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Mental Health, Suicide & 3rd Level Students: Observations from the Periphery

Mental Health, Suicide & 3rd Level Students: Observations from the Periphery

Niall McElwee, PhD & John Madden, B.A.


Heart stethoscopeWe pointed out in our first Clinic discussion paper on suicide that, as a nation, we are becoming more aware of the complexities around mental health and suicide. The conversation around these growing issues is evolving from being “taboo” to a more open, real and frank discussion. This is evidenced by the volume of responses we received both on and off line. Indeed, after we wrote our first blog on the topic of suicide, a former student of Niall’s, now a friend, wrote to him from a very personal and tragic perspective as one of her own family had suicided. We write ‘suicided’ here as opposed to ‘committed suicide’ because we both have always detested the latter term criminalising the deceased.

Julie wrote, This is interesting Niall. I am glad the article recognises that despite all research and analysis there is no definitive explanation for why a person chooses to end their life. I am no expert but I can only speak from personal experience. And I still have no answers. My thoughts are that human beings are multifaceted therefore I believe and agree that the person who dies by suicide has been affected by an interplay of different factors – to the point where all hope is lost. External support services may be available…Family may be available….but this is futile if the person has not got the ‘inner resources’ (ability to communicate/ articulate feelings without shame) and ‘courage’ to reach out and use these supports. The Socio Economic influence cannot be underestimated. But we cannot always control recessions and unemployment. What we can control is building resiliency in people – young/old/male/female and create a culture and climate that is understanding and empathic. Even if a person has a biological/genetic predisposition to ‘ depression/suicide’ I believe the above factors can play a huge part in ‘preventing’ suicide. Schools have such a crucial responsibility in helping young people learn life skills / build self esteem no matter what their background or life story. There is no simplistic answer on this unfortunately. But thank God there is more education and awareness about this subject so now when we come across a ‘Pagliacci’ the Clown….Our tears of laughter will turn to tears of sadness for we ‘know’ the suffering that hides behind his smile.” Thank you Julie for taking the time to write to us and share your thoughts. We wish you and your family well.

In this paper we will explore how suicide affects the younger generation of Ireland and, in particular, third level students. The rate of suicide among young men, defined as men aged between 20 and 24, in Ireland was the fourth highest in Europe in 2011 according to The Central Statistics Office. This is deeply worrying. And suicide affects both males and females. At the time of drafting this paper, local media outlets in Galway City reported that a 22 year old woman was “seen walking into the water at 2.30am Saturday morning…”. Tragically, her body was recovered the following day. Another statistic, another family devastated, another young woman who felt so hopeless, suicide seemed to her the only viable alternative. But, it is not, hence our second article.

We both have quite an insight into mental health and suicide. Both of us are formally trained in suicide intervention, have worked in both the University and Institute of Technology sectors in addition to private 3rd level Colleges and now work in the private sector here at the Clinic with students over the age of 18. In all contexts, we have many, many times over the years encountered students with a wide range of mental health problems and who felt suicidal.

Primary School Children, Mental Health and Suicide

Let us first go back to the very start of the student experience. There is now a growing concern around younger children mental health issues. At the Irish Primary Principals’ Network conference, held on 29th January 2016, IPPN President Maria Doyle summarised a wide range of issues that primary school teachers are faced with every day. In her speech she was quoted as stating. “We have children as young as junior and senior infants displaying significant symptoms of depression.” Further to this she went on to report, “We have children in primary schools speaking about suicide, we have them self-harming,” and “this would not have been the case ten, fifteen years ago, but it currently becoming a problem at primary level.”

This may seem like a new trend to many readers but, alas, it is not. We can look retrospectively to the work of Israel Orbach, a highly influential sociologist who wrote a large body of work in the area of suicide, notably the book “Children Who Do Not Want to Live: Understanding and Treating the Suicidal Child” (1988). In this publication Orbach tells us, in spite of much research, there still exists a wishful fantasy that young children are somehow protected from the extreme anguish and paint that adults may experience…., many still find it hard to believe that children as young as five or six can sincerely wish to die- and that some actually do commit suicide…it is commonly but mistakenly believed that children do not comprehend the meaning of death. In most cases, it is exactly because children do understand the meaning of death that they wish to die.”

In May 2014 the ‘What are European countries doing to prevent intentional injury to children? ‘Report was launched by the European Child Safety Alliance. The report is part of an initiative set out to make recommendations to governments in apply evidence based strategies for the prevention of injury to the youth of their respective countries. The report informs us that the incidence of suicide was higher among Irish adolescent girls than any other EU State, and their male counterparts were second highest in the EU. Both genders remain almost twice the EU average for suicide rates. How could this be? Why might this be the case? Surely, our 3rd level students are among the most well informed students that have ever been enrolled across all disciplines in the Colleges. Surely, most of them are ok. We will write about the second level in our third paper, but for now, we’ll concentrate on the third level sector.

The Third Level Sector in Ireland: Statistics in Context

Thankfully, there is now an emerging body of literature on suicide in third level around the world and Ireland is no exception. As an example, the School of Psychology at University College Dublin completed a study recently for the organisation Headstrong — the young people’s mental health organisation — and had shocking findings. Of their sample of 8,000 students between the ages of 17-25 years old, as many as 7% had ‘tried to take their own lives’ at some point and 43% articulated at some point in their life heretofore they felt ‘life was not worth living.’ Additionally, the Higher Education Authority (HEA), enumerated a total of 6,414 students — equating to 16% of all first-year student numbers — quit their college courses in 2014.

Suicide in the Third Level Sector in Ireland: A Case Observation from Niall

My first experience of suicide in University was when I was a student myself. I was good friends with a chap called Darren and we were both interested in music and we played in different College gigging bands. His older brother, Joey, would often come and watch my band, The Hungry Judges, play and I enjoyed many a pint with him over a period of three years. I remember distinctly on a rainy September afternoon meeting Darren on the Promenade in Salthill, Galway. We chit chatted for a few minutes about how we got on in London and New York that summer as J1 students and I then enquired about Joey. I’ll never forget Darren’s response as he looked at me and asked, ‘Don’t you know? Joey killed himself during the summer and I had to come home’. I was completely shocked and didn’t know quite what to say. I just couldn’t believe it. Joey had been what we colloquially refer to in Galway as a ‘head’. He was one of the cool lads. He seemed happy. And yet…

Suicide in the Third Level Sector in Ireland: A Case Observation from John.

I have been fortunate down through the years to have been trained to deliver a suicide awareness programmes which, of course, has put me at the coalface with people who have experienced the loss of a loved one, or are concerned for another as well as people that participate to gain a better understanding of the issues. Whatever has been said to me within such a setting is between myself and the person brave enough to talk, often times I would have had a past participant approach me and say that they have used the steps in the course when they were concerned about another person. The feedback has always been 100% positive and is a great testimonial of the programme. I always knew the programme was strong. To me it had been reinforced numerous times in several academic studies but that was the extent to which I knew of its realness and application. That was until…

The working day was over and the office closed, don’t ask me why but I remained back after, probably finishing up work that I should have done hours ago. I thought I’d heard a faint tap on the door but I did not jump to my feet as I was thinking to myself, “it’s after 5, we’re closed, whoever they are can wait!”, but then curiosity got the better of me and I peeped my head out of my little cubby hole office. I saw somebody was walking away from the door with a familiar looking bag. I shouted “with you in a sec”, but Marie just turned slightly and gestured with her hand as though she was saying “it’s grand, don’t worry about it” in a dismissive way. A little bewildered I stepped back to grab my phone, that instant it rang, somebody from the National Office with a quick question. The moment the phonecall ended I walked out to see if I could nab Marie. There was a cash machine beside our office and it was there that I found her. I watched for a minute and witnessed her putting the card in several times to check her balance, as though it was going to change. I heard a distinct snuffle, that somewhat unmistakeable one where you know somebody is upset and teary. “Marie, you ok?” … She turned, “No” as tears streamed down her face. I brought her into the empty office and I asked her what was going on that she was so upset. She told me a lot, an abusive past, an unsupportive husband, many outstanding debts and a perceived bleak future. It was the checking of her bank account that, in her own words was “the last straw”, her husband was supposed to have put money in for the direct debits that come out on a monthly basis but he hadn’t, and as a result she didn’t have two cents to rub together. She was a broken woman, and inconsolable. So I asked, what are you going to do? To which she replied, “it’s ok, I know what to do, I’ll sort it”. To me that raised alarm bells, because that kind of language is a huge ‘Tell’ from the programme that I deliver. Vague, ambiguous responses such as these are even used as examples in the programme to demonstrate the sometimes subtle hints a suicidal person might give about their intentions. So I asked… “Marie, are you talking about suicide?” She remained quiet, maybe she hadn’t heard what I asked or just had a stoic reaction to the question, I asked again… “Marie, are you talking about suicide?”. Her bowed head raised and her eyes met my own, tears welled up in her eyes as she tried to swallow. She paused, looked at me and give the gentlest nod and tried to speak through what must have been through unimaginable heartache, “yes…my head is all over the place, it’s too hard to even think”. I sat with her for several hours that evening, she talked, I listened. It was getting late and I knew the caretakers would be around to lock up soon so I said to Marie, “we need a plan”, just a small one”. She agreed. At that moment I was safe in the knowledge that she was not going to be in any danger that night but I gave her my number and told her to call at any time, but she was to promise me that she’d come back into me tomorrow when she had a chance and that from there we’d take the first step together at beating this. Sure enough at 9:17am the following day she was there at my office with a cappuccino in hand “one sugar, yeah?”, “just the way I like it, thank you, Marie”. We sat and spoke for a while about what she could do and where she might go for help. We linked in with several resources internally and externally so that she had a choice in who to talk to. She had always been a friend to me and somebody whose opinion I often sought before proceeding with a project or initiative across the campus, something of an anchor support for me at time.

She was, and still is a person I knew to be strong and unflappable but for me it was a learning curve around the fact that no matter what front a person puts up, nobody and I mean nobody, really knows what is going on underneath the surface, and ultimately sometimes the best thing you can do is simply ask. It’s not an easy question to ask, and not a question that anybody would want to have to ask but it is a question that can save a life, “Are you feeling suicidal?”

Concluding Commentary

The Connacht Tribune of June 2014 reported Dr. Declan Aherne of IAUCC, and Head of Counselling at University of Limerick, stating that counselling services across the country– have lengthy waiting lists as suicide and mental health remains ‘a huge issue among young people’. Despite the many advances, fully joined up thinking and triangulation of all involved does not happen in each and every University, Institute and College around Ireland. It should.

It’s as simple as this. Mental heath, mental ill health – whatever terms you wish to use – is a deeply complex area. People, including third-level students, are unhappy for many reasons and some people have better coping skills than others, even when faced with what seems to be on the surface, at least, very similar problems. But, there are strategies one can use to reach out and help someone who is distressed. As a first point of call, we would suggest that one trains up in one of the many formal and empirically tested programmes available. It’s only a few days out of your life. We are not trying to sell any particular programme – each has its merits and limitations and readers can choose the one that best ‘fits’ their worldview. But, at least, try to be informed if you have an interest in this area. That way, one may act more from just a sense of goodwill but, instead from a knowledge and skills base. We owe it to our young people to ensure they know, at the very least, there are people who care about their mental health.

 

Useful References

Chambers, D. & Murphy, F. (2011). Learning to Reach Out: Young People, Mental Health Literacy and the Internet. Dublin: Inspire Ireland Foundation.

Chambers, D. & Murphy, F. (2015). Technology, Mental Health and Suicide Prevention in Ireland: A Good Practice Guide. Dublin: ReachOut Ireland.

CSO (2014) Suicide Statistics. Available at: http://www.cso.ie/en/releasesandpublications/er/ss/suicidestatistics2011/2014

Department of Health (2015). Connecting For Life: Ireland’s National Strategy to Reduce Suicide 2015 – 2020. Dublin: Department of Health.

Dooley, B. & Fitzgerald, A. (2012). My World Survey – National Study of Youth Mental Health. Dublin: Headstrong (The National Centre for Youth Mental Health) & University College Dublin School of Psychology.

Houghton, F., Keane, N., Murphy, N., Houghton, S. & Dunne, C. (2010). Tertiary level students and the Mental Health Index (MHI-5) in Ireland. Irish Journal of Applied Social Studies, 10(1), 40-48.

Hunt, J. & Eisenberg, D. (2010). Mental health problems and help-seeking behaviour among college students. Journal of Adolescent Health, 46, 3 – 10.

Irish Examiner. (2016). Junior infants children ‘displaying significant symptoms of depression’. http://www.irishexaminer.com/breakingnews/ireland/primary-school-children-are-now-self-harming-principals-group-warns-717992.html

MacKay M & Vincenten J. (2014). National Action to Address Child Intentional Injury – 2014: Europe Summary. Birmingham: European Child Safety Alliance; 2014.

Orbach, I. (1988). Children Who Don’t Want to Live: Understanding and Treating the Suicidal Child. University of Michigan, Wiley.

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