In June 2011 Manchester University released its National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. This UK-wide project was commissioned by the Public Health Agency. In the forward to the report the Minister for Health, Edwin Poots, wrote:
…to reduce the risk of suicide it is important, where possible, to identify common themes and patterns.
The report established a link between suicide and mental ill health with 295 of people who committed suicide having had previous contact with mental health services.
However, the figure also clearly reveals that there are a substantial number of suicides which arise out of contexts where there is no identifiable mental ill health. It is, therefore, important to identify other themes in the cause and reasons for suicide in NI. It is important if strategies are to be developed which can effectively address the problem we are facing and the pain of a society that is now being torn apart by the ramifications of suicide.
2000 – 2008 1,865 suicides occurred in NI. The evidence is that suicide is on the increase.
207 suicides per year, lower only than in Scotland.
29% of suicides were people who had previous contact with mental health services.
The information gathered in relation to young people is the most revealing and the most challenging and is best quoted directly from the report:
The largest difference between suicide rates in Northern Ireland and other UK countries was in young people and they should be a priority for suicide prevention. 332 suicides occurred in people under 25 during 2000-2008, 37 per year. Young people who died by suicide were more likely than other age- groups to be living in the poorest areas and they had the lowest rate of contact with mental health services (15%). Young mental health patients who died by suicide tended to have high rates of drug misuse (65%), alcohol misuse (70%) and previous self-harm (73%).
The report recommends that further work be done to establish why the suicide levels are higher in NI than in England and Wales. Additionally the Protect Life strategy to address suicide needs to be monitored and its effectiveness established. Mental Health services need to pay attention to the figures and services for young people need to take careful account of the information, not least in areas which it has already been established are areas where suicide is more likely to occur. Indeed we might contend that rather than waiting to form a responsive strategy there should be proactive strategies and services at work in these identified areas to seek out at risk young people and to begin to address their difficulties with them and alongside others trusted in the locality.
As it happens there are a considerable number of support groups and responses in local areas which in itself makes effective co-ordination of services a difficulty. The difficulty of pulling services together may further endanger young people as the lack of co-ordination can be coupled with a lack of skill, although often not of experience, in the field. Delivering an effective, skilled, proactive service which is co-ordinated and targeted seems to me to be of paramount importance at this juncture. The Protect Life strategy was published in October 2006 and ran until 2011. It seems to me that this is still under review with information gathering still in progress and a way forward still being charted. I may be wrong but I cannot locate anything more up to date than the 2006-2011 strategy.
Why does any of this matter to me today? It matters because for the second time in four months I have had to walk behind a hearse among a crowd of young people saying goodbye and paying their last respects to a member of their peer group, a friend, a brother, cousin, son, grandson, partner, father. The horror of the silence eventually settles in behind the wailing and the wrenching grief that before your eyes wracks the bodies of young people who know that this experience is out of place and unnatural. Unable to cope, having turned to whatever they turned to for help, alone and distressed there was no way out it seemed but to take their own life. The reality of what is left behind is a story too hard to tell, there are no words for the loneliness of the mother, the burden of a father, the dismay of siblings and the ever present grief of friends who once laughed with the one now cold and still and unresponsive. So whatever is going on in the world of planning and preparation there are some things that need to be done and they need to be done with some haste if they have not yet been done:-
- the information needs to be pulled together properly and it needs to be easily updated with the passing of time so that changes can be charted without waste of time or resources
- a much firmer strategy of co-ordination needs to be put in place so that well-meaning people who have much to offer can do that in the best way possible and not leave themselves with more guilt than they already have
- the social circumstances need to be taken seriously. The streets awash with drugs and alcohol will not clear themselves. Education, good policing, effective community work all in a co-ordinated movement to provide a new and more hopeful world for young people who are not only losing hope but also losing life – it all has to be pulled together without delay
- if there are people who can help deliver to the streets what will make a difference then government needs to call them in, resource them further and empower them to make the difference that needs to be made
If we don’t deal with this as a society, if we don’t learn not only to value life but to treasure every young person – privileged and impoverished alike – then there is no hope for us. There is no hope for a healthy and shared society if all we do is draw new lines of division and pat ourselves on the back for getting rid of the old ones. So
Dear Mr Poots
What is being done?
What more needs to be done?
How quickly can it be done?
Is there anything I can do?
Drugs, alcohol, self-harm and poverty – what needs to be done and when can we see a co-ordinated, resourced, effectively informed response?