WHEN a person dies by suicide, they leave behind family and friends who are gripped not only by grief at the loss but also with questions, the most common of which is why?

Ennis psychotherapist and facilitator of the Solas support group for those bereaved by suicide, Johanna Treacy said, “Those bereaved by suicide are left in shock mostly and have so many questions that will be left unanswered, ‘how could this person do this’, a sense of betrayal ‘if they really loved me how could they have left me?’ and a lot of whys. The why question is one of the things that really makes suicide difficult. It is something you can’t blame anything or anyone for and you are left questioning yourself all the time, if I did this or if this happened, if… The answer goes with the suicide.”
She believes there is still a stigma attached to suicide.
“With suicide, we examine our life, our past, our attitudes and actions. We search ourselves for whatever we did wrong but ultimately we must rather search for what we did right. It is not anybody else’s decision. It is the other person’s but still we feel maybe there is something that we could have done to prevent it. With hindsight, things might make a lot of sense but sometimes there aren’t obvious signs,” she said.
Johanna explained that a person may have had a sudden uplifting change in emotions prior to the suicide.
“It is a solution to them but it is a permanent one. If you can imagine that you had a problem that was causing you an unbearable amount of pain and distress that you couldn’t find a resolution to and then you found a solution. Wouldn’t that make you feel a lot happier? That is what it can be like for someone in that type of situation,” she said.
While there is a perception that all those who die by suicide are depressed, Johanna says that it not the case.
“It could be that they lost a job, their marriage or relationship broke down or it could be because they got a lot of sudden knocks and are finding it difficult to get back up afterwards. Drink and drugs also play a part, as people react differently to drink and it is a depressant. The economic climate has had an effect also. Children will often hear about financial worries and problems in the family and can be affected by this also,” she added.
However, help is available and Johanna believes that people need to break through the stigma associated with suicide and that it is okay to talk about these feelings.
“I think suicide is society’s problem and society has to play its part to prevent it. I do think more resources are needed and resources that can be accessed quickly, even at weekends. People have a fear that if they go to a hospital that people will think they’re mad. There is a huge fear of being judged and what people will think of you for thinking these thoughts. From my experience as a psychotherapist, I often come across people who will say ‘I should have come here a year ago’ or ‘the reason I didn’t come was I didn’t know what counselling was about or what would come up’. There is also the financial factor, ‘I couldn’t afford it’ or due to waiting lists if it’s the public sector they go through.
“It’s another misconception that there has to be something wrong in order to go to counselling. I always say, counselling isn’t always about something being wrong but it is about preventing things from going wrong. Having your thoughts out there and talking about it helps. It can help a person to get some kind of a plan together of how to look after themselves; simple things like looking after what they are eating, exercise, talking to their doctor or joining a support group,” she explained.
She said destructive conflict in schools and in the workplace can also have a negative impact on people and their outlook. “Many people are stressed and anxious. The unemployment rate has risen and those who are still in employment report that conflicts and stress at work are increasing due to a change of working conditions and rate of pay. There can often be little or no communication within organisations to discuss the impact all these changes have on morale and the health of all.
“Understanding suicidal behaviour is not enough if we as a society don’t change and look at some of these issues and develop the skills needed to deal with them,” she said.
Solas is based in Ennis and is a support group for those bereaved by suicide. It was set up by Johanna and another local counsellor in 2005.
“It is of great help to people because it means they don’t have to wait a couple of weeks or a couple of months. The benefit of a support group is that they can meet other bereaved who have similar experiences. It is a place where someone is there to listen and doesn’t judge them because they are in the same boat. It is about acceptance. Sometimes those bereaved fear rejection if they share their real feelings with family and friends. In the support group you can express any emotion and be accepted.
“We have a number of members who are there since 2005 and they have five years of dealing with this and people can say this is what helped me or your feelings are perfectly valid and that normalises the feelings and that helps them. We offer them support when the inquest is coming up as to what to expect and we can offer support at an inquest if a person wants that. We also tell them about Living Links,” she said.
Johanna said the stigma and grief associated with suicide can cause those bereaved to withdraw from people.
“The group can help re-establish social connections. People will say it feels great to just come in some place and be so accepted,” she added.
Solas meet on the second Saturday of the month from 11am to 12 noon in the CIOC offices of the Elevation Business Park in Ennis. For further information about the group, call Johanna on 086 0828807 or arrive on the day.
The group will also be running an eight-week education programme on grief and loss, including suicide, later this year. This is open to anyone who has been bereaved and all are welcome.

TD claims incidents are underreported

THE Central Statistics Office has recorded 16 deaths by suicide in County Clare for the year 2009 but according to Limerick TD and suicide prevention campaigner Dan Neville, this figure could be much higher.
Deputy Neville is a co-founder and the current president of the Irish Association of Suicidology, which was founded in 1996 by the late Dr Michael Kelleher, consultant psychiatrist and vice-president of the international association of suicide prevention, and Dr John Connolly, consultant psychiatrist in St Mary’s Hospital, Castlebar.
He stressed that the whole area of suicide and psychiatric illness is still very stigmatised, something that the IAS is campaigning to change.
“There were 527 people who died from suicide last year. The true number of suicides, however, is more like 650 because of under reporting and non identification of suicides. I’m being conservative at 650, others would be put it higher. Identified suicides are simply not reported to the Central Statistics Office because coroners won’t bring in a verdict of suicide. Some coroners, even though it’s known as suicide, they won’t bring in a verdict of suicide. We have more than 190 open verdicts recorded nationally,” Deputy Neville claimed.
Asked why some coroners don’t return verdicts of suicide at inquests, although they are open to them, the Limerick deputy claimed that in the main there is a certain sensitivity around suicides.
He also maintained that there is underreporting of suicides by gardaí, who he said also have a role in reporting such deaths.
“The suicides are underreported but there is also an issue of non-identification, which causes difficulties. For instance, if someone drowns how do you know is it an accident or a suicide, while there are suicides that are genuinely believed to be accidents. Identifying a suicide is not as clear-cut as a road accident, for example, and because of that, there is an issue with underreporting,” he added.
It was also claimed by Deputy Neville that a certain number of road accidents are, in fact, suicides. “I would put it somewhere between eight and 15 nationally based from international research. In fact, the coroner in Mayo recently brought in two road deaths as suicides,” he said.
Another issue that raises a red flag to health care professionals are the numbers presenting at accident and emergency who have attempted suicide and self-harming.
“Most self-harming cases present at A&E between 11am and 3am but the crisis nurses in accident and emergency are on from 9am to 5pm, where there are crisis nurses. They are not in every hospital. The follow-up to those who self-harm is inadequate. For everybody who presents at A&E with self-harming, there are six or seven more who do not do so. So you are talking in the region of 70,000 people in a year. The highest rate of self-harming for women is between the ages of 15 and 20 and for males it’s between 20 and 25,” he said.
The current economic crisis is also contributing to those taking their own lives, according to Deputy Neville, and with added pressures, such as financial problems and dealing with unemployment, these have a knock-on effect for a person’s mental health.
“We want the State to be more proactive in ensuring that they provide direct assistance to somebody in crisis and to de-stigmatise the whole area of seeking help in those areas. We don’t have a problem seeking help in the medical area in that we go to our doctor if we have serious chest pain. But if we are in crisis or there are problems in the family and there’s a job loss in the family then pressure comes on and there’s a series of knock-on events like a relationship breakdown or marriage break-up. That’s what is happening in a very big way in many areas at the moment with the recession. When a person gets into that kind of position, we want them to be able to say, ok now I need help rather than saying I can’t cope and I’m at my wits end. We would rather that they say I must ring A, B or C or I must see my GP. I would also stress that the GP must have the information and the skills of where to refer that person in such cases,” he said.
Deputy Neville believes that the stigma attached to suicide and to psychiatric illnesses is among the reasons that the two areas are not funded as well as other areas of the medical sphere.
“The Government is not funding the area because it is not a political issue. This Government will not respond to something that doesn’t reward them with votes. Really, the fact of the matter is that if you have a general health problem, where you’re on a waiting list for a hip replacement or a cardio-intervention or someone with cancer problems, then we shout from the rafters to get something done. Does anybody shout about a child who is waiting three years for a psychiatric assessment? It’s because it’s stigmatised. When the political system goes out to the electorate it responds to the demand that’s out there and people don’t demand services for their loved ones in crisis because they want to protect them from the stigma,” he claimed.
He remains positive, however, and recalled other illnesses in the past that overcame stigmatism.
“I also have some hope in this and I’ll tell you why, because if you go back over the centuries, TB was in exactly this position. It was shunned, it was stigmatised and people were allowed to die and we were able to break that back. Similarly, cancer was the big C, you spoke about people having the Big C, now we don’t call it that anymore. There is no stigma now. There was a time when it was under the carpet. We now want mental illness and suicide to come the same way and that’s what we are working towards,” he concluded.