Suicide in Belfast

Suicide is a complex phenomenon and a devastating event for all concerned. Although there is no single measure that can prevent it, there are several strategies that may help to reduce it, for example, making services more accessible to those who are vulnerable. Moreover, there are a number of factors which are well known to aggravate suicidal ideations which include

social isolation, history of poor health and poor mental health, unemployment, drug and alcohol misuse, recent events such as bereavement, stigma and lack of access to mental health services (Department of health [DH] 1994).

The National Confidential Enquiry into Suicide and Homicide by People with Mental Illness, 2011, illustrates that in the UK suicide rates are increasing, particularly in Northern Ireland (NI) and Scotland, see appendix A.

As the Chief Executive of Belfast Health Care Trust, I am concerned by the high levels of suicide in the city, particularly when compared to other parts of Northern Ireland (NI). See appendix B.

In the period 1999 -2008 rates of suicide in Northern Ireland increased by 64%. Most of the rise was attributable to young men in the 15 to 34 age group. A large proportion was concentrated in disadvantaged areas and, in particular, north and west Belfast (The Guardian, 2011). See appendix C.

This study will focus on young men in Belfast which could be described as a sub-culture of the community as a whole.

Spector, 2000, defines culture as "the nonphysical traits, such as values, beliefs, attitudes and customs that are shared by a group of people and passed from one generation to the next."

Although suicide can potentially affect any person of any age, research consistently illustrates that young males are more at risk (reference). There are some common themes and values that many young Northern Irish men share such as the NI conflict, pressures of growing up and finding work, issues surrounding masculinity and becoming a man, drug and alcohol abuse, religious conflict and stigma towards mental illness.

In order to put suicide in Belfast into context, it may be helpful to make some comparisons with the UK and Northern Ireland in general.

The UK suicide rate is 6.4 per 100 000 inhabitants per year (WHO, 2010), whereas the rate is 9.8 per 100,000 in Northern Ireland overall and in Belfast is 12.9 per 100,000(DH 1999-2003).Given that the population of Belfast is approximately 270,000 (Belfast City Council, 2012), this equates to 35 deaths by suicide per year in this city alone.

The discrepancy in the time frames for when this data was collected would suggest that the current level for Belfast is currently likely to be even higher.

During the period 2000-2004, figures in the North and West Belfast Parliamentary Constituencies of Belfast revealed alarming rates of 17.2 and 16.2 respectively, (see appendices B and C), giving rise to an even greater level of concern. From 1998-2004 the suicide rates in these two areas were in fact 50% higher than in the UK (ONS, 1991-2004).

One important factor may be the legacy of the "Troubles" which is particularly relevant to the city of Belfast. There is evidence that the experience of the NI conflict is associated with poorer mental health (Miller et al, 2003). Those who have experienced violence have significantly higher rates of depression, a factor that is well known to be a major cause of suicide and males are more likely to have been affected by violence than females as they are more likely to receive punishment beatings and be affected by parliamentary intimidation (Smith, 2004).

In addition there has been significant social, economic and political upheaval (Morrissey, 1999) which has placed further stresses on the younger generation.

Another reason why more men than women commit suicide is because many men are reluctant to talk about their feelings. Many men feel they are expected to cope with problems themselves and young men in particular demonstrate their masculinity by being dismissive of their emotional pain - often to the extent that they appear 'unemotional' and intimidating to

others. By withholding certain feelings and