Sir, - I started to read John Waters's column of February 16th with interest initially, but then with increasing trepidation as its contents became clear.
Mr Waters is right to be concerned about the incidence of suicide in young men. However, to infer that this issue is not highlighted or discussed is untrue and does a disservice to all the statutory and voluntary agencies working in this area - not to mention those at risk or those families bereaved in such tragic circumstances.
The complex biological, psychological and social issues involved defy any simple explanation but attention has been given to all possible relevant facts. The late eminent Dr Michael Kelleher referred to in Mr Waters's article wrote an editorial in the British Journal of Psychiatry in September 1998 discussing youth suicide rates in the Republic of Ireland and particularly addressing the issues relevant to young men.
Of grave concern to me also is Mr Waters's simplistic, dichotomous view of those individuals who make suicidal attempts and those who complete the act. There is considerable overlap between these two groups and it is well recognised that a significant minority of those who attempt suicide will die in a subsequent attempt. Equally, of those who have killed themselves a significant number have made at least one previous suicidal attempt. The simplistic generalisation that parasuicide "is a female phenomenon" is also untrue.
It behoves us all when discussing this serious public health issue to give the facts and not individualistic interpretations of them. An approach such as that of Mr Waters's article is unhelpful at best and may serve to alienate those individuals, in particular young men, who are at risk, as well as adding to the distress experienced by bereaved families.
It would be more constructive instead to focus on all of the relevant issues as they are known relating to suicide in young men and highlight the availability of services, both statutory and voluntary, that are there to help such people. - Yours, etc., Dr Katherine Brown,
MB, MRCPI, MRCPsych., Consultant Psychiatrist, Mountrath, Co Laois.