World Suicide Prevention Day: We need a new way of helping those at risk of suicide

A couple of months ago a young man I worked with took his own life in a very violent way. I am the manager of the rehabilitation programme in Dublin he was attending and this event has had a powerful impact on me professionally and emotionally. I was the person who had assessed his risk of suicide as high, less than 18 hours before he pointed the gun at himself and pulled the trigger.

The young man in question had attempted to take his life before but I didn’t know that. His drinking and drug use were major factors in feeding his suicidal behaviour. While he was able to connect with what we call the protective factors such as partner, children, job and friends, all of this dissipates when alcohol or drugs are involved. At such times, people in crisis are likely to follow through with taking their own life by “accident” because their feelings of anger, loss or despair are heightened.

Just a few days earlier, I had been made aware of his risk of suicide by another member of the care team. The timing couldn’t have been worse, as it was Friday and our services are closed at the weekend. Thankfully, the initial session to assess intent and access to the means of suicide had been successful in that he came back on the following Monday – our agreed plan and his protective factors having kept him focused over the weekend.

Waiting lists

However, during the follow-up session that morning it soon became clear the situation had worsened and his behaviour demonstrated a high risk of suicide. I spoke to the care team and they agreed. The decision was made to take him directly to his GP to have him referred to the local mental health services. His GP agreed the situation was critical. However: bad news, there was a two-month waiting list. The only fast-track option was to refer him to Tallaght hospital’s emergency department.

We drove back to my office to regroup and inform the care team. He was willing to attend hospital but insisted on going with his partner rather than a member of staff. We agreed he would phone the team when he got there and keep in regular contact for the rest of the day. The calls never came. We rang him several times but no answer. We tried again before 5pm as we closed. No answer.

The following morning, a member of our staff approached me with the news a body had been found in a field not 50 yards from our door. As the other participants on the programme arrived for work, the word was the body was that of the young man. It was 2.20pm before we got confirmation.

Role of GPs

As a professional who deals with suicidal behaviour and self-harm, my experience is there are some effective services for dealing with suicide in our hospitals and community. However, they don’t seem to be communicating with each other, and while GPs are central they are bound by patient confidentiality which makes interagency collaboration very difficult.

What we need is a new protocol for working with individuals assessed as being at high risk of suicide which would involve the provision of an emergency 48-hour residential facility where the individual in crisis could be monitored around the clock until they have been brought to a safer situation through counselling and medical support. This emergency intervention must also involve those closest to the individual.

Ireland has the highest rate of suicide in Europe for young women and the second-highest for young men.

Studies in the UK point to restricted access to means of suicide and the use of individualised and intense cognitive and behavioural therapies as showing promise in reducing attempted suicide and self-harm.

While there are no guarantees, we have no optionbut to try.

Derek J Byrne is an academic and journalist, and manager of an addiction rehabilitation programme

Today is World Suicide Prevention Day. If you have been affected by this issue or have feelings of suicide you can find help by contacting the Console 24/7 helpline at 1800 247 247 or by texting HELP to 51444