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Opinion: We are in the midst of a national crisis. How many more deaths before the government acts?

The recent story of two patients checking themselves out of psychiatric units days before taking their own lives is not a once-off.

Vicky Kavanagh

SYSTEMATIC FAILURE. These are the only two words I can think to use when remembering a number of suicide-connected news stories over the last few months. Conor McNally’s heartbreaking open letter about the death of his cousin, statistics showing 475 people died by suicide last year – and most recently, the release of two psychiatric patients who killed themselves shortly afterwards.

I’ve been volunteering as a mental health advocate since I was 18. Over those five years, I’ve been both a witness and participant to the metamorphosis around the topic. Due in large part to a number of awareness campaigns, people are talking about their mental health more. The openness of high-profile personalities about their own mental health struggles has encouraged us to look at the topic in a different way.

Little by little, the mystery is being removed from mental health. ‘It’s OK to not feel OK’. ‘Please talk’. ‘Reach Out’. The landscape has shifted and the biggest challenge to the exceptionally high suicide rates we have in Ireland lies not within our mind, but with the inadequate government supports on offer.

Geography

The recent story of two patients checking themselves out of psychiatric units days before taking their own lives is not a once-off. The circumstances of Glen Murphy McNally’s death were not a once off. Since the publication of A Vision For Change in 2006, there have been patchy attempts at reforming mental health services in Ireland. Last year, the Mental Health Commission found that the implementation of these reforms had been “slow and inconsistent”. Allow me to paint the reality of these terms.

If you are experiencing a mental health difficulty, your first professional contact will probably be with your GP. After speaking with you, they will make an assessment, possibly start you on some medication, and refer you to the local mental health community team, who will send you an appointment to begin availing of the appropriate services. Typically, the wait time for such an appointment is 3-5 weeks.

When you connect with your local mental health team, the level of support and help you receive differs dramatically depending on your location. Outside of the biggest cities – Dublin, Cork, Limerick and Galway – the support offered by the HSE is limited, to say the least. The physical location of a mental health specialist and the real-time in between appointments is just the tip of the iceberg for those in rural areas needing intervention.

In the cities themselves, things are not much better. Again, depending on your geography, you may or may not find adequate or timely services to assist you. If you are feeling suicidal, you’re directed to your local Emergency Department – a wholly unsuitable environment for a person experiencing emotional distress. If the person waits the average couple of hours it will take for them to be seen, they will be assessed by the mental health professional on-call at the time and will be dealt with in one of two ways; admitted to the local psychiatric unit or sent home and told to refer to their community mental health team. The former option is not a long-term solution and the latter reignites the game of letters, referrals and hoping for help.

Filling the gaps

As is stands, there is no national strategy on suicide prevention in Ireland. We’ve consistently topped the polls both nationally and in the EU for our high-suicide rates, but the government has yet to implement a national strategy to deal with the issue.

As a result, the responsibility of dealing with our nation’s mental health problems has been left to charities and nonprofits. Pieta House especially has seen an increasing demand for their services over the last number of years and most recently, opened a face-to-face counselling service in Cork in response to demand. Reachout.com and MyMind.org appeal to our young people in an attempt to provide information and assistance to combat the number of people, especially young men, taking their own lives..

Instead of these organisations complementing the HSE system, they are compensating for them. With limited resources and funds, they are attempting to stop the ship sinking by throwing buckets of water overboard.

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First-hand knowledge

I speak of these issues with the knowledge of someone who is active in the sector and has also been personally subject to the realities of it. When I was 16 years old, my mum tried to kill herself, the first of many suicide attempts that were to follow over the next seven years. Within 24-hours of her first attempt, she was released from hospital.

The advice my sister and I received from hospital staff was to watch her 24/7 and hide all the medications in our house. A letter was sent to our GP stating what had happened. It was over three weeks before we even received an appointment for her to see the community mental health team. This sequence of events became a pattern as over the years, my mum repeatedly tried to end her own life. Over-worked nurses and doctors, ill-trained community health care workers and apathetic psychiatrists fed the cycle. The biggest danger of falling through the cracks in our system lies in how easy it is to do so.

My mum, thankfully, is still alive. I’ve been told time and time again by people how lucky she is. It shouldn’t be a case of luck. Her life, the lives of those two patients, the life of any person in distress who seeks help from the HSE, shouldn’t be luck. It shouldn’t be dependent on who’s working that day or where you live. Our government is gambling with the lives of our most vulnerable and we are the ones who are paying for their loss. With our parents and our siblings, our children and our friends.

I will not cheapen the deaths of those who have died by suicide and say the time has come for change. We are past the time for change. We are in the midst of a national crisis. Our system is in dire need of repair. How many more deaths need to happen before the government acts?

Vicky Kavanagh is a journalist and writer. Among other things, she also works as a Mental Health Ambassador for ReachOut.com. Follow Vicky on Twitter @VickyWritesor visit her blog Life of a Blackbird.

Column: ‘He was given a clean bill of health, walked out of the hospital and took his own life’

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