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Column: Facing the fear – over half our population drinks in a high-risk way

It’s impossible to seriously address mental health in Ireland without resolving our harmful relationship with alcohol, says Suzanne Costello.

Suzanne Costello

LAST MONTH World Suicide Prevention Day was marked, and last week World Mental Health Day took place – it was good to see the important issues raised on these days being debated and heard.

The importance of good mental health is beginning to gain the recognition it deserves in Ireland. But it is impossible to be serious about addressing mental health in Ireland without also being serious about resolving our harmful relationship with alcohol.

Over the past ten years, progress, albeit slow, has been made towards reducing the stigma that exists around talking about mental health. It has been encouraging to see the bravery of individuals who have come forward to talk about their own experiences – it has a normalising effect on the issue and reduces the isolation of people who may feel alone in their struggles and it can encourage them to seek help.

We are also beginning to recognise and take seriously how particularly hard it can be for men to open up emotionally; the frankness of many high-profile individuals, particularly men, is changing our perspective; hearing successful and famous figures talk about their own mental health issues certainly explodes the myth that it is some kind of ‘weakness’.

Our harmful relationship with alcohol

So now we have started talking about our mental health we need to talk about how to look after it and addressing our harmful relationship with alcohol is a key part of that.

Every one of us will face challenges, sadness and loss at some time in our lives. To cope with these times when they come along it is essential we develop resilience and coping skills. Talking, a good support network, a purpose and direction in life and a healthy lifestyle help build resilience. Understanding the importance of these things in day-to-day life will not provide immunity to mental health problems but they will certainly reduce risk.

Critical to building that vital resilience is to have a low-risk relationship with alcohol. Alcohol can affect our ability to cope, manage and overcome everyday stresses and significant life events such as unemployment or bereavement.

Unfortunately in Ireland over half the population drink in a high-risk way.

So many people in Ireland drink this way that it seems like pretty standard behaviour. We speak casually about experiencing ‘the fear’ on Sundays and Mondays after a heavy weekend session of drinking. It seems scarcely believable that we are inducing a state for anxiety, fear and depression in ourselves as a result of over-drinking – and we are all OK with that. And although most people overcome these feelings after a day or two for some, regular binge-drinking does serious damage to their mental and physical health.

Irish people binge-drink more than anyone in Europe – and amongst the public and politicians there is a general acceptance of this risky and harmful behaviour – it’s said to be part of our ‘culture’. The medical community have spoken extensively and alarmingly about the damage being done to people’s health. And yet there has been no real change. When presented with the evidence-based measures that would address this issue of harmful drinking and the myriad problems created for individuals, families and communities as a result, we seem overwhelmed by apathy.

Young people and drinking

Of particular concern is the impact of harmful drinking on young people. There is a good reason why drinking under eighteen years of age is illegal – because children and adolescents are neither physically nor emotionally equipped to deal with the effects of alcohol. The exposure that Irish children have to alcohol is enormous – it’s widely available, it’s cheap and, through well-resourced marketing campaigns, made to look very appealing.

At least adults are better equipped to try decode the shiny advertising messages, to understand the potential damage of misusing alcohol and, to an extent, cope with the anxiety and depression heavy drinking sessions can induce.

The great work of mental-health campaigners will shortly hit the brick-wall of apathy that surrounds the impact of harmful drinking in Ireland. Increased awareness of the importance of mental health is helping everyone – but awareness must be accompanied by understanding of how to maintain good mental health, develop resilience and reduce risk and the action required to support that understanding.

Alcohol is factor in over 50 per cent of suicides in Ireland – this stark figure alone should motivate everyone to deal with this problem for once and for all. The World Health Organisation has estimated that the risk of suicide when a person is currently abusing alcohol is eight times greater than if they were not.

If we have a chance to reduce the risk of suicide and self-harm in Ireland we must take it. If we have an opportunity to build resilience into Irish people and communities we must take it.

This is not an insurmountable task – the evidence-based policy measures that will finally bring about a positive change in our harmful relationship with alcohol are set out in the Steering Group Report on the National Substance Misuse Strategy. The three key areas we need to tackle are the pricing, availability and marketing of alcohol.

Minimum unit pricing?

The introduction of minimum unit pricing would have a dramatic and immediate effect on the numbers of people drinking – this has been the case in other countries where this measure has been introduced. As minimum unit pricing effectively targets the very cheapest, strongest alcohol sold in the off-trade, it addresses consumption among the most harmful drinkers among us and our young people, who tend to favour these drinks.

Introducing effective regulations for alcohol marketing, including bringing an end to alcohol sponsorship of sporting and cultural events, will also help protect children and young people from the current high levels of alcohol marketing exposure that is driving early and harmful drinking patterns,

Reducing the availability of alcohol through structural separation in retail outlets will also help reduce our alcohol consumption to the target of 9.2 litres set out in the Healthy Ireland plan earlier this year. This is the level we would reach if everyone aged 15 and over in Ireland drank to their maximum low-risk limit every week – is that really such a big ask?

If we are aiming to develop a healthy, resilient society, harmful drinking has no part to play. And if we are serious about improving mental health in Ireland we need to be serious about reducing drinking.

Alcohol Action Ireland’s conference Facing ‘The Fear’: Alcohol and Mental Health in Ireland takes place on Wednesday, November 20, at the Royal College of Physicians, Kildare Street, Dublin 2, from 9.30 a.m. to 4 p.m.

Expert speakers will discuss how alcohol is impacting on mental health in Ireland and the conference will also hear from people who will share their own personal experiences of alcohol and the impact it has had on them and their loved ones.

For further information or to register for the conference follow this link.

Column: Budgeting our depression? Funding cuts are disastrous to mental health

Read: Recognising the warning signs can prevent suicides

Read: One in five young people is experiencing a mental disorder – RCSI

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