In the second part of our series, Natalie Voorheis speaks to Paul Bergin of 1Life about how mental health services cope with an ever-growing problem.
Suicidal behaviours pose a global public health problem and Ireland has not escaped this trend. The World Health Organisation reported in 2005 that youth suicide rates in Ireland were the fifth highest in all of the European Union. Health and social services in Ireland have been under strain to meet the demand in relation to care and services that are needed in this country.
In 2009, 527 deaths were recorded by suicide. During the 80s in Ireland, suicide rates experienced a considerable rise and research has estimated that with the current economic downturn, these figures will again rise along with unemployment figures. Young men in rural areas are currently acknowledged to be most at risk.
The issue of suicide is a complex one and must be understood as such. Causes of suicide are never simplistic but involve psychological, biological, social and environmental factors. Consequentially, no single approach to intervention can hold the answer for treatment of those experiencing difficulties.
This means a well-rounded system of social and medical care must be established and that education of the public across the spectrum of age and social divisions in relation to mental health is needed.
Common public opinion has a significant effect on the development of a society where mental health issues are not taboo and where the services exist to effectively provide appropriate care for those with mental health problems. The destigmatising of mental health issues plays a key role in this. Yet while suicide was decriminalised in 1993 in the Republic of Ireland and 1962 in Northern Ireland, the stigma attached to it is something that society has struggled to shake off.
The Irish Association of Suicidology (IAS) lays out a series of the most widely held beliefs about suicide in the country. They explain that these beliefs are in fact, myths. The IAS attempts to oppose them by putting the facts concerning suicide into wider circulation. According to commonly accepted myth, those who talk about suicide are the least likely to attempt it. The reality is that around 80 per cent of those who take their own lives will have talked about it to some significant other in the few months before hand.
Another commonly held belief in Irish society, which is, in fact, a myth is the hugely damaging assertion that if someone who attempts suicide will do it and there is no way to prevent it. In fact, the majority of those who take their own lives have mixed feelings about doing so until the end. For most people who complete suicide, there are overwhelming feelings of wanting to end their pain but not wanting to die. This may seem a subtle difference but it is a crucial one.
For many Irish people, talking openly about mental health issues can be challenging, people feel uneasy about how to face the issue and many hold the belief that talking about suicide encourages it. Actually, raising the issue of suicide with those who are depressed or distressed can aid the commencement of their therapeutic intervention and be the beginning of a heeling process.
Today there are a number of excellent support services around the country on a local and national level. The premise that talking to somebody about how you are feeling can be instrumental in acknowledging your feelings and beginning to deal with them. On a student level, these organisations include the Please Talk campaign and the Niteline free phone service and on a national level, 1Life and Samaritans provide services of varying descriptions.
The organisation Please Talk is one who owes its name to this idea that talking can be a heeling and positive process. Please Talk has a significant presence in the student community. Established in January of 2007 in UCD, Please Talk advocates that talking is a sign of strength, not of weakness. Its prevalence has grown rapidly since 2007 and it is now active in 27 colleges throughout Ireland.
The University Observer spoke to Paul Bergin who works for 1Life, a suicide helpline. Bergin studied Psychology in UCD, and wanting to gain an insight into the world he saw himself working in, began by volunteering for Niteline in his second year of college, eventually becoming head of the service. Bergin spoke about the different services provided by Niteline and 1Life and gave his professional opinions on the support services available in Ireland currently.
Niteline requires a two-year commitment from its volunteers, who are exclusively students and does not allow first years to apply in order to preserve the dedicated working ethos that a job of such responsibility requires. Training takes approximately eight weeks and prospective volunteers are put through test calls in order to determine their suitability. The process is time consuming and Bergin is weary to give The University Observer details of its exact nature due to the delicacy of the issue of anonymity and confidentiality that surrounds it.
1Life began in October of 2009 and deals specifically with suicide intervention. Bergin explains: “It’s a much more hands on type of role than what your average listening services would be. They try to get you [the caller] to come to your own conclusions. It would be more affirmative in its actions. If the caller gave permission, they may ring up the ambulance for the caller for example. They would encourage this more so than most listening services would.”
Bergin describes the service 1Life provides as being more directive than other helplines stating that they actively inquire the caller as to what course of action they could take for them. “What can we do for you right now? Can we set you up with this counsellor? Can we call a family member and let them know what kind of state you’re in? It’s much more hands on. It’s very good, I do think its something that works.”
The University Observer discussed with Bergin the differing nature of student run non-directive services such as Niteline and more professional, nationwide ones such as 1Life. “Niteline is somewhat limited but it can’t be anything else other than what it is because of the nature of how it is set up and how it’s run,” explains Bergin. He made clear the difference between the two services by explaining that Niteline involves student volunteers while workers for 1Life are “psychotherapists and councillors at the end of the day”.
Although the advantages of getting a similar perspective on the issues you are having as a student, which is what Niteline offers, are enormous. Bergin says that there’s an element of concern regarding this. “If you think about it, there is a very good chance that with Niteline, you risk anonymity in a big way and that’s why anonymity is such a big issue for Niteline.”
Further outlining the difference between the two services, Bergin elaborates; “Niteline has this view that the four worst words you can hear in the English Language are ‘I took your advice’ – the reason being that none of these people are professionally qualified to take these calls.”
Despite the different level of experience of workers for the two services, Bergin seems to remain in support of student involvement in services such as Niteline, stating: “It’s set up so that students can vent their issues. It’s worth mentioning that there is a difference in the suicidal nature in the calls” between the two services.
“Although of course Niteline does take calls of a very serious nature. 1Life takes the same callers over a period of time, but with Niteline, every call is treated as a new call. More of a relationship is built up between the callers to 1Life and the councillors.”
Bergin cannot detail the nature of the calls to either services, but said that there are a very wide variety of issues. “It’s obvious from the statistics over the last few years that suicide was going down in numbers up until the recession and it’s flown back up again. In 2008, it was about 429 people then in 2009 it went up by about 100 and is expected to go up again.
“Of course, when they give these statistics it doesn’t account for a large amount of cases that are not officially deemed suicide. “There are cases for example where there may have been a note left and yet they are not officially deemed suicides,” explains Bergin. “It’s an underestimate if you will, an official number, but you’re looking at anywhere between 5 and 25 per cent higher. You need to put it into perspective. You’ve got nearly three times as many people taking their own life as you do people dying on the roads.”
Feelings of isolation are always connected intricately with suicide. Bergin explains that people who feel they cannot go on have reached a point where they feel entirely along in their suffering. Considering this, Bergin called for a more allied coverage of the different services available in Ireland. He says: “there isn’t an allied effort, you’ve got five or six different organisations at different levels that are supposed to be doing the same job. There isn’t that one unifying group.”
Bergin went on to say that this lack of a unified group is somewhat debilitating. “There isn’t one single service that says you can go here, here and here in terms of different options or has a fully established list of options for helplines. There should be a greater connection between the different services out there.”
Coverage of specific suicides in the media is a complicated issue with studies showing that some reporting can cause so-called clusters of suicides, or copycat suicides in certain areas. Bergin states with conviction; “I think when you create more awareness about something, you help fight the issue.” However, the education of mental health and availability of services and helplines must be reported upon not just for suicide rates to decrease, but to try and break down the social barriers that leave so many suffering in silence.
1Life is a 24-hour professional counselling service working nationwide. They can be contacted on 1800 24 7 100. Niteline is available during term time on Mondays from 9:00pm to 1:30am and until 2:30am from Thursday to Sunday. They can be contacted on 1800 793 793.