Sobering message about suicide few in Ireland want to hear

Danny Healy-Rae thinks that people should be able to drink a couple of pints and drive home, but only on quiet country roads. Otherwise, the isolation that people suffer will put them at risk of suicide.

Isolation and loneliness are real problems in rural areas, as is the lack of viable public transport. The solution hardly lies in suggesting that people will die by suicide if denied the chance to do something harmful like drinking and driving.

For understandable reasons, people talk about destigmatising suicide, in the hope that people will be more inclined to look for help when in distress. The message we want to give is that there is always a better way.

Normalisation of suicide

However, while the aim is to destigmatise both the person who died by suicide and the bereaved family, what seems to have happened instead is the normalisation of suicide as one of a number of possible reactions to stress.

This process is exacerbated by irresponsible reporting, such as the suggestion that recent deaths by suicide in teenage girls were simply a response to cyberbullying. Many journalists are extremely careful in the way they report suicide, and there are some who carry best practice even further and highlight cases where people have successfully overcome their desire to die by suicide, and learned to cope and even flourish.

However, some media outlets still highlight suicide in headlines, reveal the contents of suicide notes and offer simplistic, single-factor explanations. This is in spite of the well-documented danger of suicide contagion, or copy-cat effect.

The effects of this kind of coverage were documented in Taiwan by Dr Andrew Cheng. An extremely popular actor, MJ Nee, died by suicide in 2005. Saturation coverage followed, which breached virtually every media guideline. Cheng was able to document a marked increase in suicides for four weeks after the media coverage, with most of the male suicides favouring the method used by Nee.

‘Circles of vulnerability’

Interestingly, most of the males who died by suicide were much younger than the actor, illustrating the effect often called “circles of vulnerability”. There are three categories, which sometimes overlap, that signal increased risk of suicide contagion.

The first is geographical proximity, in other words, witnessing a suicide or being close to where it happened. (This can be exacerbated by media coverage, which brings disaster into everyone’s living room.) The second is psychological proximity, which is the level of identification with or admiration for the person who has taken his or her own life. The third is being part of a population at risk, that is, people who are vulnerable because of having a mental illness, significant recent trauma, or a history of family conflict or substance abuse.

Risk factor

The last factor mentioned is a trunk-waving woolly mammoth in the room. Most people don’t want to think about alcohol abuse as a risk factor for suicide, because alcohol abuse is our national pastime.

A 2011 study by Prof Brendan Walsh of University College Dublin and Dermot Walsh of the Mental Health Commission showed that alcohol consumption has a significant impact on suicide rates among males of all ages, and young women aged 15 to 24.

According to Conor Cullen of Alcohol Action Ireland: “The World Health Organisation has estimated that the risk of suicide when a person is currently abusing alcohol is eight times greater than if they were not abusing alcohol. However, a person doesn’t have to be a heavy drinker or even a regular drinker to be at risk – just one occasion of heavy drinking can reduce inhibitions enough to self-harm or act on suicidal thoughts.”

This week, research on suicide published by the Men’s Health Forum of Ireland, concluded that reduced drinking is one of the few unequivocal measures that bring down suicide rates.

Who, in Ireland, wants to hear that message? We would much prefer to talk about helping men to get in touch with their feelings, and better able to express them. Yet that theory falls down somewhat when you realise that rates of depression, anxiety and eating disorders are far higher in women, the alleged experts in the communication of emotions.

Poor impulse control

Rates of attempted suicide are also high in women. However, men tend to choose more violent methods that, sadly, succeed more often. There is also some evidence that the ability to control impulses matures later in men. It’s a vicious cycle – poor impulse control is more likely to lead to problem drinking, which in turn leads to more impulsive and dangerous behaviour.

The stalling of the Sale of Alcohol Bill, perhaps until the middle of this year, was one of the unfortunate consequences of Róisín Shortall’s resignation. We could do with her driving energy now.

Imagine if Healy-Rae had announced that he was turning his pub into a cafe, so as to offer an alcohol-free venue where people could safely socialise. The derisive laughter would have been deafening. Who would bother leaving their homes on a cold winter’s evening for a nice cuppa and a chat? And that inevitable response tells us more than we might want to know about our attitudes to alcohol.