Well? Issue 4: Spring/Summer 2004
Tackling Suicide in later life
Tabloid newspapers often portray older people as tragic victims, especially in relation to street crime and attacks, but these stories may mask an even more shocking and disconcerting reality.
Stuart Hay, for Help the Aged in Scotland, provides a perspective on suicide in later life
The disturbing truth is that people in their later years are far more likely to die by their own hands, than those of an attacker. The question is: what underpins such alarming statistics and how should the problem be tackled? Globally, older suicide is a well-recognised problem with death rates often peaking in the upper age bands, a fact reflected in UN reports on the topic. But the high number of suicides amongst younger people in Scotland sets us apart from other countries:
"The seriousness of suicides within the younger age group in Scotland tends to diminish and distract us from the problem at the upper end of the spectrum.
"Figures for the period 1992 to 2001 for the 55+ age group show that, on average, just over 200 older people take their own lives each year, making up 24% of all suicide cases. In comparison during 2001, only 17 older people died as a result of assault. Certain areas such as West Lothian are also hot-spots where suicides amongst males are highest in the +75 age bracket.
The level of older suicides has been relatively constant in recent years, although the numbers are too small to establish any statistically robust trends. However, anecdotal evidence suggests that the true scale of the problem is underestimated, because higher levels of mortality mask suicides amongst older people.
"Older people are more likely to have access to prescribed medicine increasing the risk of overdoses. And the higher probability of death from natural causes, such as long-standing illness, diminishes the need for an extensive investigation, whereas low mortality rates among young people automatically trigger a thorough investigation to pinpoint the specific causes of death.
"Other controversial theories have suggested that some doctors may spare the anguish of grieving families by refraining from considering suicide as a possible cause of death. What is undoubtedly true is that tragic loss of a young life will catch the media's attention in a way that an older person's suicide won't.
"Certain areas such as West Lothian are hot-spots where suicides amongst males are highest in the +75 age bracket"
"Considering the number of other negative factors that older people may experience, it could be argued that the comparatively lower level of reported older suicides is surprising:
Older people are more likely to be alone, isolated and coping with bereavement.
The incidence of ill health increases with age, especially long-term and debilitating conditions.
There is increased pressure on spouses or partners who are often burdened as sole carers.
Financial insecurity can undermine older people's lives, with fewer opportunities to improve their financial position (1 in 5 older people fall below the official poverty line).
There can be significant psychological and biological effects of ageing and medical treatment.
This combination of factors also makes developing a preventive strategy more difficult. Whilst there are many similarities, clearly certain aspects of older people's lives make them distinct from other groups:
"Older people make up a disproportionately small share of hospital admissions recorded as cases of self harm and attempted suicide. They're also thought to be less able to self diagnose and less willing to seek help with mental health problems.
However, despite these apparent differences, recent Scottish Executive reviews have revealed few examples of existing initiatives catering for older people with acute mental health problems. Most importantly, consideration should be given to how any new mainstream mental health initiatives help older people who have the most acute problems and face the greatest suicide risk.
The scale of suicides amongst the young in Scotland is a national tragedy, which is deservedly being seen as a priority for action but this must not be allowed to obscure the growing challenge of increased pressure in retirement and the rapid ageing of Scotland's population. Every individual suicide is a personal tragedy and draws attention to failings in society.
"The fact that a suicide has occurred in the latter part of a person's life is irrelevant and makes it no less shocking. The challenge is balancing specific action for older people today, whilst giving younger people the life skills that prepare them for the many pressures and challenges they will face in old age."
Stuart Hay
Help the Aged,
t: 0131 551 5415
e:Stuart.Hay@helptheaged.org.uk
www.helptheaged.org.uk
SOBS
Survivors Of Bereavement by Suicide (SOBS) is a self-help, voluntary organisation aimed at helping people who have been bereaved by suicide. Until recently, the only SOBS group in Scotland was in Fort William, but a group was established in Glasgow in 2003.
Margaret is a founding member of the Fort William SOBS group which provides a safe and confidential environment in which bereaved people can share their experiences and feelings:
"We've been running the group now for two years and people are free to come and go as they wish, although we have a core of about 12 people who come on a very regular basis to our monthly meetings. "Although we're based in Fort William we get calls from all over Scotland. When we held an open day we had people travelling from Glasgow and Aberdeen and one of our regulars travels from the far side of Inverness. So there's definitely a need for similar groups elsewhere."
Expressing feelings and developing coping strategies on how to deal with the horror of someone you love committing suicide form the central theme at SOBS meetings, but Margaret believes that "moving on" is also crucial to the healing process.
"At SOBS we believe that people have a choice as to whether they wish to be permanently hurt by the last act of an individual or not. The horror never goes away, but sharing feelings of guilt, anger or confusion, being patient and working through feelings until you can let go are all part of the healing process. Letting go, however, does not mean forgetting."
SOBS runs a National Helpline on
t: 0870 241 3337,
available 9am - 9pm every day.
The UK headquarters are in Hull.
www.uk-sobs.org.uk
Scottish Branches:
Fort William, Margaret,
t: 01397 772446
Glasgow, Susan,
t: 0141 434 0767
CRUSE VIDEO TRAINING Cruse Bereavement Care Scotland (CBCS), with financial support from the National Programme, has produced a powerful video, Living With Suicide which features frank testimony from people who have been bereaved by suicide. CBCS are now developing further resource materials to increase the video's training potential. The video and supporting materials will be available later in 2004 and are aimed at a wide range of organisations such as the police, social workers and health professionals. Cruse Bereavement Care Scotland
t: 01738 444 178
www.crusebereavementcare.org.uk |
PAPYRUS
'Don't Die of Embarrassment' is the title of a powerful drama conceived and produced by 2nd year pupils from West Derby Comprehensive School in Liverpool following an exploration into issues surrounding suicide in young men. It's just one initiative managed by Papyrus, a network of individuals commited to the prevention of young suicide and the promotion of sound mental health and well-being.
Founded in 1997, Papyrus members include parents who have lost a son or daughter to suicide and who contribute in a practical way to reducing suicide statistics by sharing skills and experiences.
"In Scotland, young men are twice as likely to kill themselves as to die in road accidents," says Dorothy Robertson, a Papyrus member in Dumfries. "There are approximately 500 males and 100 females between the ages of 15 and 24 who take their own lives every year, many of whom are not classified as mentally ill. Our aim is to use our members' experiences to enlighten others to recognise and manage potentially suicidal young people."
The work of Papyrus includes:
Working with local health committees and forging links with a number of MPs including the House of Commons All Party Group on Clinical Depression.
Contributing to the consultation process for the review of the Mental Health Act and the development of 'Choose Life', Scotland's National Suicide Prevention Strategy.
Providing information and support for parents or carers of suicidal young people.
Developing a training video for teachers offering information and advice on how to identify potentially suicidal young people.
Producing leaflets with information specifically relevant to Scotland for inclusion in information packs.
Working with the Safer Custody Group of HM Prisons (England) to develop a booklet for young people in young offender institutions.
The development of a website on suicide prevention and mental health, based on research at Hull University which will publish new research and web links from around the world ( www.suicideprevention.info ).
Dorothy Robertson
t: 01387 266043
www.papyrus-uk.org
Ken Laidlaw is senior lecturer in clinical psychology at the University of Edinburgh:
"Amongst older people, suicide is most common amongst older men over the age of 75 who live alone. This may be partly explained by the fact that older people are more likely to use high lethality methods of suicide completion, with drug overdose being very common.
"But there's a paradox about suicide in older people. Women typically live longer than men which exposes them to increased risk of developing chronic diseases commonly associated with age. Women are also much more likely to be widowed and be less well off financially. So you would predict, therefore, that it would be older women, not older men, who have an increased risk of suicide. Yet it's the male survivors who are most at risk of death by their own hands.
"A potentially important factor which might explain this is the concept of supportive social networks. Men generally have more constricted socially supportive networks, often turning to their wives for emotional support. Women tend to look to other women for emotional support, so they often develop supportive networks outside the home.
"We need to recognise that suicide in older people is a serious issue and importantly that our tacit acceptance of the negative age stereotype needs to change. Recent research suggests there's much to be optimistic about in relation to ageing, as people are not just living longer, but remaining healthier too. An age-integrated society that values the contribution that older people make is one in which suicide in later years cannot be neglected or tolerated."
e:k.laidlaw@ed.ac.uk |
BEREAVEMENT BOOKLET The Scottish Association for Mental Health (SAMH), with support from the National Progamme, has produced a booklet for people bereaved as a result of suicide, which covers emotional issues and grieving, registering the death, Fatal Accident Inquiries and useful contacts and resources. Available in May 2004. SAMH,
t: 0141 568 7000.
e:info@samh.org.uk |