Alcohol and inequality factors in people taking own lives in rural areas

FOR ONE young man, suicide seemed a more natural option than trying to get into college. An older man said he would be better off dead because he was a burden on others.

A new study, Pain and Distress in Rural Ireland, is based on in-depth interviews with 26 men who were admitted to hospitals or psychiatric units following suicide attempts or serious self-harming episodes.

The joint UCD-Teagasc project was led by UCD sociologist Dr Anne Cleary, who said suicide was an untold story. When a person died by suicide, explanations were constructed by family and friends but they were often inaccurate.

“The nearest you can come to study those who take their lives is to study those who attempt to do so,” she said.

With PhD student Maria Feeney and Dr Áine Macken-Walsh of Teagasc, she analysed the experiences of the 26 men, aged 19-75. The study found the men came from lower socio- economic groups and half were unemployed. Most were single or separated.

Some 80 per cent had a history of contact with the health services for psychological problems. Dr Cleary noted a reluctance among the men to talk to GPs about mental health problems for confidentiality reasons.

She said alcohol was a key factor in these stories, with one-third of the men having a history of alcohol dependency.

“Self-medication with alcohol and the alcohol culture just has to be addressed,” Dr Cleary said.

She said the stigma surrounding mental health issues in rural areas could be targeted with a public health campaign.

It was crucial to explore the link between inequality and suicidal behaviour, Dr Cleary added. There were, for example, far fewer suicides in universities than were found among lower socio- economic communities.

Teagasc health and safety officer John McNamara said the agricultural authority had supported the study because it wanted to seek a better understanding of the issues involved with a view to improving its prevention strategies. The farmers interviewed spoke about struggling to survive on small holdings and the stress caused by changing regulations.

However, IFA farm family chairwoman Margaret Healy said depression and stress were problems for all types of farmers, including large, successful ones.

Minister of State with responsibility for mental health Kathleen Lynch said rural communities were more vulnerable to suicide than urban communities.

According to the Central Statistics Office, the suicide rate in Offaly last year was 23.5 per 100,000 population, compared with 5.1 in the Fingal area and 7.3 in Dún Laoghaire-Rathdown. Dublin city recorded a rate of 9.1.

PEOPLE AT RISK: IN THEIR OWN WORDS

Ryan* is a returned emigrant in his 70s. He is single and lives in a nursing home which he says he hates.

“I had great plans for myself [when I came home]. I thought I’d have no bother at all when I retired. I should have mapped out something . . . now it’s gone hour to hour, minute to minute so it’s kind of a struggle to keep going The future looks bleak at the moment . . . I think there’s a point where you’d be better off dead than alive. Definitely.”

Larry is in his early 20s. He did the Leaving Certificate but he didn’t like school and has worked since then in whatever jobs he was able to find.

“I was on the dole for a while and then I was given the option of going to college or not. No dole money any more and that’s really when [it hit me] . . . the suicide seemed like a more natural option really than trying to go to college . . . if I don’t have any money, I can’t pay for rent or anything like that so I just thought I’d be better off.”

Niall is in his late 50s and is separated. He says the break- up of his marriage is a key factor in his suicidal thoughts. He also has an alcohol problem.

“ lonely, very lonely. I was getting more depressed and more depressed. I’d never cooked in my life before. I never washed clothes or anything like that . . . I just haven’t got the courage to live at the moment.”

Eddie is in his 20s, has a third- level degree and is unemployed. He began to use alcohol to cope with anxiety.

“I was drinking a lot to combat that [anxiety] because I was self- medicating . . . I had a problem with anxiety . . . I didn’t go to the doctor. I’d be fairly nervous about going to my parents and telling them something like this . . . that I’m suffering from depression.”

Oliver is in his late 40s and separated. He took an off-farm job to help financially but had to give it up due to an injury.

“It’s only an auld hobby now, farming. There’s no money out of it . . . It’s awful to be sitting at home there looking at four walls on your own.”

*All names have been changed. Source: Pain and Distress in Rural Ireland, Dr Anne Cleary; Maria Feeney and Dr Áine Macken-Walsh