Intervening in time to prevent suicides

STATISTICS for 2010 show a total of 486 deaths by suicide in Ireland, of which 386 were male and 100 female — a decrease of 8% on the record high the previous year of 527 suicides.

In 2003, psychologist Joan Freeman closed down her counselling business and dedicated herself to finding out how best she could help people who were suicidal, and what effort would provide the most beneficial result to those coping with the condition.

The result of her deliberations was Pieta House in Lucan, Co Dublin, opened in January, 2006, as a counselling service for those who were suicidal and self-harming. Suicide was, she discovered, “a topic never discussed and rarely understood” — and so she set about changing this reality through her own efforts.

Over its five years, Pieta House has grown to 60 therapists and staff to cope with the demand — a situation that increases every year. In January 2011, Pieta House opened two new centres — in Ballyfermot and Limerick.

“Pieta House was the first centre in Ireland that specialised in the prevention of self-harm and suicide, an alternative way of helping people in crisis, and one that encourages collaboration with hospitals and doctors,” Freeman explains.

“Our instinct as human beings is about self preservation and that is perhaps why suicide and self-harm seem not only terrifying but also inexplicable. Suicide is still a taboo subject, while self harm is normally consigned to sensationalist story lines on melodramas. There has never been any focused attention paid to it or any therapy created for the behaviour.”

While the advent of the recession has seen an increase in suicide rates, she notes that it has also prompted a rise in the numbers of people coming to Pieta House for help: “We are slowly but surely removing the stigma of suicide, and certainly the recession has had an impact.

“We see clients as young as six and as old as 83 — so it really is the case that this can happen across all stratas of society, all genders and age groups. It is not just the case that the causes of suicide are financial — at every stage of life we are vulnerable to events that can happen in our environment that make us unable to cope.

“People don’t want to die, they want to end that feeling of despair and the causes can range from schoolyard bullying amongst the very young, to adolescent relationship break-ups to the loss of a loved one in the older person,” she says.

Prior to Pieta House, there were few alternatives other than hospitals, psychiatric units or heavy medication — and frequently a combination of all three. “We were convinced that there had to be some other way of helping people. Going to a hospital or taking tablets will not cure the problem,” says Freeman. “People need desperately to talk about it.”

Referrals to Pieta House can be made by anyone, including friends, parents, a partner or a counsellor — a doctor’s referral is not necessary. Waiting times are around a week, but the organisation does reserve two emergency slots every day for people who are actively suicidal. “For people in acute crisis there is no waiting list,” Freeman says.

Treatment is completely free of charge, but donations are accepted. Therapy generally takes up to six weeks, commencing with a client assessment by a therapist best suited to individual needs. “All sessions run on a one-to-one basis. The client will work closely with the therapist who will endeavour to lift their depression, remove negative, despairing thoughts and exchange reasons for dying with reasons for living.”

Family provide the home link with distressed individuals, an important part of ongoing therapy where educating the family runs in tandem with counselling the client. “Family members can become paralysed with fear when they discover that their loved one is suffering from severe depression. By teaching them and explaining to them about depression, we try to demystify the problem and empower them.”

In certain situations, the family are assigned a support therapist who is available on a daily basis during the entire period of the client’s recovery. With the cost of running Pieta House currently at around €1.3m, funding is an ongoing concern — a situation that has remained constant from the beginnings of its existence. “It cost under €100,000 the first year we opened, a figure that has ballooned 13-fold in five short years,” she says.

“Back in 2006, we had six staff, we now have 60. Financially speaking, we lurch from month to month wondering how we can make ends meet. That said, we are managing to deliver our core aim — helping all those who come to our door for help.”

Looking to the future, Freeman hopes that, recession economics notwithstanding, a more transparent approach to the problem of suicide will prevail. “We sincerely hope this new government will embrace the problem of suicide and channel more financial help to organisations like ourselves trying to deal with the problem.”

While Pieta House is currently in receipt of 20% of its annual running costs through government assistance, she would never want to see a day when the organisation was 100% funded by the state. “If we leave the problem entirely in the hands of government, we are not taking ownership or responsibility of it. Indeed, one of the reasons that Pieta House has survived is that people who have been affected by suicide are reaching out in the midst of their despair and grief to help with our fundraising efforts. As well as being a remarkable gesture of generosity, it is also good for survivors themselves to do this as it makes them feel that their loved one has not died in vain.”

Joan Freeman concludes by noting that at least 10 times more money is spent on road safety measures than on suicide prevention, despite the fact that more people kill themselves than die on the roads. Ireland continues to have one of the highest youth suicide rates in the EU.

“Our vision and aim is to have eight centres spread around Ireland, to put a Pieta House within easy reach of every person in the country.”

Name: Joan Freeman

Occupation: Founder Pieta House

Background: Pieta House, the Centre for the Prevention of Self-Harm or Suicide, opened in January 2006. The centre has helped 4,000 people, and opened two further Outreach Centres, as well as two other Centres of Excellence in Dublin and Limerick. She received a People of the Year award in 2011.

Picture: Maura Hickey