Prevention of Suicide – Christmas 2004

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The need to think more deeply about what it means to be Human

For a little more than fifty years now the standard treatment for depression and anxiety which often leads to suicide has been psychoactive medication-anti-depressants, tranquillisers and sleeping tablets. At present according to the Irish Patients Association, 300,000 people in Ireland are taking anti-depressants. Most of these anti-depressants are S.S.R.Ls. This particular family of drugs like Prozac, Seroxat, Cipramil and Lustral are prescribed for many people who have expressed suicidal ideation or who have had suicidal feelings. Yet, it is interesting to note that in the United States, the Food and Drug Administration pointed out that between 1997 and 2002 there were 3,309 suicides attributed to the six most commonly used S.S.R.l.s.

Here in Ireland where we have a particular problem with suicide especially but not only among young males, merely prescribing medication is obviously not working. We need urgently to think more deeply about what it means to be human and how as human beings we respond to both our interior and exterior “worlds”.

The World Health Organisation in a report issued in July 2004 pointed out that strategies which improved restriction of access to common methods of suicide have proven to be effective in lowering the rate of suicide. Prescribing, unnecessarily, medication which can be used to overdose is obviously not helpful in preventing this tragedy. Something much more is required.

The report just mentioned points out the need to adopt a multi-faceted approach involving different activities and interventions, especially Centres where those who are suicidal know they can get trained professional help to work through the different personal problems that lead to thoughts and feelings of suicide as the only way out.

Every person who is suicidal experiences the urgent need for a change in life’s circumstances in both he interior struggle and the exterior events of life. The suicidal person’s vision of how this change might come about is temporarily blocked. The constant inner response to what is happening to the person is nearly always expressed as “l can see no way out of this”. There is always a ‘way out‘ that need not result in the tragedy of suicide.

However, the suicidal person cannot see this on his or her own.. There is a need for someone else there, somebody who is compassionate and is specially trained to help the wounded person find the ‘way out‘ the path back into meaning, and hope and life.

There is no scientific evidence that there is an inherited chemical imbalance that leads to the depression that engenders suicide. Even if it were true that such existed the mere prescription of medication which happens so often is not the answer.

Suicide is a consequence of many complex factors. Studies in Manchester (British Journal of Psychiatry 1999) in the United Kingdom, Sweden, Netherlands, Belgium Canada Australia and U.S.A. (British Journal of Psychiatry, 1998) and in Germany (Max Planck Research institute for Psychiatry,

Munich,2000) all point to the need to be aware that medical bio—chemical intervention in itself is not enough. For instance, Professor Hans-Ulrich Wittchen who led the German study states in his report: “The doctor must do more than just write out a prescription for an Anti-Depressant”.

Professor Wittchen points out that the exact reasons why depression develops are not yet known, Psychological, social and behavioural factors have all an equal part to play. He says that Family Separation, Unemployment, Life Crises, Losses and Loneliness offer possible explanation for the growing numbers of young men and women between eighteen and thirty-five years who present with depression. The Manchester Study, already mentioned, also pointed to unemployment, the mis-use of alcohol or other drugs, unhappy personal relationships and struggles with personality as contributing to suicidal behaviour. The World Health Organisation Report cited socio-economic difficulties, family and individual crisis situations, for example the loss of a loved one or employment or the loss of personal honour, as factors associated with suicide.

Given this well researched knowledge surely it is time if we really value human life, each individual human life, that we set up urgently appropriate responses to this most painful and tragic scar in our society. We know now what the need is.

We also know what the best possible answers are. Why wait? The funding required for a number of strategically located Centres which could offer the kinds of Experiential Depth Psychotherapeutic Intervention on either a residential or non-residential basis as might be required is minimal given our Health and Social Welfare Budgets. The advantage of such a response is that such Centres would not result in or signify the long – standing personal and social cultural stigma of “psychiatric illness” which unfortunately still exists. Surely, we must hang our heads in shame nationally that we continue to fail those who are most in need in our communities.

It has been reported that ¢17.5 million has been invested in suicide prevention since the publication of the “Report of the National Task Force on Suicide” in 1998. One can justifiably ask where this money has gone. Are current policies working? Are we hamstrung by holding to the Bio-Medical Model when obviously something different and more creative is required? These are the hard questions. Those who are suicidal require more urgent and more effective answer.

Biographical Note: Dr Jim O’Donoghue is Clinical Director of Castlebar Counselling and Therapy Centre which offers help to those who are suicidal. He is Consultant Psychotherapist to Kedron, a 15-Bed Residential Unit and also founded and directed Dundalk Counselling and Therapy Centre and Dublin Counselling and Therapy Centre all of which provide Psychotherapy for Depressed and suicidal Clients.

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About this record

Written by Jim O\'Donoghue M.I.A.H.I.P

Published here 28 Dec 2023 and originally published Christmas 2004

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