Alcohol had been taken by 45% of men and 35% of women who had self-harmed

By Noel Baker in the Irish Examiner

Saturday, June 30, 2012

Two studies into suicide and self-harm have raised issues about the enforcement of laws on the sale of paracetamol and of patients “escaping” between ambulances and emergency departments.

The Suicide Support and Information System pilot ran from Sep 2008 to Apr 2011. It investigated the backgrounds of 178 suicides and 12 open verdict cases.

It found: 38.1% of those who died were unemployed; 32.8% worked in construction; 45% had a history of self-harm and of those, 52% had self-harmed in the week prior to death.

More than half had abused alcohol or drugs and 80% had attended a GP or mental health service prior to death.

Dr Ella Arensman of the National Suicide Research Foundation, which carried out the pilot project, said there was scope for greater use of standardised assessment to better understand which people might be more prone to depression.

Data from the National Registry of Deliberate Self-Harm shows an explosion in self-harm in certain parts of the country. Between 2007 and 2010, self-harm among men rose by 124% and by 98% in Cork county and 94% in Cork city.

By contrast, it rose 9% in the same period in Dublin and fell in Galway city.

Among women, the rate of self-harm rose by 112% in Co Longford, by 48% in Laois, and 38% in Cork City, but reduced in Offaly, Westmeath, and Cavan.

Some 545 people had self- harmed more than 10 times, resulting in 9,758 presentations, which Dr Arensman said may indicate borderline personality disorders.

The main method of self-harm was by overdose, followed by cutting. Alcohol had been taken by 45% of men and 35% of women who had self-harmed, and paracetamol was also heavily used.

“There are issues with the enforcement of the selling of paracetamol,” Dr Arensman said, claiming despite the limitations on the purchase of individual packets, it was still too easy to purchase it in large quantities.

She said the pilot had shown, in some cases, people who had self-harmed had been brought to a hospital by ambulance but had “escaped” and never made it into the emergency department. In some cases, they later took their own lives.

She said Ireland also needed to look at ways of reducing the number of suicides by hanging.

A self-management web programme would start in the autumn, she said, which could benefit people with mild depression.