“Every suicide is preventable until the last moment of life.”
This and other facts about suicide were communicated at a suicide prevention briefing in Enniskillen Townhall last Thursday, presented by Contact NI, the charity which specialises in suicide prevention and provides the free-phone Lifeline helpline in Northern Ireland.
A huge societal shift is needed to eradicate the stigma and myths surrounding suicide, the meeting heard. Health professionals, police and prison officers, politicians, religious leaders, families, bereaved relatives and the public require training and awareness on the most up-to-date suicide research, according to Fergus Cumiskey, Chief Executive of Contact NI. This process will involve “cool heads and open hearts” and a process of “mobilisation, legislation and reform”, he claimed. In addition, the charity wants to see a public awareness campaign about suicide that is as comprehensive as the road safety campaign which has reduced the number of road deaths in Northern Ireland from 300 in 1977 to 68 in 2016.
The charity is lobbying the Assembly to bring forward a Suicide Prevention Bill.
The most recent statistics show that there were 318 deaths by suicide in Northern Ireland in 2015, with 14 of those in Fermanagh. By comparison, in 1997, there were two deaths by suicide in Fermanagh.
“Stigma busting work is very important. People who are suicidal have the same myths about suicide as health professionals and family do,” said Mr. Cumiskey during the candid discussion.
Myths about suicide include: if a person is serious about suicide then there is nothing you can do and talking about suicide is a bad idea as it may give someone the idea to try it.
“Suicide is transient. The impulse passes. It is preventable until the last moments of life,” stated Mr. Cumiskey.
He outlined research by Christabel Owens, who talked to relatives and close friends of people who had died by suicide and found that signs and signals given by the suicidal person were highly ambiguous, contradictory and open to a variety of interpretations.
And even when friends and relatives recognised that something was wrong, they were often paralysed by fear, which rendered them unable to say or do anything to prevent the tragedy. Ms. Owen’s research found that talking openly with someone who is very low and asking them directly whether they are having thoughts of suicide is the best way to keep them safe and ensure they get the help they need.
A mother from Trillick who lost her son to suicide two years ago told the meeting: “I feel like I have failed. My son fell through the cracks. I rang the psychiatric team [following a suicide attempt] and they asked if my son had been medically assessed . My GP told me to ‘forget about it’ if he had alcohol on board. He said he has lots of young men coming in at weekends with alcohol on board saying they are suicidal. Why didn’t they spot the signs?”
She added: “People keep telling me you can’t prevent suicide.”
Mr. Cumiskey replied: “That’s an absolute myth. It’s transient. It’s preventable until the last moments of life. Do you know how we know that? Because those who have made near lethal attempts have told us that, as they were [attempting to take their own lives], they were regretting it.”
In response, the distressed mother cried: “Don’t tell me that!” Mr. Cumiskey stated: “Every family says what you just did. But you didn’t know what you know now. It’s impossible that you could have known in advance. We can’t bring anybody back but we can draw a line here for the future.” He thanked the woman for her contribution and said: “You are an advocate for suicide prevention. Thank you.”
The bereaved mother concluded: “The police need to know that death by suicide is traumatic. There should be a liaison officer. They shouldn’t just take the view that: ‘He didn’t care about his own life, so why should we?’”
Another local mother who lost her adult daughter to suicide six years ago voiced her frustration at the fact that, as parents, they were not told that she had presented at A&E.
Mr. Cumiskey said that there is confusion in the health sector between “patient, client confidentiality and secret keeping.” He said: “If someone’s life is at risk we should push for a safety contact, an adult who cares and who they can trust. That means we have shared the level of risk and are working on a collaborative safety plan.”
Signposting a suicidal person to other services can make them feel more deflated, therefore, Mr. Cumiskey would like to see “a warm referral.” He explained that this would involve “not one of our patients gets lost in the system, no one falls through the cracks, every service partner commits to real-time bridge building, dissolving silo working, celebrating humane and engaging systems of care, supported by switched-on, can-do leadership.”
Contact NI believes that legislation is needed around clinical duties of candour, competence and cooperation which means that clinicians would have a duty to disclose what went wrong to the family in a timely manner and to implement lessons learned with immediate effect. The last time suicide was legislated for was 1961 when suicide was decriminalised. Mr. Cumiskey said that Northern Ireland needs new legislation to demonstrate the region’s “relentless resolve to drive the NI suicide rate down.”
He praised Scotland’s Suicide Prevention Strategy which has resulted in a strong downward trend in the suicide rate over the last 10-12 years. However, he noted that Northern Ireland is 10 years into its Suicide Prevention Strategy but it has the highest rate of suicide in the UK. Mr. Cumiskey refuted suggestions that the higher suicide rate in Northern Ireland was entirely due to the legacy of the Troubles.
Sinn Féin MLA Sean Lynch asked what “direction of travel” such a bill would take. In response, Mr. Cumiskey said it could take two years of discussions before a bill was on the table. He added: “We need constant dialogue that’s not blame focused; that’s when you will have a culture change.”
A member of the public asked Mr. Cumiskey: “What’s the most positive thing we can take away from here today?” He replied: “Put the Lifeline number into your phone (0808 808 8000); have courage to ask someone if they are OK and stick around to hear the answer; and talk openly to each other.”