In his address at the opening of the 15th Annual Conference of the Irish Association of Suicidology , which has as its theme is ‘Suicide Prevention – Supporting Families in Crisis’ Dan Neville TD, stated that the present economic crisis has created difficulties within families. The stress of changed occupational and financial conditions can put strain on relationships within the family and the stress experienced by the changed conditions will inevitably strain relations. This has contributed to the dramatic increase in suicides since the recession commenced. I wish to outline why I think this profound increase in suicide is taking place. During recessionary times, there is a sudden gap between material needs and resources. In economic downturns, frustration increases as an increasing proportion of people fail to meet their financial goals. There is clear evidence that suicide is linked to financial difficulties. The WHO has identified that the potential psychological impact of economic recession on public health is severe. Job loss, job insecurity, job uncertainty, economic strain, loss of income, home repossession and restricted access to credit lead to a reduction in mental well-being, an increase in mental health problems and mental ill-health, increased substance misuse, especially alcohol and drugs, and intimate relationship breakdown and divorce. There is a loss of perceived social worth, purpose and daily structure, a reduction in social contact, an increase in social isolation, and an increased risk of suicidal behaviour, non-fatal self-harm and completed suicides. A protracted period of unemployment, especially at a young age, seems to have a particularly deleterious effect on the mental health of young men, regardless of their social background. Rates of suicide are two to three times higher among those who are unemployed.
Family has a key role to play in the recovery of a member in crisis including suicidal ideation. I am concerned that a large section of the psychiatric profession fail to recognise this. To many professionals refuse to include family members in the recovery of the patient. In too many instances psychiatrists refuse to discuss the after care needs of a patient on discharge from a mental ill health residential service. This is unique in the health services where in general medicine, professionals see the family involvement as part of the recovery programme after discharge from hospital. Too often I have met families who are stressed due to lack of information on the treatment regime that best serves the convalescence of the patient. Patient confidentiality is quoted as the reason. Family members are key to identifying a member in danger of loosing their life. Too often, I receive complaints that the professionals do not listen and sadly the views of the family are bourn out and the person in crisis takes their life. This culture of exclusiveness of family in the recovery programme of a person with a mental ill health difficulty or suicide must change
A bereavement by suicide falls outside the normal range of human experience. It is an overwhelming loss which leaves the bereaved family confused and helpless, overwhelmed by many emotions and many unanswered questions. As well as the normal range of grief reactions the bereaved of suicide often experiences a sense of stigma, shame, loneliness or rejection. The death is sudden, unexpected, violent and extremely traumatic. Consequently the bereaved family may also find themselves experiencing the symptoms of post traumatic stress.
Counsellors working with those bereaved by suicide need additional training and extra supports to understand the special needs of those bereaved by suicide and to continue effective ongoing work with them. This is to help them understand the special problems of those bereaved by suicide.
Bereavement by suicide has very particular problems that prolong the grieving process and make it more intense and more difficult.
For parents the loss of a child is always a tragedy. Losing a child by suicide is a catastrophe. Probably bereaved parents are those suffering most from guilt and remorse.
Few, if any, will ever overcome the feelings of guilt, feelings that in some way distort their grief and at times make the normal work of overcoming grief impossible. One reason why the loss of a child due to suicide is so hard on parents is that basically it is irreconcilable with their role as reproductors. Of course, in general people do not walk around seeing themselves as a link to the ongoing continuity of mankind but subconsciously the death of a child means a break in the chain. In the case of suicide pain and remorse increase because the parents are (again subconsciously) inclined to take upon themselves all the blame for the break.
Suicide by a parent has quite serious implications. All research on so called deviant behaviour among children and adolescents underline the negative effects of a “broken home”. There is however huge differences in the effect on the child according to how the home was broken, and also they show that the death by suicide of a parent is the most traumatic event that can ever befall any child. There are several reasons for this. There are the usual reactions such as grief, self reproach, guilt and shame but also the suicide may have a grave detrimental impact on the Childs self esteem. “I cannot be of any value at all when father would rather die than stay with me”.
Support must be given to suicide bereavement services to assist families to deal with the terrible tragedy of a loved ones suicide