In a country with 5.2 million people, the stark reality of over 60,000 being affected by suicide in any given year exposes the true extent of mental health in Ireland today.

And yet this is the conservative estimate offered by those whose mission it is to understand the causes and consequences of suicide.

A study released last year by HUGG, a charity that supports those bereaved by suicide, in conjunction with the HSE’s National Suicide Prevention Office found that as many as 135 people may be affected by one single death by suicide, with 15 to 30 people severely affected.

The research also found that those recently bereaved by suicide are ten times more likely to die by suicide.

According to the report, the prevalence of suicide amongst men is particularly high, with the most recent CSO statistics (issued in 2023) showing 72.6% of the 504 people to take their own life in 2022 were men.

Certain occupations have higher suicide rates than others, including those who work alone, such as farmers and vets.

The UCD Agri Mental Health team published a study in June this year to replicate and extend preliminary research exploring the mental health and suicide risk of Irish farmers.

A total of 457 farmers responded to an online survey, devised by Mark Creegan and Dr Alison Stapleton, that included measures of well-being, psychological distress, suicidal ideation, farm attachment, farm stress, social support, exposure to suicide, and demographics.

Stigma

The study revealed 22.8% of participants were considered at risk of suicide, and farm stress was significantly associated with higher suicidal ideation and psychological distress.

A 2022 study, also carried out by the UCD Agri Mental Health team found farmers’ top stressor is government policies designed to reduce climate change with other factors deemed to be a suicide risk including financial/economic pressures, environmental factors, social isolation, lack of social support networks and the stigma associated with seeking help for mental health.

Research reported in the Irish Veterinary Journal also shows a high prevalence of various risk factors for mental health disorders among practicing vets.

In addition to a high risk of suicide, there is increasing evidence of burnout and depression, which are higher than in the general population and among other occupational groups.

Certain occupations have higher suicide rates than others, including those who work alone, such as farmers and vets

Dr Eve Griffin is Chief Executive Officer of the National Suicide Research Foundation (NSRF) at University College Cork. Over the past 30 years, the foundation has been researching suicide and influencing HSE policy on ways to reduce loss of life.

“Suicide is such a complex issue. It affects everyone in society; across the lifespan, across different demographics and I think more and more we’re starting to realise suicide is a public health issue and a public health priority,” she says.

Over the past year, Dr Griffin has overseen the establishment of a Lived Experience research panel at the NSRF, where people who have experienced a suicide attempt or lost a loved one to suicide are informing the research being done.

Lived experience

“It became apparent to us over the last number of years that in order to do research on the topic of suicide you can’t do research about people and exclude them,” she says.

“We want to make sure our research stays relevant and responds to the needs of the people who are living with mental health conditions, who have attempted suicide or who have supported a loved one who is impacted by suicide.

"Our Lived Experience panel is made up of 12 people who come from lots of different backgrounds and experiences, and live all over the country.”

The involvement of people with lived experience in the research has, according to Dr Griffin been ‘hugely transformative’.

“To be honest, it has changed things massively and immediately,” she says. “Our research has been informed by the people who have had this experience, have been involved in the service, have the experience of losing someone to suicide.

"We have close to 50:50 gender breakdown in our panel which is important because we really struggle to get male participation in any of our research projects. Generally speaking, mental health research has an 80:20 split favouring female participation but we are much closer to gender equality in our Lived Experience panel.”

Men in mind

Dr Griffin also believes that until services are overhauled to target those most at risk, men will remain more vulnerable to the risk of suicide.

“We published a paper a number of years ago that looked at rates of suicide at a geographical level in Ireland and one of the things that came out of that was rurality being a really important risk factor for suicide, particularly for men of all ages,” she says.

“The factors we have identified as placing someone at risk of suicide include job insecurity, income concerns, climate concerns, political policy pressures, isolation of the job and the rural location, so this can be a perfect storm for farmers.

“Services haven’t been developed with men in mind and that’s a big gap that we are seeing.

"If we are designing services, and you include people from the start in terms of the design process and thinking about what they actually need or what would be acceptable to a man in terms of a mental health service, it would look very different to what I might imagine it to be or what the research might say.

"Unless we have that narrative and perspective there from the start, it’s never going to be fully implemented and you don’t get the buy in.”

Suicide bereavement

Dr Griffin says the true extent of suicide and the impact it has on society has grown exponentially in recent years.

“We estimate there are about 60,000 people impacted by suicide in Ireland every year. Years ago, it was thought that when someone died by suicide, about six people were impacted and that was the close family circle. More modern estimates are 135 people, so those ripple effects are extensive.”

The NSRF joined forces with HUGG a number of years ago for a collaborative research project on suicide bereavement. The study, which was carried out during the pandemic received a hugely positive response from the public, many of whom shared their stories for the first time.

“There haven’t been many studies like this done internationally so we thought we were going to struggle with it, but we ended up with over 2,000 responses,” says Dr Griffin.

“It wasn’t an easy survey to complete but people were so willing to tell their story. We need to do a lot of work on suicide bereavement in Ireland but we have been missing the voice of the people who have been impacted because we don’t know who has, or in what way.”

A surprising aspect of the research findings was the effect suicide has on those who encounter it in a professional setting.

In the aftermath of a suicide, it is so important how we respond as a community and how we support people

“We tried to keep the survey as open as possible, by inviting family members, partners who had lost loved ones, friends, work colleagues, people in the community to take part,” explains Dr Griffin.

“We also had a lot of responses from professionals bereaved by suicide – GPs, psychologists, doctors, front line workers, Gardaí, paramedics, and that was a big surprise for us.

"These people have ongoing exposure to suicide and some of them had encountered 16 deaths to suicide throughout their career so it’s that repeated, cumulative exposure.

“We have a better picture of the impact of suicide, regardless of how close a person is to the person who dies, family circle or not. It can have a devastating impact and can also increase the suicide risk for people who have been bereaved.”

The after effect of suicide on family and friends was highlighted by the HSRF study which found that 20% of respondents to the survey had had thoughts of suicide or self-harm themselves which is five times higher than the national average.

“It’s definitely becoming more and more apparent that suicide bereavement is a huge risk factor and exposure to suicide, especially among young people. We’re beginning to understand more of the impact it has on suicide risk and other physical and mental health outcomes,” adds Dr Griffin.

“In the aftermath of a suicide, it is so important how we respond as a community and how we support people.

“That stigma is still there and also the fear of not knowing what to say or do, it’s one of the priority areas that if we’re to address suicide we need to get better at supporting people and having that conversation.

"We’re so good as a society in supporting people when someone dies but that doesn’t always translate when a suicide occurs.”

If you or someone you know have struggled with any of the themes in this story, support is available at: