Why a joint approach is needed to tackle suicide

WHEN IT arrives, suicide baffles, confuses and panics families and communities. Families look for answers to often unanswerable questions.

Young people look to each other for support. Entire communities can feel isolated not knowing how to respond.

It’s little surprise, then, that suicide- prevention groups and services have popped up right across the State in recent years in response to local tragedies.

They are an attempt to comprehend what has happened – and to help prevent other needless deaths.

But it may also be the wrong model. There are now hundreds of suicide-prevention groups, dozens of different counselling services, numerous different support phonelines and websites. The scale is impressive, but it is also deeply fragmented and isolated.

Many groups very often are not sharing their experiences or working together to improve support or training; it also means State funding for groups – about €5 million this year – may not be producing the kind of value for money they could be.

Most of all, however, it means that we are not as effective as we could be in reducing the number of people taking their own lives.

Geoff Day was the head of the HSE’s National Office for Suicide Prevention until recently. He says mergers between major suicide-prevention groups are vitally important, but came up against resistance to the idea during his tenure.

“There are some who want to go their own way and aren’t interested in alliances or mergers. They may feel they bring something unique to the table or that their approach is the only valid way,” he says.

“But, increasingly, there are those who realise they need to work with others through formal or informal alliances. This can prevent duplication and allow for the sharing of resources and knowledge.”

Console is one of the biggest groups working in the sector. Founded a decade ago, it is a national service which supports people in crisis as well as those who are bereaved by suicide through counselling, support and helpline services.

Console founder Paul Kelly sees the need for fewer and better organised services.

“There is plenty of scope for organisations like Console to merge or amalgamate with others regarding facilities, funding or training. It’s common sense,” says Kelly.

“There is less money to go around for everyone. In fact, we’ve been collaborating with organisations in areas like training, sharing salaries for counselling and clinicians. It’s common sense.”

It is important, he says, that there is strong national direction for organisations and standards to ensure counselling or other interventions are of high quality and work off a solid evidence-base.

One of the organisations Console has started working with in recent times is Beacon of Light in Clondalkin, established in the mid-1990s due to rising concern over substance abuse and suicide in the west Dublin suburb.

Now, it has six paid counsellors, as well as some 25 volunteers, who provide support to vulnerable people five days a week; last year alone, it provided some 5,000 counselling sessions.

But all that work has been under threat since the group found out recently it had lost its major source of grant aid. Now, the organisation is working in partnership with Console which will enable it to continue operating.

“Ethically, we owe it to our clients to be here,” says Beacon of Light’s co-founder, Patricia Kidd. “Thankfully, there is a lot of crossover with what Console does. So, some of our staff will work in its centre, and some of its [staff] will work over here. It will help us to keep moving forward, though we could still do with more funding.”

In addition to the volume of support groups, counselling services and support lines, there has been a big rise in the number of different websites offering advice and help.

The argument for rationalising in this case is less convincing, given the smaller overheads involved in running a website and its potential reach to the wider population.

Derek Chambers of ReachOut.com, which provides advice for young people on mental health issues, says there remains an urgent need for a variety of services which target different parts of the population.

“We’re often asked how we differ from other online services. People see that you’re online and don’t look at what it is you actually do, which in our case is providing a youth mental health service,” he says.

“Other websites provide general youth health information or target adults, or maybe address specific issues such as eating disorders. Just because we’re all online doesn’t mean we do the same thing, far from it.”

He says online mental health support and suicide-prevention services give the chance to make a population-wide impact by achieving scale through well-evaluated, cost-effective, online resources that understand young people and their behaviours.

His point about services being well-evaluated is an important one.

For some time there has been concern about the quality of many suicide-prevention services and whether they are properly managed and run, and if they are training their staff well, and if they are sufficiently focused.

There is quiet work being done to address this. The Irish Association of Suicidology, for example, has commenced the process of establishing an accreditation model for voluntary organisations working in this sector. This model would set minimum standards for good governance, training and education and client service, according to the association.

However, the standards will also need to encourage and foster co-operation and continued development of best practice within the sector.

In addition, the HSE’s National Office for Suicide Prevention is doing more work to link its funding to organisations with a commitment to work in partnership with other groups.

There are aspects to suicide which are out of our hands, such as the economic downturn. But there are areas where suicide prevention can make a real difference: by adopting evidence-based approaches to suicide which are proven to lessen the risk of suicide such as resilience, peer support and early intervention.

The more organisations work together, the more effective they can be – and the more compelling a case they can make to Government for more public funding.

Last year, just over 480 people died by suicide – not including up to 200 undetermined deaths. People are still much more likely to die by suicide than as a result of a car crash. It is still the main cause of death among young people.

Campaigners are hopeful we can begin to change these figures, even at a time when public funding is being cut back as never before.

“Everyone wants to see results,” says Geoff Day. “More effective work will encourage people to give more money. I think that more and more, organisations are beginning to understand this.”