The vast majority (220, 80%) of those who died with a verdict of suicide were men. The overall average age was 41 years, and men were significantly younger at the time of death (mean age 39 years) than women (mean age 46 years). The majority were Irish (93%), single (51%), and living in a house or flat (95%). Thirty-three per cent were unemployed, 22% were living alone and 2% were living in a supervised hostel. In terms of occupation, 41% had been working in the construction sector.

 

The majority (63%) of the 275 suicide cases died by hanging; 12% died by drowning and 10% by intentional drug overdose. Legal drugs used in the overdose cases included both prescribed (53%) and non-prescribed (46%) medication. Illegal drugs used included cocaine, ecstasy and heroin. 

 

Of those with drugs in their toxicology results, just over one quarter (26%) had drugs above the therapeutic range, and 21% had multiple drugs recorded. In addition, benzodiazepines were recorded in 54% of cases, antidepressants in 39%, benzodiazepines in 54%, opiates in 39% and other drugs in 29%. Seventeen per cent of the total number of cases had taken medication and/or drugs in combination with other methods, such as hanging or drowning. A minority (14%) had used other methods, including cutting or stabbing, carbon-monoxide poisoning, firearms and jumping from a height or in front of a train. Close to one third (31%) of cases had left a note, in the form of a letter, e-mail or text message.

 

Sixty-one per cent of the suicide cases had a family history of mental disorder and the same proportion had a personal or family history of substance abuse. Over 39% of cases had either personal experience of significant physical, sexual or emotional abuse or a family history of such abuse. Ten per cent of fatalities had a parent or sibling who had a non-natural death, such as suicide, homicide or accident.

 

A history of self-harm was known for 132 cases, of whom 86 (65%) had engaged in at least one act of deliberate self-harm. Of these, 33% had engaged in one act, 14% in two acts and 10% in three acts. Twenty-seven per cent had engaged in deliberate self-harm in the 12 months prior to ending their lives, 14% less than a week before and 10% less than a day before.

 

Sixty-two (20%) cases were known to have experienced suicidal behaviour (fatal and/or non-fatal) by family members or friends at some point in their lives. Of these 62, 85% had a relative or close friend who had died by suicide and the remaining 15% had engaged in non-fatal self-harm. In eleven cases (18%) the deceased had lost three relatives or close friends by suicide.

 

A psychiatric assessment was known to have taken place in 123 cases. In the majority (69%) of these cases, mood disorder (such as depression) was the primary diagnosis, followed by anxiety disorder (6%), schizophrenia (5%) and alcohol, drug or alcohol and drug dependence/misuse (6%).

 

In the year prior to death, 173 of the cases had abused alcohol and/or other drugs. Of these cases, 49% had abused alcohol only, 28% had abused both alcohol and other drugs and 21% had abused other drugs only.

 

A total of nine statistically significant clusters were observed between August 2010 and June 2012. There was much overlap and nesting within these clusters, with two groups of clusters emerging. The report states: ‘In order to illustrate a sample of the types of clusters that emerged, we detail two distinct clusters here that do not overlap in time or space’ (p.26).

 

Cluster 1 involved 13 cases of suicide (12 men and one woman) in Co Cork over a three-month period, from April to June 2011. Nearly half the people (46%) had died by hanging and 38% had taken an overdose intentionally. At the time of death, 31% had used drugs, 23% had used alcohol and drugs, and 38% had a clear toxicology. More than one third (38%) had been diagnosed with a psychiatric illness and nearly two thirds (61%) had been diagnosed with a physical illness.

 

Cluster 2 involved seven cases of suicide (three men and four women) in Co Cork over a two-month period, from September to October 2011. The majority of the people involved had died by hanging, and the next largest number had died by jumping from a height. At the time of death, the majority had drugs only in their toxicology results.

 

1.     Arensman E, Wall A, McAuliffe C et al. (2013) Second report of the Suicide Support and Information System. Cork: National Suicide Research Foundation. www.drugsandalcohol.ie/20508