Suicide still bears a sadly lethal stigma despite our greater ease talking of it
Members of Gorey Community School with their Project Smile , promoting positive mental health and making people happier at the Young Social Inovaters event in Dublin in March.
Carl O’Brien’s series, “After the Asylum”, raises important questions about how best to support individuals who have mental health difficulties, but it also highlights how much stigma still exists.
That stigma is in no small part responsible for the underfunding of mental health services even during our so-called Celtic Tiger era, and now they are in an even worse state.
During the week, consultant psychiatrist and clinical director of Cluain Mhuire Community services Dr Siobhán Barry likened our community mental health services to Jenga – the game where players pull blocks from a wooden tower. She said that so many blocks had been pulled from community mental health that it seemed likely the next one would cause the system to collapse completely.
It is likely that suicide-prevention services will be one of the casualties of cutbacks, at a time when people are experiencing significant new stresses that contribute to the complex factors that sometimes trigger suicide.
Naive notion of openness
However, seeking to remove stigma must be carefully handled. For example, we have the naive idea that by talking about suicide we have somehow reduced the stigma surrounding mental illness. If only.
It seems to me that instead of normalising help-seeking behaviour, suicide has become part of a repertoire of possible responses in a way that would have been unthinkable even 20 years ago.
Furthermore, See Change, a partnership of 74 Irish organisations working to change attitudes to mental health problems, published research that indicates Irish people are becoming more fearful, not less, about revealing a mental health difficulty.
In 2010, half of those surveyed by See Change would not want others to know about their mental health problem, but in 2012, it had risen to 56 per cent.
Similarly, the figures for those who would delay seeking treatment for fear of someone else knowing, rose from 18 per cent to 28 per cent, while those who would hide a mental health issue from friends rose from 32 per cent to 41 per cent.
Erving Goffman wrote a classic work in 1963, Stigma: Notes on Management of Spoiled Identity. It talks about stigma in terms of a “discredited person facing an unaccepting world”.
Sadly, despite more enlightened times, it is still too often true today. For example, take medication. It is only a part, yet for some people a vital part, of the treatment of mental illness.
However, needing to take medication to control a condition is perfectly acceptable if you have diabetes or asthma, but often stigmatised if you “only” suffer from mental health difficulties .
Similarly, a chronic condition like a bad back is likely to receive support and interest, whereas admitting to depression often provokes embarrassment and avoidance.