View Suicides in Northern Ireland 1998-2012 in a full screen mapBy Kathryn Torney
ALMOST as many people have died from suicide in Northern Ireland since the signing of the Good Friday Agreement as were killed during the entire Troubles.
That’s the disturbing key finding from an examination of 15 years of suicide data carried out by The Detail.
The signing of the Good Friday Agreement in 1998 was a landmark moment in Northern Ireland’s history and followed decades of murder.
However, the political deal could not completely wipe out our troubled past and this – warns researchers – is still impacting on the mental health of people here today.
It has been estimated that around 3,600 people were killed in Northern Ireland’s bloody conflict between 1969 and 1997.
A less well known statistic is that almost as many people took their own lives in the 15 years which followed this.
The latest figures show that a total of 3,288 suicides were registered in Northern Ireland from the beginning of 1998 to the end of 2012.
Or to put it another way, deaths from suicide were almost double the number of people (1,825) who died in road traffic collisions during the same 15 year period.
Of those who died from suicide, 77% were men.
In the last 10 years the suicide rate per 100,000 of the population in Northern Ireland has increased from 10.8 in 2002 to 15.2 in 2012.
Today, The Detail also reports on new research by academics which they say adds further weight to evidence of the need for routine assessment of suicidal thoughts in high risk populations, such as those affected by the Northern Ireland conflict.
And the Department of Health tells us that Northern Ireland faces a difficult challenge to reduce suicide rates, particularly in light of the additional threat posed by the current economic downturn.
It adds that it is now more important than ever to work across all sectors to reduce the high incidence of suicide and self-harm in our local communities.THE DATA
For this project The Detail examined data held by the Northern Ireland Statistics and Research Agency (NISRA) on suicide registration. The 2012 data is the most recent available and currently provisional.
All suspected suicides are referred to the coroner and take time to be investigated. This means that there can be a substantial period of time between a death occurring and it being registered.
For example, of the 313 suicides registered in 2010, only 141 actually occurred in 2010 with the remainder taking place in earlier years.
Using these figures we created an interactive map to give a breakdown of the number of suicides registered in all council areas. See above.
The highest number of deaths registered between 1998 and 2012 was in Belfast where 718 people took their own lives over the 15 year period. The lowest number was in Moyle District Council area where 31 people died from suicide.
Using the suicide rate rather than the actual number of suicides allows comparisons to be made between different geographical areas taking account of different population sizes.
We used NISRA mid-year population estimates and also included a deprivation measure from the Northern Ireland Multiple Deprivation Measure 2010 for each district which shows how widespread high levels of deprivation are in each area.
Our analysis confirmed that the highest suicide rate over the last three years was in the most deprived council area (Belfast) and the lowest was in the least deprived area (Magherafelt).
The average annual suicide rate per 100,000 of the population based on the last three years’ data (2010-12) was 24 deaths in Belfast compared to seven in Magherafelt.
The 2008/11 Programme for Government set the target of an average annual death rate of 10.7 per 100,000 of population over the three year period 2010 to 2012.
Our analysis shows that the attempt to meet this government target failed. The average annual suicide registration rate per 100,000 of the population in Northern Ireland for 2010-12 was 16 deaths.
Click here to access NISRA’s suicide data in full.THE IMPACT OF THE TROUBLES
Research by Professor Mike Tomlinson at Queen’s University Belfast published in 2012 concluded that the conflict in Northern Ireland had a profound effect on our suicide rates. He said that the steep increase in recent years may be accounted for by those who grew up in the 1970s during the worst years of the violence.
The Detail can reveal today that new research carried out by a team at the University of Ulster confirms that people in Northern Ireland who experienced a conflict-related traumatic event are even more likely than those who experienced other types of trauma to have suicidal thoughts and plans.
Professor Tomlinson said: “Recognition that recent suicide trends are a legacy of the conflict alters the perspectives that shape suicide prevention as well as the identification of at-risk individuals, groups and communities.
“Experience of conflict and its consequences, the cohorts, occupational groups and communities most involved in the conflict, are all absent from current prevention strategies.
“Acknowledging the relevance of the conflict would be a major step forward in suicide prevention.”
Professor Tomlinson’s research – entitled ‘War, peace and suicide : The case of Northern Ireland’ – examined 40 years of death registration data and found that the highest suicide rate was for men aged 35-44.LEARNING FROM DEATHS
The research team from the Bamford Centre for Mental Health and Well-Being at the University of Ulster has examined the link between conflict-related events and suicide attempts in Northern Ireland.
Their analysis of data from over 4,000 people – collected in 2008 for a World Mental Health Survey initiative – backs the suggestion that traumatic events associated with the Northern Ireland conflict are associated with suicidal thoughts and plans.
The results are due to be officially published later this year.
Professor Siobhan O’Neill is leading the research and spoke to The Detail about their study.
She said: “Suicidal ideation (thoughts) and behaviour are important public health issues, not least because they give us an insight into the factors associated with death by suicide.
“There are many causes of suicide and it is a complex issue. Mental disorders are an important risk factor with the majority of those who die by suicide having a mental disorder.
“However, most people with a mental disorder do not go on to die by suicide and many people who die by suicide have no recorded mental health disorder.
“It is therefore important that the associations between suicide and other factors, such as trauma, are examined.”
International studies of trauma and suicidal behaviour have already shown that traumatic events are associated with suicide. Certain traumatic event types related to sexual and interpersonal violence are associated with a higher risk of suicidal thoughts and behaviour than others.
“The Northern Ireland conflict offers an opportunity to examine the associations between trauma and suicidal behaviour,” Professor O’Neill said.
“Questions have already been raised about the role of the conflict in explaining the increased rates of suicide in the years following the peace agreement in 1998.”
The World Mental Health Survey Initiative found high rates of mental disorders in Northern Ireland with the rates of Post Traumatic Stress Disorder here the highest of all the countries involved in the initiative.
The most frequently reported conflict-related event in Northern Ireland in the mental health survey was ‘civilian in a place of ongoing terror’ followed by ‘witnessed death or a serious injury’.
Professor O’Neill concluded: “Individuals who have experienced any traumatic event have a significantly elevated risk of having seriously considered and planned suicide.
“People who had a conflict-related traumatic event were even more likely than those who have experienced other types of traumas to have suicidal ideation and plans.
“These findings add further weight to the evidence for the routine assessment of suicidal ideation in high risk populations, such as those who have been affected by the conflict and those with mental disorders.
“Those who have suffered as a consequence of the conflict should therefore not only be monitored and provided with evidence based treatments for the mental disorders, but also for suicidal thoughts, plans and behaviours.”
The UU research indicates that having experienced a conflict related trauma carries an additional risk of suicidal behaviour, even when adjusted for the effects of mental disorder.
The university researchers are currently testing the theory that those with a conflict related traumatic experience are more likely to die following their first suicide attempt.
The University of Ulster team has also created the first suicide database for Northern Ireland.
This was compiled by working carefully and sensitively through anonymised coded data from coroners’ files on suicides registered in Northern Ireland.
The database covers a seven year period from 2005 to 2011 and it is hoped that funding will be available to maintain it into the future.
Professor O’Neill said: “This database is an important resource and is helping us to learn more about those who have died by suicide.
“The information the database contains includes when the person had their last GP appointment and their history of service use.
“We hope that information held in the database will allow us to spot trends and to learn from deaths here. Ultimately, we hope that it will save lives in the future.”THE DEPARTMENT OF HEALTH’S VIEW
We requested a comment from Health Minister Edwin Poots on Northern Ireland’s high suicide rate and whether the Protect Life suicide prevention strategy focuses in any way on those who experienced the worst of Northern Ireland’s violence.
A response was issued by a department spokesperson.
She said that reduction in the Northern Ireland suicide rate continues to be a major priority for the department.
And she continued: “Over £7m is allocated annually to suicide prevention in Northern Ireland. This is more per head of population than any other UK country.
“Suicide is a very complex societal issue and the reasons for the relatively high rate of suicide in Northern Ireland are not known.
“However, it is clear that poverty, recession, deprivation, the legacy of the conflict, exposure to violence, and higher levels of mental health needs are all influencing factors.
“There is a strong link between mental ill health and suicide. However it is concerning that many people who go on to take their own lives are not accessing statutory mental health services, with less than a third in contact with services in the preceding year.
“This highlights the need to ensure that services are accessible and responsive when people require them and the key role that the non-statutory sector can play.”
The spokeswoman said that Northern Ireland faces a difficult challenge to reduce suicide rates, particularly in light of the additional threat posed by the current economic downturn.
“It is therefore more important than ever that we continue to work together across all sectors to reduce the high incidence of suicide and self-harm in our local communities.
“Emerging evidence indicates that Northern Ireland has high levels of, often untreated, Post Traumatic Stress Disorder as a result of the Troubles.
“Protect Life services are open to all and many of the clients who have used Protect Life suicide prevention services to date have been affected by the conflict.”
In relation to the focus of suicide prevention activities on any particular age group, she said that the department is aware that the highest risk group for suicide is men aged from 25 to 54 who live in deprived areas.
“The emphasis on younger age groups has largely been in the media,” the department spokesperson claimed.
“All deaths are tragic, however, where the death involves a young person this appears to attract more attention.
“Suicide prevention and mental health promotion interventions are available to people of all ages.”
The department’s response is available in full below this article.
How the Irish Times reported this story – see here.HELPLINE DETAILS
- Lifeline is the Northern Ireland crisis response helpline service for people who are experiencing distress or despair. It can be contacted confidentially on 0808 808 8000 or click here.
- The Samaritans can be contacted by telephone on 08457 90 90 90 or email [email protected]
- The Public Health Agency’s mental health promotion website is here.