Over the past few decades, Northern Ireland has overtaken England, Scotland and Wales in suicide rates. To investigate the causes, Professor Mike Tomlinson of Queen’s University Belfast, UK, focused on people who grew up in the worst years of “The Troubles” in Northern Ireland.
This period of conflict, over the constitutional status of Northern Ireland, began in the late 1960s and is usually considered to have ended with the “Good Friday” Agreement of April 10, 1998.
Professor Tomlinson examined death registration figures for the last 40 years, He found that the highest suicide rate was among men aged 35 to 44 years (41 per 100,000), then the 25 to 34 age group, and then the 45 to 54 age group. This suggests that children who grew up in the worst years of violence, between 1969 and 1978, now have both the highest suicide rate and the most rapidly increasing rate.
Overall, the suicide rate for men and women doubled in the decade after 1998, following the signing of the Good Friday Agreement. It increased from 8.6 per 100,000 people in 1998 to 16 per 100,000 by 2010. Among men, it went from 13 per 100,000 in 1997 to 24 per 100,000 by 2008. For women, the rise was 3.9 to 7.3. Almost three-quarters of the people who committed suicide had no history of previous contact with mental health services. For those who knew them, the suicide “came out of the blue.”
The study also found that Derry, the second-largest city in Northern Ireland, had a higher rate of hospital attendance due to self-harming than eight other cities across Britain, Northern Ireland and the Irish Republic. The rate in Derry was 611 per 100,000 of the population in 2009. This compares with 352 in Dublin at the same time. Full details appear in the journal International Sociology.
Professor Tomlinson said: “During the 1970s and 1980s, the suicide rate rose steadily up to a rate of 10 per 100,000, low by international standards. It then fell slightly over a ten year period. The puzzle is, why have we seen such a dramatic increase in the rate since 1998?
“People born and growing up in the conflict experienced no other social context until the late 1990s,” he explains. “There are clear indications from the research that this cohort not only has the highest suicide rate but also the most rapidly increasing rate when compared with other age groups.”
The increase in suicide rates coinciding with the move from conflict to peace, “can be attributed to a complex range of social and psychological factors,” he suggests, “including the growth in social isolation, poor mental health arising from the experience of conflict, and the greater political stability of the past decade.
“The transition to peace means that cultures of externalized aggression are no longer socially approved or politically acceptable. Violence and aggression have become more internalized instead.”
This is in addition to the well-documented rise in suicide risk for those who have direct experience of the front line of conflict.
Professor Tomlinson believes that the conflict has had, and continues to have, “deep and widespread effects” because it has been the context of daily life and experience for decades. The long-term violent conflict had a profound impact, he states, because no matter which side people were on, all sides of the political divide ended up sanctioning violence to some extent. A culture of violence “seeped into everyday life.”
“The people of Northern Ireland seem to have adjusted to peace by means of mass medication with antidepressants, alcohol and non-prescription drugs, the consumption of which has risen dramatically in the period of peace,” he says.
He adds that, “Northern Ireland’s suicide prevention strategy has so far made little impact on the upward trend. It may well be missing the target by over-emphasizing interventions with younger age groups and failing to focus on those who experienced the worst of the violence.”
Professor Tomlinson says he is planning on carrying out work that could aid the development of more effective suicide prevention policies. “Acknowledging the relevance of the conflict would be a major step forward in suicide prevention,” he concludes.
War, peace and suicide: The case of Northern Ireland. Tomlinson, M. W. International Sociology July 2012 volume 27 No. 4 pp. 464-82 doi: 10.1177/0268580912443579
Tomlinson, M. The Trouble with Suicide. Mental Health, Suicide and the Northern Ireland Conflict: A Review of the Evidence. Published by Department of Health, Social Services and Public Safety (Northern Ireland) June 2007.