Alcohol abuse in final year a factor in 78 per cent of suicide deaths, Cork study reveals

NEARLY FOUR out of five people who died through suicide in a 2½-year period in Cork had been abusing alcohol in the year prior…

NEARLY FOUR out of five people who died through suicide in a 2½-year period in Cork had been abusing alcohol in the year prior to their death, a major new report on suicide has found.

The first report of the Suicide Support and Information System (SSIS) shows that 78.1 per cent of people who took their own lives were abusing alcohol in the year prior to death and more than half were abusing alcohol and/or drugs.

The report includes data on 190 consecutive cases of suicide in Cork city and county between September 2008 and March 2011.

The high number of suicide deaths involving alcohol abuse has prompted the director of research with the National Suicide Research Foundation, Ella Arensman, to call for a warning to be placed on all alcoholic products stating that “excessive use of alcohol can cause mental health problems”.

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Dr Arensman said all of the stakeholders involved needed to take this finding very seriously and engage on the issue.

In terms of risk factors, the SSIS report highlighted a clear and higher than expected link between the recession and suicide – more than 38 per cent of those who died by suicide were unemployed and 32.8 per cent had been working in the construction sector.

Other frequently reported occupations included agriculture, students, the medical profession, business and commerce, the education sector, and taxi drivers. However, Dr Arensman pointed out that there were a multitude of other risk factors involved in these deaths.

“More than two-thirds had already experienced the loss of a family member or friend through suicide, which is also much higher than expected,” she said. “This highlights how important it is that bereavement support counsellors be alert to other family members who may be at risk following a death through suicide.

“In the year prior to death, over 80 per cent of people studied had been in contact with their GP and the majority had contacted their GP four times or more during the year before their death.

“This finding underlines the need for more awareness among GPs to pick up the subtle signs of suicidality. The National Office for Suicide Prevention is in the process of implementing national training for GPs in conjunction with the Irish College of General Practitioners, which will be most welcome.”

A history of self-harm was another major risk factor in death by suicide, according to the report, with 45 per cent of people having self-harmed in the past.

Dr Arensman noted that researchers were also struck by the fact that two-thirds of families reported their deceased family members had received no apparent benefit from the mental health outpatient services they attended, highlighting a need for a serious review of these services.

The SSIS report included a cluster of 19 suicides involving males aged 14-36 between September 2008 and December 2010 in a small area of Co Cork.

This revealed a risk profile characterised by severe alcohol and drug abuse, often starting in early adolescence; exposure to and grief related to the loss of a friend by suicide; non-communication of suicidal intent; over-attachment to peers; and glorification of suicide.

“The outcomes of the SSIS pilot study support the maintenance of the programme in Cork and its expansion to other regions, in particular those with high rates of suicide and a history of suicide clusters,” said Dr Arensman.

Figures released last week showed the number of suicides registered in Ireland rose to 525 in 2011, an increase of 7 per cent on the previous year.

The data from the Central Statistics Office revealed a total of 439 men and 86 women were recorded as having taken their own lives, the majority of whom were aged 15-44.

Street drugs: Suicide link

THE CLOSURE of head shops has been linked to a significant drop in the use of street drugs or formerly “legal highs” in cases of intentional overdoses, according to new figures.

The latest annual report from the National Registry of Deliberate Self Harm 2011 shows a reduction of 27 per cent in the use of street drugs in intentional overdose episodes.

The director of research with the National Suicide Research Foundation, Dr Ella Arensman, says: “The significant reduction in the use of street drugs in self-harm cases is linked to the closure of head shops following the introduction of legislation banning these substances from sale. “This reduction underlines the benefit of doing further work in restricting access to means of self harm, in particular overdose, in line with the international research.”

The report, compiled by Prof Ivan Perry and Dr Paul Corcoran of the foundation, collects data on all persons presenting to hospital emergency departments as a result of deliberate self-harm.

It is being launched today by the Minister of State for Health, Kathleen Quinn, in Dublin.

After four years of successive increases in self-harm presentations, the 2011 report shows a 4 per cent decrease on 2010 – there were 12,216 presentations involving 9,834 people last year.

Dr Arensman points out that with 20 per cent of presentations due to repeated self-harm, these patients still remain a major challenge for the hospital services.

Alcohol was involved in 30 per cent of cases of self-harm reported in 2011, with similar rates in men and women. Drug overdose was still the most common method of deliberate self-harm (69 per cent) and more so in women than men.

As in previous years, the female rate of deliberate self-harm was higher than the male rate, but gender differences have reduced significantly over the years to 10 per cent in 2011.

The peak age for women to self harm is between 15-19 and for men, between 20-24.

“There is still significant variation in the aftercare provided to people who self-harm depending on HSE region,” Dr Arensman says.

“I have been involved in the development of national guidelines for the assessment and management of self harm for the national mental health clinical programme and we should work to have these implemented as soon as possible.” MICHELLE McDONAGH

Michelle McDonagh

Michelle McDonagh

Michelle McDonagh, a contributor to The Irish Times, writes about health and family