Sharp increase in suicide rates in Northern IrelandNorthern Irish suicide rates

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Sharp increase in suicide rates in Northern Ireland

Northern Irish suicide rates have risen by an alarming 64% in the last decade. O'Hara reports on how communities are taking action

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O'Hara

The Guardian, Wednesday 16 March 2011

Article history

Some families felt the authorities weren't taking the problem of rising suicides seriously enough, says Creaney, director of the Suicide Awareness and Support Group. Photograph: McErlane

In autumn 2010, during a visit to my home town of Belfast, one topic was dominating public conversation: suicide. Over a short period of time, a number of young people in the city had killed themselves, and the deaths seemed to be having a striking effect within communities. In shops, at bus stops and in bars, people could be heard ruminating on why the suicides had occurred. They wanted to know what health authorities and politicians were going to do about what appeared to be an escalating and serious problem.

Local newspapers splashed on the deaths, while politicians, including west Belfast MP and leader of Sinn Féin, Gerry , declared the situation a "crisis" and vowed to act. A friend of mine articulated a commonly expressed sentiment: "Why is there so much money being spent on road safety when more youngsters are killed by suicide than on the roads?"

Suicide rates have been rising markedly in Northern Ireland over the past decade. According to the Public Health Agency (PHA), after a period of relatively static figures in the latter half of the last century, between 1999 and 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. In 2002, 76% of all suicides in Northern Ireland were male, and 60% were between 15 and 34 years old. By 2008, the latest year for which a reliable breakdown of the statistics is available, 77% of suicides were male, but the proportion aged between 15 and 34 had risen to 72%. Figures for 2010 are as yet unavailable but, according to data collated by the PHA, the number of deaths registered as suicides last year looks set to exceed the 260 identified in 2009.

For a while it looked as though the issue had faded from view – until last month, when the alleged suicides in a single month of two children (a 13-year-old boy and an 11-year-old girl) captured the local media's attention. Both were from the Twinbrook and Colin districts of west Belfast, one of the most deprived parts of the city and one that had seen a disproportionate number of last year's suicides. The deaths seemed to reawaken community anxieties around the subject. Although the young girl's family said publicly that she hadn't meant to kill herself, the statement failed to temper concern among other parents. Politicians were again calling for action, schools were on alert to the possible impact on pupils, and counsellors and local suicide support groups appeared in the area's housing estates offering assistance to worried families.

There is an understandable reticence to speculate as to why suicide rates have gone up so sharply in the past decade. Experts caution against over-simplification of what is a complex act. Nevertheless, there are a number of possible explanations for the upwards trajectory in Northern Ireland compared with the rest of the UK, where rates have remained relatively static over the same time frame.

Theories being mooted within Northern Ireland include the long-term impact of entrenched deprivation in some communities when coupled with issues of identity in a "post-conflict" society and the legacy of the Troubles for some of the younger generation of men and boys.

Platt, Samaritans' trustee and professor of health policy research at the University of Edinburgh, says: "The suicide rate in Northern Ireland appears to have increased after the end of the period known as the Troubles. Previous studies have shown that suicides decrease during periods of war because people feel a sense of integration in their communities while uniting against an adversary. When war ends, this feeling falls away to the detriment of mental health.

"Suicide rates can also be affected by a number of different things including recession, rising unemployment, budget cuts and other social factors."

Grassroots campaigners argue that politicians failed to intervene early on with robust suicide prevention initiatives when signs of a rise in the suicide rate were emerging. Heading, an SDLP politician and deputy mayor of Lisburn, who knows the Twinbrook and Colin areas well, argues that without investment in jobs for local youngsters (youth unemployment is as high as 35% in some parts of west Belfast), the prevailing sense of hopelessness they feel will persist, he says. "Many young people need to feel there's some future. Sometimes, by the age of 21, they already feel like there is nothing good ahead of them."

Consultant psychiatrist Philip McGarry contends that there are a number of important aspects of suicide to be considered in the Northern Ireland context, including the legacy of the Troubles. While some people are mystified that suicide rates have risen since the Good Friday agreement was signed, McGarry harbours no such bemusement. That paramilitary violence remained a feature of working-class communities such as west and north Belfast "long after" the agreement was signed, and that so many young men in those areas have mental health problems as a result, he says, is no coincidence.

Jim Weir of Fasa, a community organisation based on the Shankill Road, which focuses on substance misuse, self-harm and suicide, works mainly with young men aged between 11 and 25. Like McGarry, Weir believes it is a misnomer that the peace process suddenly resolved deep-rooted issues. "A lot of young men have issues around identity. They have complex problems and sometimes alcohol or drugs make it worse."

What is clear is that even after a decade of rising rates of suicide there remains uncertainty about how to reduce them. What local families want above all, though, is a sense that the problem is a priority and is being tackled.

"When [our group] had its very first meeting there was a lot of anger in the room, but people didn't know where to direct it. Families felt as if the authorities weren't taking the problem seriously enough," says Creaney, co-founder and director of the voluntary organisation, the Suicide Awareness and Support Group, based in west Belfast.

Recent research conducted on behalf of the PHA among young men who had attempted suicide and survived, concluded that there was a clear need for more "proactive outreach" approaches to suicide prevention. It also recommended that more be done to make young men aware of the type of advice and assistance already available.

Black, an assistant director at the PHA, says that, while overall numbers of suicides are low, the focus on young people and the impact of their deaths on the tightknit communities that typify deprived areas can be profound. If the media coverage is sensationalist or distorted, Black says, it can make a sensitive situation even worse.

Along with historic underinvestment in mental health services, this partly explains, she suggests, why "grassroots" suicide prevention groups – often spearheaded by bereaved parents – have sprung up across Northern Ireland over the past decade. Such groups, she says, have helped drive reforms that culminated in the implementation of a province-wide suicide prevention strategy in 2006, known as Protect Life, and other initiatives including a 24/7 telephone helpline. "This came from within communities," Black says. "There were services available, but people weren't necessarily aware of them."

Minister for health in the devolved government, McGimpsey, says that as well as extending the Protect Life strategy to 2013, in response to rising suicide rates, there is agreement that politicians need to think more "innovatively" about the issue. A number of "intermediate" responses are on the table too, he says, amid fears that the economic downturn could "place added pressure on vulnerable people". These include the development of community response plans to tackle suspected suicide "clusters".

But Philip McTaggart, who set up the community-based suicide prevention and support group, Pips Programmes, when his 17-year-old son killed himself in 2003, is more stridently critical of progress to date on either prevention or support for vulnerable youngsters. He says that while there might be a strategy in place, it is "far from" sufficient. "People in the statutory sector see it as a nine-to-five job," he says. "They say they have a strategy, but that's not what I see out on the street. Communities are still firefighting on this."

Black cautions that while more is now being done, a concerted approach "in partnership with communities" is imperative. One of the many difficult messages to get across, however, is that change will not come quickly. "People want a simple solution, understandably," she says. "But there is no simple solution. We need to take a long-term view. It requires action over a long time."

Samaritans UK Helpline: 08457 909090

http://www.guardian.co.uk/society/2011/mar/16/suicide-rates-northern-ireland?CMP=twt_gu

[Guest guest]

Sharp increase in suicide rates in Northern Ireland

Northern Irish suicide rates have risen by an alarming 64% in the last decade. O'Hara reports on how communities are taking action

Share

Comments (0)

O'Hara

The Guardian, Wednesday 16 March 2011

Article history

Some families felt the authorities weren't taking the problem of rising suicides seriously enough, says Creaney, director of the Suicide Awareness and Support Group. Photograph: McErlane

In autumn 2010, during a visit to my home town of Belfast, one topic was dominating public conversation: suicide. Over a short period of time, a number of young people in the city had killed themselves, and the deaths seemed to be having a striking effect within communities. In shops, at bus stops and in bars, people could be heard ruminating on why the suicides had occurred. They wanted to know what health authorities and politicians were going to do about what appeared to be an escalating and serious problem.

Local newspapers splashed on the deaths, while politicians, including west Belfast MP and leader of Sinn Féin, Gerry , declared the situation a "crisis" and vowed to act. A friend of mine articulated a commonly expressed sentiment: "Why is there so much money being spent on road safety when more youngsters are killed by suicide than on the roads?"

Suicide rates have been rising markedly in Northern Ireland over the past decade. According to the Public Health Agency (PHA), after a period of relatively static figures in the latter half of the last century, between 1999 and 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. In 2002, 76% of all suicides in Northern Ireland were male, and 60% were between 15 and 34 years old. By 2008, the latest year for which a reliable breakdown of the statistics is available, 77% of suicides were male, but the proportion aged between 15 and 34 had risen to 72%. Figures for 2010 are as yet unavailable but, according to data collated by the PHA, the number of deaths registered as suicides last year looks set to exceed the 260 identified in 2009.

For a while it looked as though the issue had faded from view – until last month, when the alleged suicides in a single month of two children (a 13-year-old boy and an 11-year-old girl) captured the local media's attention. Both were from the Twinbrook and Colin districts of west Belfast, one of the most deprived parts of the city and one that had seen a disproportionate number of last year's suicides. The deaths seemed to reawaken community anxieties around the subject. Although the young girl's family said publicly that she hadn't meant to kill herself, the statement failed to temper concern among other parents. Politicians were again calling for action, schools were on alert to the possible impact on pupils, and counsellors and local suicide support groups appeared in the area's housing estates offering assistance to worried families.

There is an understandable reticence to speculate as to why suicide rates have gone up so sharply in the past decade. Experts caution against over-simplification of what is a complex act. Nevertheless, there are a number of possible explanations for the upwards trajectory in Northern Ireland compared with the rest of the UK, where rates have remained relatively static over the same time frame.

Theories being mooted within Northern Ireland include the long-term impact of entrenched deprivation in some communities when coupled with issues of identity in a "post-conflict" society and the legacy of the Troubles for some of the younger generation of men and boys.

Platt, Samaritans' trustee and professor of health policy research at the University of Edinburgh, says: "The suicide rate in Northern Ireland appears to have increased after the end of the period known as the Troubles. Previous studies have shown that suicides decrease during periods of war because people feel a sense of integration in their communities while uniting against an adversary. When war ends, this feeling falls away to the detriment of mental health.

"Suicide rates can also be affected by a number of different things including recession, rising unemployment, budget cuts and other social factors."

Grassroots campaigners argue that politicians failed to intervene early on with robust suicide prevention initiatives when signs of a rise in the suicide rate were emerging. Heading, an SDLP politician and deputy mayor of Lisburn, who knows the Twinbrook and Colin areas well, argues that without investment in jobs for local youngsters (youth unemployment is as high as 35% in some parts of west Belfast), the prevailing sense of hopelessness they feel will persist, he says. "Many young people need to feel there's some future. Sometimes, by the age of 21, they already feel like there is nothing good ahead of them."

Consultant psychiatrist Philip McGarry contends that there are a number of important aspects of suicide to be considered in the Northern Ireland context, including the legacy of the Troubles. While some people are mystified that suicide rates have risen since the Good Friday agreement was signed, McGarry harbours no such bemusement. That paramilitary violence remained a feature of working-class communities such as west and north Belfast "long after" the agreement was signed, and that so many young men in those areas have mental health problems as a result, he says, is no coincidence.

Jim Weir of Fasa, a community organisation based on the Shankill Road, which focuses on substance misuse, self-harm and suicide, works mainly with young men aged between 11 and 25. Like McGarry, Weir believes it is a misnomer that the peace process suddenly resolved deep-rooted issues. "A lot of young men have issues around identity. They have complex problems and sometimes alcohol or drugs make it worse."

What is clear is that even after a decade of rising rates of suicide there remains uncertainty about how to reduce them. What local families want above all, though, is a sense that the problem is a priority and is being tackled.

"When [our group] had its very first meeting there was a lot of anger in the room, but people didn't know where to direct it. Families felt as if the authorities weren't taking the problem seriously enough," says Creaney, co-founder and director of the voluntary organisation, the Suicide Awareness and Support Group, based in west Belfast.

Recent research conducted on behalf of the PHA among young men who had attempted suicide and survived, concluded that there was a clear need for more "proactive outreach" approaches to suicide prevention. It also recommended that more be done to make young men aware of the type of advice and assistance already available.

Black, an assistant director at the PHA, says that, while overall numbers of suicides are low, the focus on young people and the impact of their deaths on the tightknit communities that typify deprived areas can be profound. If the media coverage is sensationalist or distorted, Black says, it can make a sensitive situation even worse.

Along with historic underinvestment in mental health services, this partly explains, she suggests, why "grassroots" suicide prevention groups – often spearheaded by bereaved parents – have sprung up across Northern Ireland over the past decade. Such groups, she says, have helped drive reforms that culminated in the implementation of a province-wide suicide prevention strategy in 2006, known as Protect Life, and other initiatives including a 24/7 telephone helpline. "This came from within communities," Black says. "There were services available, but people weren't necessarily aware of them."

Minister for health in the devolved government, McGimpsey, says that as well as extending the Protect Life strategy to 2013, in response to rising suicide rates, there is agreement that politicians need to think more "innovatively" about the issue. A number of "intermediate" responses are on the table too, he says, amid fears that the economic downturn could "place added pressure on vulnerable people". These include the development of community response plans to tackle suspected suicide "clusters".

But Philip McTaggart, who set up the community-based suicide prevention and support group, Pips Programmes, when his 17-year-old son killed himself in 2003, is more stridently critical of progress to date on either prevention or support for vulnerable youngsters. He says that while there might be a strategy in place, it is "far from" sufficient. "People in the statutory sector see it as a nine-to-five job," he says. "They say they have a strategy, but that's not what I see out on the street. Communities are still firefighting on this."

Black cautions that while more is now being done, a concerted approach "in partnership with communities" is imperative. One of the many difficult messages to get across, however, is that change will not come quickly. "People want a simple solution, understandably," she says. "But there is no simple solution. We need to take a long-term view. It requires action over a long time."

Samaritans UK Helpline: 08457 909090

http://www.guardian.co.uk/society/2011/mar/16/suicide-rates-northern-ireland?CMP=twt_gu

[Guest guest]

Sharp increase in suicide rates in Northern Ireland

Northern Irish suicide rates have risen by an alarming 64% in the last decade. O'Hara reports on how communities are taking action

Share

Comments (0)

O'Hara

The Guardian, Wednesday 16 March 2011

Article history

Some families felt the authorities weren't taking the problem of rising suicides seriously enough, says Creaney, director of the Suicide Awareness and Support Group. Photograph: McErlane

In autumn 2010, during a visit to my home town of Belfast, one topic was dominating public conversation: suicide. Over a short period of time, a number of young people in the city had killed themselves, and the deaths seemed to be having a striking effect within communities. In shops, at bus stops and in bars, people could be heard ruminating on why the suicides had occurred. They wanted to know what health authorities and politicians were going to do about what appeared to be an escalating and serious problem.

Local newspapers splashed on the deaths, while politicians, including west Belfast MP and leader of Sinn Féin, Gerry , declared the situation a "crisis" and vowed to act. A friend of mine articulated a commonly expressed sentiment: "Why is there so much money being spent on road safety when more youngsters are killed by suicide than on the roads?"

Suicide rates have been rising markedly in Northern Ireland over the past decade. According to the Public Health Agency (PHA), after a period of relatively static figures in the latter half of the last century, between 1999 and 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. In 2002, 76% of all suicides in Northern Ireland were male, and 60% were between 15 and 34 years old. By 2008, the latest year for which a reliable breakdown of the statistics is available, 77% of suicides were male, but the proportion aged between 15 and 34 had risen to 72%. Figures for 2010 are as yet unavailable but, according to data collated by the PHA, the number of deaths registered as suicides last year looks set to exceed the 260 identified in 2009.

For a while it looked as though the issue had faded from view – until last month, when the alleged suicides in a single month of two children (a 13-year-old boy and an 11-year-old girl) captured the local media's attention. Both were from the Twinbrook and Colin districts of west Belfast, one of the most deprived parts of the city and one that had seen a disproportionate number of last year's suicides. The deaths seemed to reawaken community anxieties around the subject. Although the young girl's family said publicly that she hadn't meant to kill herself, the statement failed to temper concern among other parents. Politicians were again calling for action, schools were on alert to the possible impact on pupils, and counsellors and local suicide support groups appeared in the area's housing estates offering assistance to worried families.

There is an understandable reticence to speculate as to why suicide rates have gone up so sharply in the past decade. Experts caution against over-simplification of what is a complex act. Nevertheless, there are a number of possible explanations for the upwards trajectory in Northern Ireland compared with the rest of the UK, where rates have remained relatively static over the same time frame.

Theories being mooted within Northern Ireland include the long-term impact of entrenched deprivation in some communities when coupled with issues of identity in a "post-conflict" society and the legacy of the Troubles for some of the younger generation of men and boys.

Platt, Samaritans' trustee and professor of health policy research at the University of Edinburgh, says: "The suicide rate in Northern Ireland appears to have increased after the end of the period known as the Troubles. Previous studies have shown that suicides decrease during periods of war because people feel a sense of integration in their communities while uniting against an adversary. When war ends, this feeling falls away to the detriment of mental health.

"Suicide rates can also be affected by a number of different things including recession, rising unemployment, budget cuts and other social factors."

Grassroots campaigners argue that politicians failed to intervene early on with robust suicide prevention initiatives when signs of a rise in the suicide rate were emerging. Heading, an SDLP politician and deputy mayor of Lisburn, who knows the Twinbrook and Colin areas well, argues that without investment in jobs for local youngsters (youth unemployment is as high as 35% in some parts of west Belfast), the prevailing sense of hopelessness they feel will persist, he says. "Many young people need to feel there's some future. Sometimes, by the age of 21, they already feel like there is nothing good ahead of them."

Consultant psychiatrist Philip McGarry contends that there are a number of important aspects of suicide to be considered in the Northern Ireland context, including the legacy of the Troubles. While some people are mystified that suicide rates have risen since the Good Friday agreement was signed, McGarry harbours no such bemusement. That paramilitary violence remained a feature of working-class communities such as west and north Belfast "long after" the agreement was signed, and that so many young men in those areas have mental health problems as a result, he says, is no coincidence.

Jim Weir of Fasa, a community organisation based on the Shankill Road, which focuses on substance misuse, self-harm and suicide, works mainly with young men aged between 11 and 25. Like McGarry, Weir believes it is a misnomer that the peace process suddenly resolved deep-rooted issues. "A lot of young men have issues around identity. They have complex problems and sometimes alcohol or drugs make it worse."

What is clear is that even after a decade of rising rates of suicide there remains uncertainty about how to reduce them. What local families want above all, though, is a sense that the problem is a priority and is being tackled.

"When [our group] had its very first meeting there was a lot of anger in the room, but people didn't know where to direct it. Families felt as if the authorities weren't taking the problem seriously enough," says Creaney, co-founder and director of the voluntary organisation, the Suicide Awareness and Support Group, based in west Belfast.

Recent research conducted on behalf of the PHA among young men who had attempted suicide and survived, concluded that there was a clear need for more "proactive outreach" approaches to suicide prevention. It also recommended that more be done to make young men aware of the type of advice and assistance already available.

Black, an assistant director at the PHA, says that, while overall numbers of suicides are low, the focus on young people and the impact of their deaths on the tightknit communities that typify deprived areas can be profound. If the media coverage is sensationalist or distorted, Black says, it can make a sensitive situation even worse.

Along with historic underinvestment in mental health services, this partly explains, she suggests, why "grassroots" suicide prevention groups – often spearheaded by bereaved parents – have sprung up across Northern Ireland over the past decade. Such groups, she says, have helped drive reforms that culminated in the implementation of a province-wide suicide prevention strategy in 2006, known as Protect Life, and other initiatives including a 24/7 telephone helpline. "This came from within communities," Black says. "There were services available, but people weren't necessarily aware of them."

Minister for health in the devolved government, McGimpsey, says that as well as extending the Protect Life strategy to 2013, in response to rising suicide rates, there is agreement that politicians need to think more "innovatively" about the issue. A number of "intermediate" responses are on the table too, he says, amid fears that the economic downturn could "place added pressure on vulnerable people". These include the development of community response plans to tackle suspected suicide "clusters".

But Philip McTaggart, who set up the community-based suicide prevention and support group, Pips Programmes, when his 17-year-old son killed himself in 2003, is more stridently critical of progress to date on either prevention or support for vulnerable youngsters. He says that while there might be a strategy in place, it is "far from" sufficient. "People in the statutory sector see it as a nine-to-five job," he says. "They say they have a strategy, but that's not what I see out on the street. Communities are still firefighting on this."

Black cautions that while more is now being done, a concerted approach "in partnership with communities" is imperative. One of the many difficult messages to get across, however, is that change will not come quickly. "People want a simple solution, understandably," she says. "But there is no simple solution. We need to take a long-term view. It requires action over a long time."

Samaritans UK Helpline: 08457 909090

http://www.guardian.co.uk/society/2011/mar/16/suicide-rates-northern-ireland?CMP=twt_gu

[Guest guest]

Sharp increase in suicide rates in Northern Ireland

Northern Irish suicide rates have risen by an alarming 64% in the last decade. O'Hara reports on how communities are taking action

Share

Comments (0)

O'Hara

The Guardian, Wednesday 16 March 2011

Article history

Some families felt the authorities weren't taking the problem of rising suicides seriously enough, says Creaney, director of the Suicide Awareness and Support Group. Photograph: McErlane

In autumn 2010, during a visit to my home town of Belfast, one topic was dominating public conversation: suicide. Over a short period of time, a number of young people in the city had killed themselves, and the deaths seemed to be having a striking effect within communities. In shops, at bus stops and in bars, people could be heard ruminating on why the suicides had occurred. They wanted to know what health authorities and politicians were going to do about what appeared to be an escalating and serious problem.

Local newspapers splashed on the deaths, while politicians, including west Belfast MP and leader of Sinn Féin, Gerry , declared the situation a "crisis" and vowed to act. A friend of mine articulated a commonly expressed sentiment: "Why is there so much money being spent on road safety when more youngsters are killed by suicide than on the roads?"

Suicide rates have been rising markedly in Northern Ireland over the past decade. According to the Public Health Agency (PHA), after a period of relatively static figures in the latter half of the last century, between 1999 and 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. In 2002, 76% of all suicides in Northern Ireland were male, and 60% were between 15 and 34 years old. By 2008, the latest year for which a reliable breakdown of the statistics is available, 77% of suicides were male, but the proportion aged between 15 and 34 had risen to 72%. Figures for 2010 are as yet unavailable but, according to data collated by the PHA, the number of deaths registered as suicides last year looks set to exceed the 260 identified in 2009.

For a while it looked as though the issue had faded from view – until last month, when the alleged suicides in a single month of two children (a 13-year-old boy and an 11-year-old girl) captured the local media's attention. Both were from the Twinbrook and Colin districts of west Belfast, one of the most deprived parts of the city and one that had seen a disproportionate number of last year's suicides. The deaths seemed to reawaken community anxieties around the subject. Although the young girl's family said publicly that she hadn't meant to kill herself, the statement failed to temper concern among other parents. Politicians were again calling for action, schools were on alert to the possible impact on pupils, and counsellors and local suicide support groups appeared in the area's housing estates offering assistance to worried families.

There is an understandable reticence to speculate as to why suicide rates have gone up so sharply in the past decade. Experts caution against over-simplification of what is a complex act. Nevertheless, there are a number of possible explanations for the upwards trajectory in Northern Ireland compared with the rest of the UK, where rates have remained relatively static over the same time frame.

Theories being mooted within Northern Ireland include the long-term impact of entrenched deprivation in some communities when coupled with issues of identity in a "post-conflict" society and the legacy of the Troubles for some of the younger generation of men and boys.

Platt, Samaritans' trustee and professor of health policy research at the University of Edinburgh, says: "The suicide rate in Northern Ireland appears to have increased after the end of the period known as the Troubles. Previous studies have shown that suicides decrease during periods of war because people feel a sense of integration in their communities while uniting against an adversary. When war ends, this feeling falls away to the detriment of mental health.

"Suicide rates can also be affected by a number of different things including recession, rising unemployment, budget cuts and other social factors."

Grassroots campaigners argue that politicians failed to intervene early on with robust suicide prevention initiatives when signs of a rise in the suicide rate were emerging. Heading, an SDLP politician and deputy mayor of Lisburn, who knows the Twinbrook and Colin areas well, argues that without investment in jobs for local youngsters (youth unemployment is as high as 35% in some parts of west Belfast), the prevailing sense of hopelessness they feel will persist, he says. "Many young people need to feel there's some future. Sometimes, by the age of 21, they already feel like there is nothing good ahead of them."

Consultant psychiatrist Philip McGarry contends that there are a number of important aspects of suicide to be considered in the Northern Ireland context, including the legacy of the Troubles. While some people are mystified that suicide rates have risen since the Good Friday agreement was signed, McGarry harbours no such bemusement. That paramilitary violence remained a feature of working-class communities such as west and north Belfast "long after" the agreement was signed, and that so many young men in those areas have mental health problems as a result, he says, is no coincidence.

Jim Weir of Fasa, a community organisation based on the Shankill Road, which focuses on substance misuse, self-harm and suicide, works mainly with young men aged between 11 and 25. Like McGarry, Weir believes it is a misnomer that the peace process suddenly resolved deep-rooted issues. "A lot of young men have issues around identity. They have complex problems and sometimes alcohol or drugs make it worse."

What is clear is that even after a decade of rising rates of suicide there remains uncertainty about how to reduce them. What local families want above all, though, is a sense that the problem is a priority and is being tackled.

"When [our group] had its very first meeting there was a lot of anger in the room, but people didn't know where to direct it. Families felt as if the authorities weren't taking the problem seriously enough," says Creaney, co-founder and director of the voluntary organisation, the Suicide Awareness and Support Group, based in west Belfast.

Recent research conducted on behalf of the PHA among young men who had attempted suicide and survived, concluded that there was a clear need for more "proactive outreach" approaches to suicide prevention. It also recommended that more be done to make young men aware of the type of advice and assistance already available.

Black, an assistant director at the PHA, says that, while overall numbers of suicides are low, the focus on young people and the impact of their deaths on the tightknit communities that typify deprived areas can be profound. If the media coverage is sensationalist or distorted, Black says, it can make a sensitive situation even worse.

Along with historic underinvestment in mental health services, this partly explains, she suggests, why "grassroots" suicide prevention groups – often spearheaded by bereaved parents – have sprung up across Northern Ireland over the past decade. Such groups, she says, have helped drive reforms that culminated in the implementation of a province-wide suicide prevention strategy in 2006, known as Protect Life, and other initiatives including a 24/7 telephone helpline. "This came from within communities," Black says. "There were services available, but people weren't necessarily aware of them."

Minister for health in the devolved government, McGimpsey, says that as well as extending the Protect Life strategy to 2013, in response to rising suicide rates, there is agreement that politicians need to think more "innovatively" about the issue. A number of "intermediate" responses are on the table too, he says, amid fears that the economic downturn could "place added pressure on vulnerable people". These include the development of community response plans to tackle suspected suicide "clusters".

But Philip McTaggart, who set up the community-based suicide prevention and support group, Pips Programmes, when his 17-year-old son killed himself in 2003, is more stridently critical of progress to date on either prevention or support for vulnerable youngsters. He says that while there might be a strategy in place, it is "far from" sufficient. "People in the statutory sector see it as a nine-to-five job," he says. "They say they have a strategy, but that's not what I see out on the street. Communities are still firefighting on this."

Black cautions that while more is now being done, a concerted approach "in partnership with communities" is imperative. One of the many difficult messages to get across, however, is that change will not come quickly. "People want a simple solution, understandably," she says. "But there is no simple solution. We need to take a long-term view. It requires action over a long time."

Samaritans UK Helpline: 08457 909090

http://www.guardian.co.uk/society/2011/mar/16/suicide-rates-northern-ireland?CMP=twt_gu