Suicide Rates in Northern Ireland Highest in UK, Among Highest in World

Growing up in Castlerock in County Londonderry during the Troubles, anthropologist Fiona McCormack remembers her elders telling her to be quiet about the violence.

Like McCormack, many Northern Irish people witnessed bloody encounters with bombs, crude weapons and stones. Even if someone didn’t know anyone hurt or killed, the threat hung over most families and towns.

And it wasn’t just her family who advised the hush, said McCormack, who’s now a resident of and full-time university lecturer at the University of Waikato in New Zealand. As an Irish Catholic, she’s examined a culture she says praises self-sacrifice for the good of all. Serving one’s brother was honorable, but talking about oneself was considered conceited, she said.

“It’s far more emphasis on collectivity,” McCormack said. “The whole American thing about lying on the couch and talking to your psychiatrist is sort of laughed at. It’s bloody individualist.”

In her work, she’s written about the collective experience of her upbringing, including as lead author on a 2017 article in the academic publication Anthropology and Humanism titled, “Fear, Silence and Telling: Catholic Identity in Northern Ireland.” 

For McCormack and many of her generation, not talking simply felt like the only way to move on. But that kind of coping kept people from reaching out about critical mental health issues in a country with alarming numbers of suicide, she said – and it continued long after the Troubles ended. 

Northern Ireland has one of the highest suicide rates in the world and the highest in the UK, and it’s climbing. Since 1998 – when the signing of the Good Friday Agreement officially ended the 30-year conflict – over 1,000 more Northern Irish people have died by suicide than died in the violence.

Northern Ireland saw its three record-breaking years of suicides in the last 12 years. In the highest year, 2015, there were 17 suicides per 100,000 people. That’s four more deaths per 100,000 people than the United States in the same year.

Now, it seems almost everyone in Northern Ireland has a suicide story. A cab driver remembers his twin cousins. A worker at an airsoft gun shop remembers her 16-year-old friend.

But it’s not a new crisis, and history shows the United Kingdom has a legacy of stigma around suicide.

Northern Ireland still considered suicide a crime until the ‘60s, using the now-taboo phrase “committ suicide” — as in, to committ a crime. For most of UK’s early history, suicides were buried at crossroads, only allowing churchyard burial in the 1820s. Even then, daylight and Christian services were forbidden for most of the 19th century under the Church of England. 

When Irish republican prisoners like Bobby Sands died by hunger strike in the 1980s, representatives of the Catholic Church had to insist the deaths weren’t suicides to hold proper burials, according to a study published by the University of Massachusetts Boston.

The good news, some experts say, is that stigma is beginning to peel back after years of social effort.

The movement to prevent suicide in Northern Ireland started simply, a suicide prevention expert explains. Caroline King, the Northern Ireland head of the national charity PAPYRUS (Prevention of Young Suicide), said the first step was just acknowledgement.

Like McCormack, King said the Troubles kept many from delving into their personal struggles. Reported instances of suicide, domestic violence and sexual violence were low during the Troubles, King said, but that didn’t mean it wasn’t happening.

“Everything was hidden by the Troubles,” King said. “Because if you get up every day, and your task was to get to work and back without getting shot or blown up, people don’t really pay much attention to anything else that is going on.”

After the violence slowed with the Good Friday Agreement, surviving families of suicide victims began to have a louder voice, King said. Over the next 20 years, the conversation would include those living with suicidal ideation, and the idea that suicide was preventable to begin with — an otherwise foreign concept born from stigma — spread.

But prevention started off small.

Many early suicide prevention measures here were entirely focused on means of death — how people harm themselves.

Unlike the United States, very few Northern Irish suicide deaths come from firearms, partially because of strict gun control laws that limit sales. Additionally, some over-the-counter pain medicines commonly used to overdose cannot be bought in bulk. 

In response, some modern suicide prevention strategies turned to visible, dramatic prevention involving bridges. Barriers meant to prevent jumping and signs on bridges can be found in many spots, including over the River Lagan on the Ormeau Road, pictured. Belfast residents have advocated for bridges over Belfast’s Westlink motorway to add additional suicide barriers after multiple attempts in the past decade.

Even with barriers on bridges as a public way to address suicide, some experts might still advise caution when promoting why they’re needed.

Jo-Anne Bichard, a professor of accessible design at the Royal College of Art, recalls being outright told that a suicide prevention project she was working on couldn’t obviously address “suicide,” even though that was the goal. 

Bichard helped on research for Our Future Foyle, an architectural project to make the Foyle River in Derry more appealing to people. The Foyle is a known suicide hotspot in Northern Ireland, and many Derry residents exclusively associate it with tragedy. The project’s changes included installing mechanical reeds that could change color via a phone app, and maybe change Derry’s perception of the river and its bridges. It’s art, but the art is, in large part, a suicide barrier.

If all goes to plan, 12,000 aluminum reeds embedded with LED lights will line the Foyle Bridge, beginning construction in the upcoming summer months. Residents can “adopt” a reed for a small price and change the hue and intensity of its lights.

The reeds will be at least 8 feet tall and spaced in a way that a person could not slip between them. The reeds will rise tall and slope downwards at the bell, containing people to the sidewalk side. Their slick stems will make them hard to climb. On the outermost side, footholds will be placed so someone could climb back to safety.

The artistic design is, in some ways, inspired by the Luminous Veil in Toronto, Canada, on the Bloor Street Viaduct. Once home to the second deadliest suicide bridge in North America, the Luminous Veil in Toronto placed similar barriers that lit up at night, bringing suicide deaths on the Bloor Viaduct to a near halt after its construction in 2003.

But the Toronto barrier’s somewhat obvious design failed to change the community’s perception of the bridge, a report by Our Future Foyle’s research team said. Additionally, the British Medical Journal released a report stating suicide deaths by jumping didn’t decrease in Toronto, meaning those who couldn’t attempt at the Bloor Street Viaduct likely found a different spot. 

Because perception impacts suicide risk, this was a design worth changing.

While Bichard and her fellow researchers were looking into potential designs, Bichard remembers a suicidologist shutting down the idea of signs with mental health hotlines along the Foyle Bridge. When asked why, the suicidologist was straight forward: Talking about suicide so overtly could trigger an attempt, and it’s too high of a risk with a ledge so close.

It was a moment of surprise, Bichard said, but she said she could understand it. She, too, had felt the impulse to jump before.

For Bichard, she was walking along a bridge in London years ago when she sat on a bench. It was dark out, and she had been dealing with a lot. She looked up and saw the watery view. At that moment, she knew she could jump if she wanted to. Ultimately, she stood from the bench and kept walking, ignoring the impulse, but she remembered how easy it could have been to follow the urge. “It’s a private act that becomes public,” Bichard said. 

So Bichard didn’t fight it when the suicidologist explained Our Future Foyle had to be discrete. Bichard said that she may not have thought about jumping if her London view had been a beautiful sunset, and her role in Our Future Foyle was to create that same moment of hesitation through beauty. 

But the suggestion begged the question: If suicide prevention focuses on means and is coy about suicide, how can Northern Ireland better address the psychological roots of its deep problem? There are countless factors that contribute to every suicide attempt, King said, so exclusively focusing on means won’t do enough to address the rising rates.

King said Northern Ireland’s new focus on social causes is a significant step in the right direction — one she said has made major headway in the last 10 years.

“Housing, death, poverty,” King said, “We can’t address suicide prevention if we’re not going to look at the wider societal issues that are there.”

One of the first steps for that was advocating for mental health interventions at the local level. In 2019, the Northern Irish government’s answer was Protect Life 2, a revised suicide prevention plan that outlines crisis recognition and de-escalation in schools and medical facilities.

As Koulla Yiasouma explains, there’s been a slow and needed shift in mental health awareness over the past decade. Yiasouma is the Northern Ireland Commissioner for Children and Young People, or NICCY. Previously a social worker, she advocates for children and young people’s rights on behalf of the United Nations and particularly in her own country. In her time as both the commissioner and a social worker, she’s observed and encouraged a shift for awareness.

The movement has been worldwide and especially strong among young people, Yiasouma said.  In Northern Ireland, some teenagers have begun advocating for themselves through mental health initiatives, such as Pure Mental, an entirely-youth led organization founded in August 2019 that champions young people’s mental health at a legislative level.

Yiasouma said it’s especially important for children growing up post-conflict with parents who remember the Troubles.

“Today’s children — all of whom were born out of the Good Friday Agreement, a long time after the Good Friday Agreement — are still feeling the trauma of the conflict because they live in families who are traumatized,” Yiasouma said.

Northern Irish children grow up in a world still recovering from 30 years of violence, but often receive little nuanced explanation for the signs of disruption where they live and with their families, Yiasouma said. They don’t fully know why their parents, families and churches do what they do. No one wants to explain; they expect children to just know, she added.

While young people and grassroot projects advocate for mental health awareness, their traumatized parents who survived are having a harder time keeping up, Yiasouma said, adding she doesn’t think that’s a fault to the parents, but rather a point of responsibility for the Northern Irish government.

And that falls pretty squarely on the shoulders of survivors of the Troubles, she said. 

“We cannot be saying, ‘You move on,’” Yiasouma said. Yiasouma said further advocacy for Troubles survivor recovery is a crucial step for full suicide prevention. “Otherwise, we’ll just have another generation of traumatized kids.”

Fiona McCormack said she has her doubts that much will change. She immigrated to New Zealand shortly after finishing school. Her brother went to Switzerland, and she knows many close to her age who fled across the globe to Australia, the United States and places across Europe. She said it wasn’t worth staying in a country where she constantly felt like a second-class citizen.

“You have to get out of Northern Ireland,” McCormack said. “You’d only have a life’s chance if you got out of Northern Ireland.”

But McCormack noticed a difference between her generation and the next. She’s noticed her daughter has been far more open about mental health struggles — a break from the collectivist society McCormack comes from.

While it perhaps spells hope, McCormack said the instinct to keep quiet about the Troubles won’t go away until Northern Irish people feel safer to speak up. There is still a fear of rocking the boat. Until it’s addressed, McCormack says she doesn’t expect suicides to slow down.

“How do you break it?” McCormack said, thinking of the hush. “The only way you can break it is when it’s not necessary anymore.”

But Caroline King of PAPYRUS doesn’t have these doubts. She’s certain that the problem of suicide — while difficult, complex and tragic — is one that can be solved.

“For people who think, ‘It is what it is. It’ll always be this way,’ I say, ‘no,’” King said. “This is preventable.”

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