Pat Buckley tells Carl O'Brien, Social Affairs Correspondent how suicide claimed the lives of his two brothers in Midleton, Co Cork
It happens without warning. When the telephone rings late at night. When the doorbell sounds unexpectedly. Or when a strange car pulls up to the house. And when it happens, Pat Buckley shudders deep inside.
There have been too many unsolicited calls through the years, bearing too much bad news.
"It's one of the reasons we moved here," Buckley (36) says, sitting at the kitchen table of a newly built house on the outskirts of Midleton, Co Cork. "I thought that if there was bad news, they couldn't find me at least. I wanted to up and move out of the country at one stage. I didn't want to be contactable, I didn't want to be around."
On June 24th, 2002, Pat's brother, Mark, a 30-year-old construction worker, had a couple of pints in the Session Bar in Midleton before going home to get something to eat. Instead of joining his brothers back in the pub, as he had promised, he was found hanging from his attic door by a length of wire cord.
About a year later Pat's youngest brother, James (22), took his own life in the same way, hanging himself from the balcony of his apartment. The two brothers are buried side by side.
Their deaths were the 35th and 36th suicides in Midleton in barely three years. But the suicide rate is not just causing alarm in Midleton. Clusters of suicides have been recorded in towns and villages across the country. In 2003, 444 people died by suicide, over 100 more than were killed on the roads in the same year. The rate of suicide among young men is rising faster in the Republic than in any other EU country.
Suicide is now the most common cause of death among people aged between 15 and 24 in this country and, according to the National Suicide Review Group, the highest rate of suicide over the past five years has been among young men aged between 20 and 29.
Alarm bells should be ringing at Government level, experts say, yet the authorities' response seems to lack any real urgency.
Mental health services received only 6.8 per cent of the health budget last year, down from 10.6 per cent in 1990. In the whole country there are just 20 in-patient beds with specialised services for adolescents with mental health problems, despite a Government-commissioned report five years ago which recommended at least 120 beds.
In Midleton, as in many towns and villages throughout the country, people are shocked, baffled and worried at the scale of the problem. And it keeps prompting the same question again and again: why? It's a question which haunts Pat. All three Buckley brothers used to socialise together. They'd head off to Cork City matches at weekends. On Mondays they'd meet in the pub for a few pints, have a laugh and enjoy the banter. There was no warning that Pat could see, no firm tell-tale sign that they were about to end their lives so suddenly.
"Mark was happy-go-lucky. He was great fun. He didn't seem depressed," says Pat. "He was never a person to get upset about things, even with money problems. He had a good job and a two-year-old boy, Calvin. It didn't make sense." After Mark killed himself, his family found a note in neat handwriting which read: "Tell Mam I love her, I'll look after Nan. Calvin, my soulmate, I love you. I just want to thank everyone for coming to the funeral today." Pat says: "James [ who found Mark's body] took it very bad at the start, but he was getting on with things. He had a girlfriend, a young son, he moved into an apartment. Things were getting places . . . it didn't make sense, all of it, you'd keep asking yourself why, but there were no real answers. What is it that makes someone leave everything they have behind them?" Pat asks, with a hint of steel in his voice. "What kind of pressure makes someone put a noose around their neck and hang from an attic door, and know it's the last thing they'll do? To put yourself in that position, it must be very, very bad."
IN MIDLETON, MOST of the suicides have been young men in their 20s. The youngest victim was a 16-year-old boy who hanged himself from a tree on his parents' farm. He was, apparently, unhappy at school. An 18-year-old killed himself with his father's gun and left behind a note which read: "I took life too seriously. I don't want others to do the same." The latest suicide was discovered last month when, in the middle of the search for 11-year-old Robert Holohan, the body of a middle-aged man was found on the banks of the Owenacurra River, just yards from the main street.
Many theories have been advanced over the rising rate of suicide among young people: from the rise in use of drink and drugs, as well as the declining authority of the church, to the lack of services for people experiencing depression or mental health problems. In communities such as Midleton, one suicide can sometimes trigger others, especially among younger people.
"We've removed a lot of the social and cultural protective barriers against suicide in the space of a decade," says Prof Kevin Malone, of St Vincent's University Hospital, Dublin, "but we never put any other safety net back in place." Experts internationally have estimated that up to 90 per cent of suicides can be traced back to depression or a psychiatric problem. In Ireland, the scale of mental health problems experienced by teenagers is frightening. A recent large study of young people in the Cork and Kerry area found that serious personal, emotional, behavioural or mental health problems were experienced by 27 per cent of those surveyed. Of those, fewer than 20 per cent received professional help.
"The study findings clearly indicate that there is a hidden population of adolescents with serious mental health problems who do not come to the attention of the healthcare services," says Dr Ella Arensman, research director of the National Suicide Research Foundation.
The inability of a creaking mental health service to respond adequately to young people's needs is one of the reasons they are not seeking help, says Prof Malone.
"We are light years behind places such as Scotland and New Zealand in terms of recognising the problem and investing in solutions," he says. "It's a tragedy. As a physician you're trained to look after life and protect life. It's deeply frustrating not being able to deliver the services on our doorstep which are there in other countries. We've lost a lot of lives as a result of it."
FOR ALL THE statistics and research into suicide in Ireland, much remains unknown. We know roughly how many people die each year, but there is almost no data on why suicide occurs in Ireland. The jigsaw of people's stories and experiences still hasn't been pieced together.
In the absence of an effective response at Government level, communities such as Midleton are beginning to take matters into their own hands and organise ways of helping to prevent suicide.
Dr Brian Jordan, a local GP, helped organise an education and support group for young people after he was approached by a young man, Dan Healy, whose best friend had taken his own life (see panel). About 30 young people in the area have undergone the training course run by the Southern Health Board - part of the Health Services Executive - and new courses are due to begin later this year.
"The people who have done it will tell you that if they knew then what they know now, they reckon they would have picked up on warning signs among their friends and known they were at risk," says Dr Jordan.
Pat Buckley and other concerned people have set up a charity, the Let's Get Together Foundation, to help raise awareness of the problem.
The group's ultimate aim is, in conjunction with other agencies and authorities, to establish a youth cafe where teenagers and young people can meet. It would also have links with the health service to offer support to young people if they need it.
"I was going into town the other day and saw three teenagers in their hoodies, sitting out in the park in the freezing cold," says Buckley. "They don't feel they can go anywhere else. That's the only place they feel they can go. That's dangerous for a town as big as this."
All the discussion of suicide has helped bring a subject that was once whispered about out into the open.
"Suicide is a bit like AIDS or HIV was 10 years ago. Once people might have crossed the street when they saw me or dipped their head and kept on walking. Now they'll come up to you and say well done with the campaign," Buckley says.
"I was in a restaurant one day and a man comes up to me, I didn't recognise him, and he wrote out a cheque for €500 and gave it to me for the foundation. I was close to tears. People have been unbelievable, they have been embarrassingly generous." While Pat and others have been making strides in confronting the issue of suicide, the pain of what has happened in the past remains.
"It stays with you forever - it could be a song you hear, a birthday, an anniversary or a wedding, and it hits you. I went to Anfield with my wife Sandra and when they sang You'll Never Walk Alone [ which was also played at Mark's funeral], it was hard. I feel very proud of who they were when they were alive - you don't realise how special people are when they are alive."
Early on Sunday mornings Pat goes to the graves of Mark and James, behind the Holy Rosary church. Their graves are festooned with mementoes of their favourite soccer clubs, Liverpool and Celtic.
"It's nice to go up there and have a chat," he says. "You can get things off your chest. It took me months to go up there at the start. It was too difficult, but it's easier now. I was very depressed for a long time and didn't realise it. I couldn't concentrate, I wasn't sleeping, I'd be shouting at the kids or I'd just get drunk. I was falling behind on payments and getting into debt. But there's no point wallowing in pity. What upset me was that I was letting my wife, kids and family down," says Buckley, who has two children, Jordan (six) and Megan (four).
"We've more good than bad times, that's what keeps us going. My wife has been terrific. Seeing the children at Christmas time, opening presents, seeing the looks on their faces. Things like that mean an awful lot."