There was a time in my life when the sound of an approaching helicopter conjured up images of holidays, glamour and adventure. Then three years ago I moved back home to
Limerick and took up a job with a company located near the banks of the Shannon River. Now, the dreaded drill of helicopter rotors evokes feelings in me of death, distress and despair.

Lisaslightbridge

The sight and sound of the Coastguard rescue chopper is a regular occurrence in this city and it is not hard to see why. Limerick appears, at least anecdotally, to have one of the highest suicide and self-harm rates in the country. Alongside this, we have increasing numbers seeking support for depression and related disorders.  It is safe to say that Limerick city and its people are in a state of emotional distress.

I am writing this as I too have felt this emotional distress. I have sat in the A+E department in the Regional Hospital many years ago, dazed and numb, being urged to drink a charcoal cocktail to keep me in this world.  I am writing this as like many people in Limerick I have stood at the funeral of friends and family, whom have ended their lives so tragically and abruptly by suicide. It is for these friends and family that we must begin an honest, real and appropriate dialogue on suicide in Limerick. This needs to happen as the current discourse we have in this city surrounding suicide and its prevention is warped and quite frankly, damaging.

Local media appears to focus the majority of its discussion on suicide around the heroic actions of Limerick Marine Search and Rescue, as well as Corbett Suicide Prevention Patrol. Within minutes of another burdened individual making the desperate decision to jump into the River Shannon the Limerick Post has notified its 40,000 Facebook followers of a rescue mission being underway. As soon as another lifeless body has been recovered from the River Shannon the Limerick Leader is sure to let its twitter followers know the details of where and when it’s been found. Much praise is heaped on the courage of the rescuers with the title of ‘hero’ regularly used to describe the actions of the response crews.  These articles have become as frequent and expected to Limerick city dwellers as the sounds of search and rescue helicopters overhead.

But what is missing from the media reporting of heroism, increasing suicide statistics and the locations of bodies being found in our own spectacular waterway? It is the lonely, isolated voice of someone who is suicidal and has absolutely no one else to turn to except to the dark thoughts of final embrace by the Shannon River. Our beautiful, majestic river that has brought prosperity and life to generations of Limerick people is now a hot-spot for suicide missions.

Suicide prevention research consistently highlights the role that media reporting plays in certain suicide hot-spots attaining iconic status.[1][2] Despite recommendations to the contrary, journalists persist in asserting that suicides from public sites are newsworthy. Indeed, the vast majority of evidence calls for muted media reporting of suicide[3], particularly from suicide crisis zones as the River Shannon has become. A recent UK study recommended that the media should not even report on preventive measures, such as suicide patrols, with research suggesting that this serves to advertise both suicide and the specific sites where these patrols work[4].  Cautious and muted media reporting from suicide hot spots, particularly in reference to preventative measures, have shown to be effective in reducing suicides in many EU studies[5][6] .Likewise, it has been noted that excessive media reporting appears to encourage imitative behaviour in other suicidal individuals[7].

Is it really of public interest to know, as the Limerick Post informed us on March 3rd that a distressed woman was rescued from the Shannon after jumping from the bridge? Is it really necessary, when most evidence indicates that these types of media reports only serve to enhance the likelihood of suicidal people being attracted to suicide hot spots?

The Samaritans have recently developed an excellent set of media guidelines for the reporting of suicides[8] .These guidelines specifically highlight the careful and guarded approach that must be taken in reporting of sites that have achieved notoriety as a result of suicide. By constant patrolling of the city’s waterways by suicide watchers and a continual stream of local media reporting, are we not facilitating and promoting the River Shannon as a location for people to end their lives?

Dontworrybehappy
Lisa’s Lights

Similarly, is the ‘Lisa’s Lights’ suicide prevention strategy that is now installed on  Thomond Bridge. This is a ‘strategy’ that appeared to a, very well intentioned and well meaning, teenage girl in a dream one night. Indeed, national newspapers ran with the headline of ‘Limerick girl dreams up Limerick suicide campaign’[9]. This dream now has permanent fixture along our river front. There was no evidence based research, community consultation, consultation with individuals with previous history of suicidal ideation, or review on best practice approaches to suicide prevention. They were just put up overnight to much fanfare in the local and national media.

 

I once read the experience of suicidal ideation being described as ‘a hellish existence in one’s own mind, where nothing exists but self loathing, darkness and a sense of being trapped’[10]. Likewise, the populations of people who decide to take the drastic action of jumping from a bridge are typically individuals with extremely vulnerable statuses often compounded with severe mental health difficulties[11]. Individuals who for whatever reason are experiencing overwhelming life stresses that they can just no longer deal with. Considering this type of mindset, seeing a plaque on the side of the river stating ‘Don’t worry, be happy’, how would this make a suicidal person feel? Is it not extremely patronizing to disregard the legitimate and palpable worries that have forced a frantic person to take the action of attempting suicide?

I can only think of the time that I was in that dark place and hearing the experience of others who have been in that ‘hellish existence’. Forced positive and meaningless messages telling me ‘To turn my frown upside down’, are so far removed from your endless thoughts of death and despair they may push you even further from a society and city that fails to relate to you even remotely anymore.

Additionally, as a health care practitioner I appreciate the importance of evidence-based strategies, especially when supporting individuals with severe mental health difficulties. If we don’t base our approach on research and evidence, we are developing interventions based on whims, dreams and hunches, and this is dangerous. Dreams and hunches are a highly risky approach when interceding in what are life and death situations. Indeed, an informed and evidence-based approach is the primary focus of Ireland’s national suicide prevention policy, yet this doesn’t appear to correlate to suicide prevention practices along the River Shannon.

What is missing in Limerick is a co-ordinated strategy of suicide prevention that is built on evidence- based research and best practice.  There is a growing body of suicide prevention knowledge that offers significant promise for suicidal people. At the moment our ‘strategy’ appears to be built on teenage dreams, heroic stories and a local media that has a salacious appetite for reporting what is probably one of the most dreadful ways that a person can choose to end their lives. Crucially, this strategy must include the voice and opinions of suicide survivors, health practitioners, families, friends and the voice of the whole Limerick community. A community that, like the river that flows through it, has seen rough, turbulent times but has the resilience and strength to see through to more peaceful waters.

 

References

[1] https://meansrestrictionstudy.fs.cornell.edu/file/Suicide%20Prevention%20Consultation,%20Extended%20Rpt,%202010_07.pdf

[2] https://www.iasp.info/pdf/task_forces/Australia_Reporting.pdf

[3] http://www.ncbi.nlm.nih.gov/pubmed/26212196

[4]

[5] http://econtent.hogrefe.com/doi/abs/10.1027/0227-5910.27.2.82

[6] http://www.sciencedirect.com/science/article/pii/S0277953609004948

[7] http://nsrf.ie/wp-content/uploads/journals/2013/MediaReportingSuicidal2013.pdf

[8] http://www.samaritans.org/media-centre/media-guidelines-reporting-suicide

[9] http://www.breakingnews.ie/ireland/limerick-girl-dreams-up-anti-suicide-campaign-657234.html

[10] http://ancailinrua.com/2014/01/03/donal-walsh-and-suicide-whats-missing-from-the-debate-and-where-do-we-go-from-here/

[11] http://www.ncbi.nlm.nih.gov/pubmed/10738475