Statistics reveal that Ireland has the fourth highest under-25 suicide rates in the EU
Q My nephew who was in his early 20s recently took his own life. We were all devastated and feel that we should have known that he was so down. Nobody ever suspected anything.
I thought that suicide was very rare, but since our experience I now realise that it is a lot more common than people think.
Is it true that people who intend to take their own lives often confide in someone a few weeks beforehand?
As a society we should try to do something about this problem as it is so sad to lose a young life, and the people left behind are often riddled with guilt.
AIrish novelist and playwright Sebastian Barry refers to Ireland and its "culture of concealment". Nowhere is this culture of concealment more apparent than in relation to suicide.
The statistics, while tardy and flawed, still reveal the sorry reality that Ireland has the fourth highest under-25 suicide rates in the enlarged EU (behind Lithuania, Estonia and Finland), and the third highest EU suicide rate in 15-19 year olds.
A realistic assumption based on some of our research is that there are between 10 and 12 suicide deaths in Ireland each week. One fifth of these suicide deaths are young males under 25 years (120 such lost lives each year).
Suicide is now the leading cause of death in this age group, exceeding road and cancer deaths.
As part of our research, we have interviewed suicide-bereaved families all over Ireland. My research team and I have stood in graveyards with families who have indicated the grave of their deceased loved one (often buried in their favourite GAA, soccer or rugby jersey), and have then proceeded to point out numerous graves of friends of the deceased who have also taken their own lives.
It is a bone-chilling experience that all-too-clearly brings home the stark reality of the lost lives behind the cold statistics. It also highlights to us what we know, and asks questions about what we don’t know. It is not an alternative to retreat to the culture of concealment.
Engaging with these suicide-bereaved families has been a privileged, humbling and strangely life-affirming experience. Here are families wracked with grief, sorrow and loss. They have invited us into their homes, hoping that their research engagement with us will save at least one family from going through what they have experienced.
So what have we learned this far? Youth suicide doesn’t only affect individuals – it also affects communities. A young male suicide death seems on occasions to confer an added community risk (for girls and boys).
The majority of cases of young suicide deaths in our study communicated their feelings to “someone’’ in the month preceding their deaths, which is somewhat contrary to the perceived wisdom that “young men don’t talk’’.
This is no comfort for families where there was no communication, but it nevertheless is important for potential new avenues for intervention and prevention. What happens currently when a sibling or peer learns of their distressed brother/sister/friend?
There is evidence to suggest that young people have less of a stigma around suicide. It is either an unspoken or sometimes spoken option on the social menu of life, and a more acceptable problem-solving strategy than in previous generations.
Horizontal peer-to-peer social bonds and communication pathways are now frequently more important to young people than the traditional vertical parental bonds of times past. If we are to develop effective suicide intervention strategies with young men, we need to understand much more about how peers operate, what factors influence their motivation to seek help for themselves or their pal, and what barriers to help they perceive.
In other words, instead of preaching and prescribing to them, we need to develop methods for seeing the modern world through the eyes of our generation of young men so that we can tailor help to their needs.
Most of the suicide-deceased young men in our study promised their parents that they’d “never do anything like that”, in cases where parents had a conversation with them about a known recent suicide death – but yet, they did it anyway, on occasions within days or weeks.
Suicide is a seductive and highly potent signal of power and control, and when young people are exposed to it, they seem to become immunised, remain neutral, or become inoculated and “infected” by the event. Most seem “immunised’’ or neutral, but for a sizeable number, the suicide death of their peer “gets inside their head”.
Of course, alcohol is emerging as one possible factor from our study. But it was not a significant factor in all cases. We still need to compare the alcohol consumption patterns with our living control group. It is possible that alcohol consumption may be at least as high, if not higher than the suicide group.
Forty per cent of the 104 cases in our research project died by suicide at their first attempt. This obviously means that 60 per cent of suicide deaths had made at least one previous suicide attempt.
We clearly need tailored interventions for the previous attempters. Sending them home from AE following a suicide attempt without any follow-up psycho-social support is not the answer, and may indeed send a signal to them that society doesn’t really care (and doesn’t have the tools to care).
For those who may die at their first suicide attempt, we need to cast a wider support net. We need to create a culture where signposts to care, intervention and support are clear and cool.
The recent launch of the 1life 24/7 Nationwide project (www.1life.ie, tel: 1800-247100) may well engage young men (and women) in suicidal distress on their terms and using their communication technology in creative and modern ways that might just have a positive effect.
We can’t afford to skimp on this problem unless we want to leave a legacy of abandoning our youth in their time of need, and propagating the culture of concealment.
- This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin, with a contribution from Prof Kevin Malone, professor of psychiatry and mental health research at University College Dublin and St Vincent's University Hospital.
- Send your questions to healthsupplement@irishtimes.com