t even be seen by a counsellor. How is this fair?
I cannot afford to see a private counsellor. I can’t afford to see a private dietician. Is the HSE simply going to let me rot because of my socio-economic class? I thought Ireland looked after its people.
Yours sincerely,
Cíara Molloy,
Dublin 15
Visit Cíara’s blog, Messy Desk, Messy Head”

Finally, let me take this opportunity to commend the amazing dedication and work of all those involved in suicide prevention. Many of these are bereaved families who have known the personal tragedy of loss. Their courage and determination is inspirational.