Supporting Mental Health -  Are we doing enough?

How to support someone with suicidal thoughts

by Jade Lawless

Suicide rates in Ireland are the lowest they have been in the last 20 years, according to the Holland (2019). This makes for an optimistic headline and indicates that as a nation, we seem to be heading in the right direction, however if we dig a little deeper we are faced with the very stark reality behind our record breaking low.

There were a total of 352 suicides reported in the Republic of Ireland last year and it is recognised that this figure should be higher as many cases of suicide remain unreported.  Male suicides account for 282 (80%) of the overall number of suicides and counties to the north of the country, Monaghan and Cavan, have the highest rates overall. (Holland, 2019).

In 2007, the Government introduced A Vision for Change which was a community based mental health strategy. This was a detailed, comprehensive model for mental health reform and the first strategy of its kind since 1984. It was promising and just what the country needed. Ten years later in 2017, it was reported that there was a “shortfall of €20 million in the funding required to deliver this policy and staffing at just 79% of the recommended level.” (Kelly, 2017, as cited in Ni Aodha, 2017). Real, significant change had been hampered by lack of allocated resources and that cost the lives of many.

There has been a decrease in our nations suicides which would indicate that the policies that have been implemented have been worthwhile. The interventions within this strategy were not flawed but had the correct resources been prioritised they could have been widely more successful and more far reaching.

Mental Health Reform, A National Service Plan, was introduced in 2019 which outlines increases to mental health budgets, reductions in waiting lists, increased access to community services, expansion of out of hours services for mental health and so on (HSE, 2019). It offers a lot of what we need, a lot of what those with mental health struggles need, however we have to learn from our mistakes. This is a strategy that needs to be actioned. The solutions, at least many of them, are contained within this policy but they will never reach who we need them to reach if we do not prioritise the required resources.

What are we doing to support men, who account for 80% of suicides? What are we doing to support our young people? We know that early intervention is key when it comes to mental health support and destigmatisation so it is essential to put resources here. How resourced are our local communities? And exactly how do we plan to increase access to supports and reduce waiting lists?

As mentioned above, the numbers increase the further north we go and Northern Ireland has a suicide rate of double the Republic’s, with 305 suicides reported in Northern Ireland alone in 2017, and men being 3 times more likely to die by suicide than women (Moriarty, 2019). In fact, Northern Ireland has the highest suicide rate in the UK (Keenan, 2020). Residents in Northern Ireland are raising awareness of this through the organisation of a mental health rally which aims to ‘storm’ Stormont this weekend, where they will peacefully protest the Parliament buildings on the 1^st of February. (Keenan, 2020). Over 4,400 people have expressed an interest in taking part in this event. They are saying enough is enough! The Northern Ireland Department of Health have recently published a suicide prevention strategy which aims to reduce suicide rates by 10% in the next 4 years. This sounds eerily familiar. Let’s hope lack of resources does not get in their way.

Until we see some real follow through with the promises made within these mental health strategies huge numbers of people, especially men, will continue to die by suicide in both the Republic of Ireland and Northern Ireland.

What can you do if someone you love is struggling with their mental health?

Acknowledge

Acknowledge that there is an issue, that they need support. This is the first step towards acceptance and destigmatisation. So much energy, shame and guilt can go into pretending that everything is ok. Once we drop the mask, as scary as that can be, we take a bit of power back.

Listen

Be ready to hear what is going on for your loved one. Be there for their story, without judgement, without panic. Ask them how they are feeling, don’t shy away from their pain.

Safety Check

Don’t be afraid to ask if they are safe, if they have thought about hurting themselves. If they have, ask them if they have a plan. Mentioning this won’t give them the idea – talking about suicide doesn’t cause suicide. It can be a weight off to finally admit that suicide has crossed their mind. The safety check will help you determine if your loved one needs more support than you can provide. If you think this is the case, stay with them until you can access further help.

Action

Decide what to do next. Put them in touch with their GP? A loving family member? A counsellor? Emergency services? Stay with them until this has been put in place.

Aftercare

Are you available to be a support to that person after this? If so, let them know. If not you, help them identify their ongoing support person/s. Recent research suggests that ‘Crisis Cards’ are a successful suicide intervention. These involve creating a card, perhaps pocket or wallet sized, that lists all of the healthy actions they can take, including a list of people/services that a person can contact if they feel they need support. There are templates of crisis cards online for free download and there are apps that have been developed to create virtual crisis cards which allow for contacting a person in their support network without needing to make a phone call.

Self-Care

Mind yourself. Supporting someone through their pain and trauma can be emotionally tolling. Do not offer more of yourself than you can reasonably give. Distinguish between offering support and taking responsibility for your loved one. Trust yourself to have done enough.

Tools

Crisis Cards Template:

https://www.blurtitout.org/wp-content/uploads/2017/09/Crisis_Card_V1.pdf

Crisis Cards App:

http://myhealthapps.net/app/details/476/crisis-card

References

Holland, K. (2019, Sep 3). Suicide rate falls to lowest level in 20 years. The Irish Times. https://www.irishtimes.com/news/social-affairs/suicide-rate-falls-to-lowest-level-in-20-years-1.4006869 

HSE (2019). Mental health reform: Promoting improved mental health services. https://www.mentalhealthreform.ie/wp-content/uploads/2019/01/Mental-Health-Reform-Snapshot-HSE-National-Service-Plan-2019-PDF.pdf

Keenan, S. (2020, Jan 11). Mental health rally set to ‘storm’ Stormont. Belfast Live. https://www.belfastlive.co.uk/news/mental-health-rally-set-storm-17539943?fbclid=IwAR1FAsgLK5wA3iIQrIHRt2IoL4fX-joYa2BX3kfrvBQvEYLkppwyx8R9jCY

Moriarty, G. (2019, Sep 10). Northern Ireland seeks 10% fall in suicide rate by 2024. The Irish Times. https://www.irishtimes.com/news/ireland/irish-news/northern-ireland-seeks-10-fall-in-suicide-rate-by-2024-1.4013007

Ni Aodha, G. (2017, May 21). Suicide rates are falling – but how can we get them to zero? The Journal.ie. https://www.thejournal.ie/mental-health-ireland-3-3398738-May2017/