ALTHOUGH the issue has now been reduced to something of a sound bite as news features, inquests and coroners’ reports are lost amidst a deluge of social and economic woes, suicide in Ireland has nevertheless truly reached ‘epidemic proportions’.
In the years 2009-2011, the CSO recorded 1,563 deaths as being caused by suicide, compared to a figure of 636 road deaths for the same period. Figures now show that 10 people die by suicide every week in this country, eight of whom are men; alarmingly, suicide in Ireland now ranks as second highest in Europe.
Given the success of concerted campaigns by the Road Safety Authority (RSA) in helping to prevent road deaths in Ireland, the Government’s approach to suicide prevention would appear to be wholly inadequate. To compound the issue, traditional methods of treatment offered through GPs and the psychiatric services can be one-dimensional in approach, overly clinical and ineffective.
Witnessing these problems first-hand, psychologist Joan Freeman quit her private counselling practice and, took a loan for €130,000 and, using her house as collateral, founded Pieta House, the centre for the prevention of self-harm or suicide in Lucan, Co Dublin in January 2006.
With over 18,000 people helped to date and centres in Dublin, Limerick, Cork, Tipperary, Galway and Kerry, the name of Pieta House has now become synonymous with suicide prevention. So what does the service offer by way of treatment?
“Ours is a talking therapy, and a solution-focused approach,” says Freeman. “Usually when people come to us they are responding or reacting to a life event, so we try to focus on what their problem is, instead of trying to analyse it. Our approach is also non-clinical and informal, and very rooted in compassion.
“We have no age limit — we’ve had people from age six to someone in their eighties and people from all types of wealth and poverty; when we’re in crisis, we’re the same as everybody else. The service is also free, that’s one of the barriers we wanted to remove to make it accessible, and anyone can make the phone call — you don’t need a doctor’s letter or psychiatric report”.
Freman has some reservations towards the psychiatric model of treatment. “I think that doctors are too quick to prescribe, that medication is seen as an instant remedy, whereas you should just sit down with the person and find out what’s going on in their life.
“Sometimes it’s simpler and cheaper to prescribe rather than provide therapy, but also with the vast numbers of patients presenting, the ability to provide counselling or other forms of therapy is limited, so really they’re see one answer.
“There’s also no continuity in the psychiatric services — non consulatant doctors are there for six months and then they’re turned over to somewhere else, so that if you’ve started to build a rapport with one person, you then have to see someone else.”
In 2005, ‘Reach Out’. Fianna Fáil’s 10 year National Strategy for Action on Suicide Prevention was launched by then Minister for Health, Mary Harney, but as Joan says:
“During any election time, suicide is the key topic that every candidate is going to push, then as soon as they’re elected it’s forgotten about. The government has given the National Office Of Suicide Prevention about €9 million this year to disperse amongst 300 organisations around the country, but because of lack of regulation, often this means that anybody can set up a service.
Freeman believes suicide prevention should be managed as an ‘integrated model’.
“The first component of this is primary care — your GP, A&E, mental health services, etc; the second is the model of treatment offered by organizations like Pieta House, and the third component is family and friends, because they’re the ones at the frontline. We need representatives from all sides on an advisory body — someone who uses the services, someone on the ground like ourselves, someone from a family affected and someone from primary care. That’s really the only way it’s going to work.”
With men accounting for 80% of suicides in this country, Pieta House launched a campaign in 2013, ‘Mind Our Men’, which aims to educate the public and enlist their help .
“In 2012, 47% of clients coming to us were men, but when we looked at that figure again, we saw that most appointments were made by women — usually the men’s wives or mums. Men don’t look for help, and are reluctant to go for any service, whether it’s a GP or dentist, and it’s usually women who encourage them or who make the appointment for them; sometimes men think the problem will pass, that they can fix it themselves, or they’re terrified of confidentiality.
“What ‘Mind Our Men’ does is to show people how to spot the warning signs, and to help them help save a life. We provide people with a list of signs and symptoms, tipping points etc and what to do in a particular situation. For example, if you knew that men are more vulnerable coming out of a broken relationship, you would be on alert if you knew someone in that situation. It’s about educating people,” says Freeman.
With over 90% of its finance coming from fundraising , Pieta House faces challenging times, but with its treatment model proving a success they seem well equipped for the future.
The moral imperative, however, lies with society in bringing suicide and its causes from out of the shadows. Depression, alcoholism, sexual abuse, relationship difficulties and social isolation may not make for conversation at dinner parties, yet so often they are within our view, and within our sphere of influence.
Education, a radical overhaul of services, greater resources, cooperation between agencies and reduced waiting lists would go some way towards alleviating the problem while we begin to tackle the greater societal/environmental issues.
In the meantime, as we approach the festive season, what is offered by organisations like Pieta House is a glimpse of hope, and the promise of someone who will simply sit, and listen.