Issues

Suicide crisis

1_person Since the Good Friday Agreement more people have died by suicide than were killed during the 30 years of the Troubles.

 Philip McTaggart talks to Owen McQuade about the suicide crisis and what should be done to address a growing problem.

Latest official figures show that 3,859 people have taken their own lives in Northern Ireland since 1998. This is greater than the 3,600 who lost their lives during three decades of the Troubles. And the number of suicides between 1998 and 2004 was almost double the number of deaths caused by road accidents. “Suicide rates are continuing to rise, not only here but throughout the island of Ireland. Suicide rates are double the number of people that die on the roads,” observes Philip McTaggart, who founded the suicide prevention charity PIPS and now runs his own mindfulness training company, Mindskills [www.philipmctaggart.com].

Suicide awareness is crucial in dealing with people who are feeling suicidal. It is often difficult to recognise when someone is feeling suicidal. McTaggart sees a crisis in how people with mental health issues are dealt with by the health service: “Front line staff are not trained to deal with mental health patients.

Many patients are sent home with no guidance or support to help them and their families deal with that situation. If that person doesn’t get the support they need within six months there is the possibility that two other members of that family will go on to suffer from depression caused by the impact of that family member’s problems,” he says.

There needs to be a formal programme of training for all frontline services: emergency services, PSNI, fire and ambulance services; training should also be developed for health care staff: A&E, GPs etc. and training of professionals and volunteers who come into contact with young people including sports coaches, youth workers etc.

In addition to the emergency mental health services, which do not operate on a 24 hour basis, there are 20 community organisations in Belfast providing crisis mental health services and support for families who have lost someone through suicide. McTaggart says that there needs to better co-ordination of these groups that are delivering vital services to the community. Indeed, there is often competition between providers.

Some community organisations providing counselling support have had long waiting lists with waiting times of six to twelve months for an appointment, while other providers have the capacity available to meet the needs of those waiting. Co-ordination of services is vital to use these scarce resources better to meet the needs of those in need.

“There is no co-ordination between all the organisations involved in suicide prevention. There needs to be an overarching body to monitor the work that is being done. What is the point of putting money into something that is obviously not working. If suicide rates are continuing to rise, there is clearly something wrong,” says McTaggart.

Although the health service does not provide 24 hour crisis mental health services, there is help available over the phone with Lifeline [0808 808 8000] and the Samaritans [116 123]. There has been a community response and the founding of The Nightingale Centre in Belfast [028 9590 0008] which provides services 24/7. “Although there was opposition for that to open at the start, it is the first crisis intervention centre in the North dedicated to supporting people at any hour of the day or night. People don’t just stop ending their lives at five o’clock – it often happens in the early hours of the morning and families do not have anywhere to take those in need of support. This is an initiative taken up by the community.”

McTaggart says that hospital A&E departments as they are configured at present are not wholly suitable to deal with those in mental health crisis. There are a number of practical steps that would support someone who is feeling suicidal and has presented at an A&E department such as ‘quiet rooms’ in A&E departments. When someone presents in A&E in distress this would be somewhere to sit and chat to someone rather than sit in a busy A&E waiting area for several hours. “This does not have to be a big room but would provide a vital refuge.” There also needs to be a better interface between A&E departments and mental health services. An effective partnership between A&E and suicide prevention services is critical to preventing those in distress taking their own life. There is a system in place at A&E units in the hospitals whereby patients are given a card ‘Card b4 you leave’ which indicates a date and time in which the person in crisis would be seen. “But is it working well? In some places it is and in others it is non-existent,” contends McTaggart.

There is also a potential problem with the new tendering process for such services that government wants to develop. “This could cripple an already exhausted and under pressure service. If the changes go ahead of the 20 organisations that are currently funded under Protect Life only one or two will be funded and this will make matters much worse,” observes McTaggart.

Prevention

On the wider prevention strategy, McTaggart believes that a complete rethink is required as the number of people taking their own lives continues to soar. “We have to rethink the suicide prevention strategy. It is not about a refresh strategy or a renew strategy. It is about sitting down and starting again. It is obvious that things are not working. Even though there is more help available today than there was 14 years ago, there are more people today with mental health problems than ever before and there are more people dying. The situation is getting worse,” stresses McTaggart.

In addition to emergency intervention McTaggart believes that a longer term approach focusing on young people is also required. “We need to build resilience programmes to teach better coping mechanisms from an early age,” he says. He advocates practical measures such as the Northern Ireland Curriculum for early years and 11-14 year olds including a module on ‘coping skills’. This would tackle issues such as building confidence and reliance and also tackle the growing problem of self-harm. Another objective would be to help overcome the stigma of mental health. Reducing the stigma of mental health and suicide will increase people’s likelihood of seeking assistance.

McTaggart supports a co-ordinated departmental approach across each government department on the issues of mental health and suicide. “We can help people with their mental health problems and prevent others from ending their own lives. By working together in a true partnership and with the right resources we can make life better for people,” he concludes.

An agenda for preventing suicide

1.   Better crisis services at A&E departments

2.   Suicide awareness and prevention training

3.   Prevention: Education and awareness for young people

4.   Maintain financial support for suicide prevention services and training

5.   Co-ordination of suicide prevention services

6.   Cross-departmental approach to suicide prevention in government. 

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