Walsh, Dermot (2008) Suicide, attempted suicide and prevention in Ireland and elsewhere. Dublin: Health Research Board.
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Suicide has been ubiquitous in time and place. It has been proscribed by tradition, culture and legislation. More recently it has been decriminalised almost everywhere. Historically suicide has been underreported by a factor of three in Ireland until comparatively recently.
During recent decades under-reporting has greatly diminished so that there has been a rapprochement between official and clinical rates. Because of earlier under-reporting it is impossible to say whether the number of suicides has increased in Ireland. Nevertheless it is plausible to suggest that there have been long waves of suicide change over the past 150 years in this country. Suicide rates rose until the First World War and then underwent a period of decline until 1970 when a moderate but steady increase occurred which greatly accelerated from 1990 to 2001 and then declined by an estimated 14% in 2006.
However it is too soon to claim that this decline represents a trend and it should be interpreted with caution. The late twentieth century increase, whether apparent or real, has particularly involved young males. Suicides in males aged 15–34 increased from 11.6% of all violent, accidental and poisoning deaths in 1980 to 44.2% in 2003. Suicide rates in Ireland’s elderly have fallen and are now among the lowest world wide, particularly for women. Female rates in Ireland are one third to one quarter those of males. Irish suicide rates are low in European comparison for both sexes.
However, the rate of increase of suicide in young Irish males has been greater than in other European countries. The possible impact of recent social and economic change in Ireland in increasing suicide in young males is unclear as is the reason for the recent decrease in rates, assuming this to be sustained. It is estimated that generally one in six suicides is alcohol-related. Alcohol consumption and abuse have trebled in Ireland over a period contemporaneous with the increase in suicide confirming that the long waves of change in these two parameters usually coincide. There is evidence that deliberate self-harm has increased in Ireland recently.
There have been a number of reports in Ireland and elsewhere making recommendations on actions to reduce suicide and deliberate self-harm. Most are politically convenient but scientifically fallible. Generally they rely on generic improvement in social, educational and medical provision but are short on specifics, not surprising given the lack of evidence for any single intervention. The one measure with potential for influence, the reduction of alcohol consumption through mechanisms recommended by a national task force, remains largely unimplemented.
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