This has not discouraged national health departments, including our local DHSSPS, from designing, publishing and implementing suicide prevention strategies. Ours is called “Protect Life”; the Irish equivalent is “Reach Out”. The Scottish’s government’s version is entitled “Choose Life”. Yet recent research for the Australian government (**Martin and Page, 2009) was ambiguous as to whether national strategies reduced suicide. Sometimes they do to a significant extent, as in Finland, Norway and Australia and sometimes they don’t, as in France, United States and England/Wales.
As regards ourselves, even a cursory inspection of the statistics for suicide over the recent past reveals the stark truth that Northern Ireland’s efforts as a society in suicide prevention, however well-intentioned and however sincerely delivered, have apparently failed hundreds of individuals who have died by suicide, and those thousands left to mourn sudden often violent deaths. These include family members and close friends and colleagues (“survivors of suicide”) and “clinician survivors of suicide” – GPs, psychiatrists and nurses, psychologists, psychotherapists / counsellors, community workers and befrienders (like the Samaritans) caring, expertly and professionally for many of these now deceased individuals.
What can be done to transform this depressing situation into a more positive one? It’s my conviction that, to repeat the old chestnut, if you keep doing what you’re doing, you’ll keep getting what you’re getting. What I mean is that radical change in strategic inputs is essential if there’s to be any change to actual outcomes, i.e. a reduction in suicidal behaviour among our citizens. Sadly I found little evidence of such “radical change” when, on invitation, I attended a recent DHSSPS workshop on the “scope, aim and objectives of a suicide prevention policy for 2014-2019”. What would such wholesale change mean?
Here are a few ideas.
Establish a relationship between annual economic costs of suicide (***2010/11: £546 million) and actual investment in suicide prevention.
Ensure that all and any such public expenditure is subject to evaluation.
Disentangle ‘mental health’ and ‘suicide prevention’.
Expand local research into protective factors, e.g. resilience, and evaluate their contribution, alone and as holistic elements in any new strategy.
Involve our whole 1.8 million strong population at local level but other than by expensive, non-productive advertising outlays.
Shift the suicide prevention focus towards care for the individual-at-risk and, when appropriate, away from ineffective, economically attractive (e.g. cheaper) “blanket / blunderbuss” approaches based on technology, geography and/or demography.
In summary, investigate our local “rules for suicide prevention”. Does “culture” play a role, and if so what role? Is it time for a School of Suicidology at Queen’s or Ulster University?
Watch this space for news about the launch on 27 August 2013 of the Belfast Centre for Study of Suicide.
*SPAN USA, Inc. (2001). Suicide Prevention: Prevention Effectiveness and Evaluation. SPAN USA, Washington, DC.
** Martin, G., and Page, A. (2009) National Suicide Prevention Strategies: a comparison. University of Queensland / Australian Dept of Health and Aging, Canberra
***Protect Life – a shared vision: the Northern Ireland Suicide Prevention Strategy 2012 – 2014 (Refreshed 2012). Page 87. Published by NIDHSSPS.
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