Sir, – Tony Bates (“We don’t seem to know how to talk about suicide”, Opinion, December 1st), correctly states that we need to create more opportunities for suicidal people to share their pain and despair with others and to ensure that they don’t need to hide suicidal feelings and thoughts.
Reference is made to the recent deaths by suicide of Kate Fitzgerald and Gary Speed, both people who seemed to have many opportunities to make a life and to have access to support in their immediate environment. Yet, in moments of greatest despair in their lives they were not able to share these feelings, and most importantly to remain connected with family and close friends.
Removing the stigma that is attached to suicidal behaviour and related mental health difficulties is a slow process, but we are making progress. In recent years, awareness programmes to increase people’s knowledge about suicidal behaviour and confidence in communicating with suicidal people have been successfully implemented among many health care, community services, and the general public in Ireland. Evaluations of these programmes consistently show major benefits in that people are more confident in communicating with suicidal people following the training. There are numerous examples that these awareness programmes have actually contributed to preventing suicide.
The initiative of bereaved parents to openly discuss the challenges before and after the death by suicide of their child will also contribute to reduced stigma, better understanding and more open communication. It is with great respect that I watched the parents and brother of Kate Fitzgerald on the Saturday Night Show speaking about their experiences and challenges before and after Kate’s death. There is an important meaning in the strength of family members who take the initiative to share their experiences with the general public, and we have to support them in pursuing this meaning.
There is no evidence to suggest that information and communication about suicidal behaviour when it is balanced in terms of providing information on risk and protective factors including help- seeking and access to services, is associated with an increase in suicidal acts. However, sensationalised and detailed reporting of individual cases of suicide, such as some articles that reported on the death by suicide of Gary Speed could have a negative impact, especially on young vulnerable men.
Research conducted after the death by suicide of Robert Enke, a well-known German football player, in November 2009 showed a subsequent increase in suicide during the months following his death. Media guidelines for reporting suicide and self-harm have been widely implemented in Ireland and are being used by many journalists, but this clearly requires enforcement when we are confronted with suicide by well- known people. – Yours, etc,
Sir, – With regard to the article “Psychiatrist calls for lithium to be added to water” (Home News, December 2nd), multiple studies have indeed found that areas with a naturally elevated level of lithium in the drinking supply have demonstrably lower rates of suicide. The study referenced in this article, however, is the first to deal with artificially raised lithium levels. While I acknowledge the acute nature of the problem of suicide in Ireland and the benign intentions of Dr Moosajee Bhamjee, the mandatory administration of a psychoactive compound to the general population, by any means, constitutes a violation of our inherent right to freedom of thought and is therefore contrary to Article 18 of the Universal Declaration of Human Rights. This belongs, as a concept, firmly within the confines of dystopian science fiction.
As a pharmacist, I have a strong sense of the capacity of therapeutic drugs to improve quality of life if used in a specific and measured way with the consent of the patient.
While Dr Bhamjee’s suggestion deals with relatively small, sub-therapeutic amounts of the drug, surely the way forward is through reform of mental health provision at community and national level and a cultural shift towards greater openness and acceptance of depression in all its forms.
This grossly utilitarian proposal has no place within a reasonable discourse on public health in a participatory democracy. – Yours, etc,