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Suicide in Ireland 2003-2008 SUICIDE IN IRELAND 2003-2008 Kevin M. Malone MD, FRCPI, FRCPsych Foreword uicide is the leading cause of undertaken by Prof Kevin Malone and his team at of a high quality throughout the land to afford best death for young men in Ireland. UCD. This is the most comprehensive programme of suicide intervention and prevention efforts. Training Whilst we have made great research to date into suicide in Ireland, which includes and sustained support at all levels will be required to strides in research into such a systematic tracing of suicide around Ireland, assisted ensure that this goal is reached. Effective and sensitive conditions as diabetes, heart by the testimony of suicide bereaved families. It has a communication is essential by all statutory agencies disease and cancer - research particular focus on suicide in Youths and Young Adults, with bereaved families in both the immediate aftermath into suicide in Ireland is scarce. where the bulge in Irish suicide statistics is observed. of a suicide death, and also in the longer term. Without knowledge, it is The research results are both enlightening and This includes all 1st responders, coroners and impossible to make progress challenging for our understanding of suicide in Irish healthcare professionals. The proposal for a “confidential and suicide persists unabated in society at many levels, and we - Society and Government inquiry” approach could bring about a positive change to the Irish knowledge gap. 3Ts (Turn The Tide of Suicide) is - must sit up and take notice. We must understand more the prevailing defensive healthcare position which needs a registered charity founded in 2003 to raise awareness about our “teens in trouble” and we must ensure that to change. Sof the problem of suicide in Ireland and to raise funds to they are not ‘let down’ at any level. Our systems and The Lived Lives project is a unique Irish endeavour help lower suicide rates through support for dedicated processes cannot be allowed to make matters worse with universal humanitarian potential, and has the research, education, intervention and prevention. for them, and we must learn from this. capacity to instil healing and hope, as well as engaging Our goal is to move out of the knowledge vacuum If this requires mandatory training for all statutory society in a deeper and durational conversation around that fuels the stigma of suicide, and to move beyond services who engage with them at any level, so be it. suicide in our modern society. awareness to knowledge and sustained and integrated We must conduct the necessary analyses to assess We have made dramatic inroads into what used be action. We want Ireland to become the best at beating the gaps in our mental health literacy education and described as “the carnage on our roads”, where we have suicide and to foster leadership by example, rather than our responses to young people in mental distress. Toxic seen young male driving deaths reduced by 50%, and it remaining defeated in the shadows. humiliation and polyvictimization are new terms that has not been attained by accident. Surely this model can We are passionate about finding a way to help reduce we must learn about and understand, particularly in the be embraced in our fight against suicide and a dedicated the incidence of Suicide in Ireland. 3Ts was the first context of bullying, assaults and muggings. We must Suicide Prevention Authority can finally begin to turn the group to call upon the Irish Government for the formation also understand more about “milestones to manhood”, tide of suicide. of a dedicated Suicide Prevention Authority, akin to the eloquently exposed in the “Many Young Men of twenty” Road Safety Authority. We believe that only a Suicide project included in this report. Prevention Authority can deliver an effective solution. The families in this project ‘have spoken’ about their We do acknowledge that there is positive work experiences of the interface with statutory services being done but we need to build upon that work in a during a suicidal crisis, and in the aftermath of a Noel Smyth systematic way. suicide death. Their voice must be balanced against Chairman, 3Ts I am very pleased to introduce this timely independent the professional and courageous efforts of so many research report into suicide in Ireland, which has been of our 1st responders. But the response must be To find out more about 3Ts, please visit www.3ts.ie. Suicide in Ireland | 2003-2008 SUICIDE IN IRELAND 2003-2008 Kevin M. Malone MD, FRCPI, FRCPsych Department of Psychiatry, Psychotherapy & Mental Health Research St. Vincent’s University Hospital and School of Medicine & Medical Science University College Dublin, Dublin 4 Funded by: 3Ts National Office for Suicide Prevention National Lottery Ireland Funds and Denis Kelleher, ESB Electric Aid, Be Not Afraid, Padraig Harrington Foundation, Community Foundation for Ireland, Carphone Warehouse, Stafford Foundation, Culture Ireland Suicide in Ireland | 2003-2008 Table of Contents EXECUTIVE SUMMARY RESULTS DISCUSSION Overview Project I: Suicide Survey Demographics and the Early Moving towards Aged 21 Results Emergence of Age as a Factor Socio-Demographics Conclusions “Many Young Men of Twenty said Goodbye” Mental Illness and Treatment, and Alcohol Implications and Recommendations Male Suicide and Communication of Suicide Intent Project II: Clinical and Psychosocial factors associated with Life Events Suicide in Young Adults OVERVIEW Demographic Factors Abuse The scale of the Problem: from Global to Local Mental Illness Factors Assaults Muggings and Violence Suicide Rates in Ireland – 2009 Alcohol, Substance abuse and Co-Morbidity factors Bullying Suicide Research and Prevention Funding Clusters – how do we measure up? Suicidality Factors Suicide in Children: “Troubled Teens” and “Teens-in-Trouble” Value of “Local” / Regional Research: Psychosocial and Life Event Factors Science Arts Collaboration Support for Suicide in Ireland Survey Research Proposal Abuse Factors Statutory Services – before and after Suicide Suicide in Ireland Survey: The Context Separation and Loss Factors Singletons, Couplets and Clusters Strengths and Limitations SURVEY DESIGN & METHODS Age-Specific Life Stage Factors IMPLICATIONS & RECOMMENDATIONS Overview Interface with Statutory Services Design Rationale Research Experience Feedback PERSONAL REFLECTIONS Qualitative Component 3rd Generation Psychological Autopsy contribution Project III: Quantitative Epidemiological Analysis of Suicide in ASSOCIATED PUBLICATIONS AND PRESENTATIONS TO DATE Control Groups from INSURE the Children of Ireland The development of The Psychobiographical Autopsy Design to Suicide rates per 100,000 for 1993-1998 and 2003-2008 by incorporate Qualitative Analysis. age and sex in under 18s: an analysis over 2 decades ACKNOWLEDGEMENTS Incorporating a unique Visual Arts Autopsy Study to an Integrated Project IV: Qualitative Analysis of Suicide in Children from the Science Arts design for the Suicide in Ireland Survey REFERENCES Suicide in Ireland Survey Ethics Mental distress, humiliation and violation Recruitment Informed Consent “troubled teens” and “teens-in-trouble” The Research Engagement and Interview Project V: Lived Lives, A Visual Arts Autopsy Data Management “he was my son” Statistical Analyses Suicide in Ireland | 2003-2008 “Family everything, Love Ye, Don’t be worrying about me, Im fine xxx xxx Love Always” Suicide in Ireland | 2003-2008 Executive Summary: Overview he Suicide in study happened. the analysis will continue beyond this report. Ireland Survey The research team overcame many of the This report describes the study background, set out to obstacles inherent in such a project, and viewed methodology, design, data management and contribute new obstacles as challenges to be embraced, and analysis challenges. Varying methodologies knowledge and this model has proved invaluable in bringing the were employed, ranging from a descriptive case understanding study to fruition. study approach to epidemiological analyses to the problem The project was conceptualised in 2002, of national and international data. The report of elevated and took 3 years to secure the necessary focusses on bringing new findings into the Irish youth funding, assemble the project team, develop public domain, that may have implications suicide rates the project design and bring it to the starting not just for Irish suicide prevention efforts, over the past 2 decades. The project was line in 2006. 104 families from around Ireland but which may also be transferable to other designed to inform national and international were interviewed between 2006 – 2009, countries and communities. The Report has a suicideT research, as well as policy makers about their knowledge and experience of particular focus on young people. The results are and clinicians. The project was imbedded in the lives of their loved ones lost to suicide summarized below, together with conclusions communities, and its roots can be traced to in 2003-2008. Data analysis commenced in and recommendations. the kitchen tables of Ireland, where most of the 2010. Such a project can and will most likely research engagements for the descriptive case produce many findings of interest over time, as Suicide in Ireland | 2003-2008 Results I. “Many Young Men of Twenty said Goodbye” rates (Malone et al, 2012). In human terms currently, me, Im fine xxx xxx Love Always” Recruitment into the Suicide in Ireland Survey was although based on small numbers which vary annually, Whilst several
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