The 'horrendous' misuse of alcohol has been highlighted in research to discover how to prevent young men from committing suicide, reports Elaine Keogh
Fifteen men in the small Cavan town of Bailieboro have taken their own lives over the past 15 years, prompting local research into the causes of such a high level of suicide. Alcohol abuse and peer pressure were found to be key issues. But given that those at risk don't tend to turn to health professionals when they need help, a community-based network could provide the necessary safety net, researchers found.
The initiative for the study came when local GP Paddy Halligan started to investigate the impact of suicide on rural GPs. He found that national statistics reflected his own, local experience.
It is estimated that 80 per cent of young Irish men who kill themselves have had no contact with any health professional in the weeks and days before their death. Frustration amongst people such as Dr Halligan and Dr Vincent Russell, consultant psychiatrist in east Cavan, made them determined to investigate ways of preventing such deaths. "Remember that each suicide causes intense grief in at least six people close to the victim," says Dr Halligan.
The North Eastern Health Board set up the East Cavan Project to "find out what people on the ground perceive as the problem and how to deal with it," explains Dr Halligan. The research team hopes that its approach may result in initiatives that will help people in other health board areas too.
The project targeted the high-risk group in the community, taking a sample of 71 young men aged between 15 and 35. The researchers also got the views of 79 key people in the community in regular contact with such men, and found they may be able to help identify those at risk.
Both the men and the key people were asked similar questions and gave similar responses. A number of themes emerged. "The young men identified alcohol misuse themselves as a sign of a problem, the fact that they acknowledged it within themselves surprised me and it indicates their openness," says Dr Russell.
The survey found that pubs were by far the most popular venue for socialising (95.8 per cent) and the most popular social activity was the GAA club (52.1 per cent).
"The issue of peer pressure and social pressure also emerged prominently. Previous studies have shown men tend to compare themselves negatively with others in the same peer group, and there is pressure to achieve amongst themselves, which is another known risk factor." If you are a young man not doing as well as your peers you may feel more of a failure and more isolated amid the Celtic Tiger boom than if it was the 1970s or 1980s, he adds.
The importance to a man's self-esteem of having a job was highlighted last year by separate research by the NEHB into men and their health; it revealed that men who are not doing well in work or education are emotionally vulnerable.
The researchers asked the 71 men who they would approach if they were in distress. From the responses, it was clear professionals, including GPs, were perceived negatively. The men said they would first approach their parents or friends.
The young men all perceived depression, an increase in alcohol or substance abuse, and change in behaviour as the most likely indicators of a young person in crisis. School was seen as the best place to promote awareness about mental health difficulties.
The key people - among them sports coaches, teachers, community volunteers, gardaí - offered similar views. "This group came up with the same findings as the young men and it strengthened the quality of the findings," explains Dr Russell. Again, alcohol misuse and peer or social pressures were seen as contributing to problems young people experience; and friends and family were identified as those most likely to be approached for help.
The research indicates that key people in the community could be taught to identify those at risk. "You can train people who are likely to come into contact with people in distress on the significant signs and how to respond; this is an opportunity to be developed," says Dr Russell.
THE other crucial finding highlights how most of the men's socialising is in pubs and alcohol abuse is a key factor for those at risk of suicide. "A separate study we did found that 50 per cent of those admitted to hospital after an attempt at self-harm had been using alcohol. We need to look at the circumstances under which these young men can be enticed into less risk situations: for example, burger joints, Internet cafés. This could be another area of opportunity," says Dr Russell.
This is reiterated by Dr Halligan: "I cannot say enough about the misuse of alcohol, it is horrendous. In four of the last five suicides I have been involved with, large amounts had been taken; it is a catalyst which initially is part of the problem but later it becomes an enabling agent for those who commit suicide."
The next stage of this research may be to return to the Bailieboro community and look at the role of the key people. The research team wants to feed the results of the work back to those involved on the ground so that those "researched" own the research.
Stressing the urgency of continuing such projects and initiatives, Dr Halligan adds: "We are going to have to outreach our services to the young people and get the information to them in an 'in your face' way. Along with car accidents, suicide is most responsible for the killing of young men in England and Ireland and it is of epidemic proportions in some areas in this country."