SUICIDE PREVENTION

The recent rise in Ireland’s

suicide rate is having
a direct impact upon
emergency services
personnel who are
called out to assist in
an increasing number
of difficult cases. One
Dublin-based Coast Guard
unit has responded with
a specialised training
initiative to help its
members provide the
appropriate level of care
and assistance. Report by
Elaine Healy.

TRAINING
IN SUICIDE
PREVENTION
SKILLS
ISSUE 35 EMERGENCY SERVICES IRELAND 36
 SUICIDE PREVENTION

A
unique Applied Suicide cases, emergency service personnel may are there and what their intentions
Intervention Skills Training be among the first people on the scene,” are. Approaching them the right way,
(ASIST) workshop, hosted she said. “Being able to deal with the and asking the right questions, can be
by Aware, is teaching situation in a sensitive and appropriate difficult.”
the skills necessary to intervene in way is important, as is understanding why Direct, straightforward communication
situations where suicide is a possibility. a person may end up in such a situation. is the often the best way to forge a
Aware trainers deliver these two-day It is also very important to work to make connection, Murray said. “Being upfront
interactive workshops to groups of up that person safe and then, if possible, in asking people about their intentions is
to 30 participants, including voluntary, to identify other supports that may be important. We sometimes tend to skirt
community and youth workers, Gardai, available for them.” around the issue, but often, if you ask the
teachers and members of the clergy. ASIST trains participants to person straight up what their intentions
A group of 20 members of Howth understand what a person, at risk of are, they will let you know. You must try
Coast Guard Cliff Rescue Team suicide, may need from others to help to understand and engage with them,” he
participated in the Aware workshop in them to see beyond their situation. It said. Helping people to envisage a way
September, 2009. For Howth Coast Guard encourages honest, open and direct out of their situation, and to seek further
member Colin Murray, participating in the talk about suicide. Participants are also help, is another core element of the ASIST
ASIST course provided invaluable help asked to consider how their personal programme.
in understanding the psychology behind attitudes and experiences might affect “There are three stages: connecting,
suicide. their approach. Active participation is understanding and assisting. Once you
“The course helped us to understand encouraged, using audio-visual aids and find out what the situation is, you then
the mindset of people who contemplate small work groups. try to protect the person from
suicide and what they are going through,” “It is quite an intensive course,” said it happening again,” said
said Murray. “It is difficult to deal with. All Colin Murray. “It teaches you what to do Murray. “You learn to
emergency services personnel deal with when you come across potential suicides assist them
suicide at one time or another, and often – it's about connecting with people who
all you have to fall back on is the training may be considering suicide and getting
you receive and how to work with it. to know them. It is about
“Attempted suicide is a problem we finding out why they
have always had in Howth. Some years
you would have a noticeable number and,
other years, there are hardly any. We
unfortunately had a few in 2009 and we
were aware that, with the present climate,
we may be coming across more.”
According to Aware’s spokesperson
Sandra Hogan, there is often a lack
of understanding of the warning signs
indicating depression or suicidal
tendencies. She said ASIST is aimed at
people, including emergency services
personnel, who are likely to come into
contact with individuals in this situation.
“Many people who consider suicide
will give some indication to someone
around them, although it may not always
be obvious,” said Hogan. “ASIST trains
people to understand these signals or
indications and to then increase the
means of support available to that person
to keep them safe.”

INTERVENTION SKILLS
Hogan believes that suicide intervention
skills are particularly important for
emergency services personnel. “Where
someone is suicidal, they may engage in Howth Coast Guard Cliff Rescue Team pictured during a recent
training exercise on the cliffs in Howth
suicidal action or self-harm, and in some

ISSUE 35 EMERGENCY SERVICES IRELAND 37

 SUICIDE PREVENTION

in planning a way out of the situation and
find a way that it will not arise again in the
immediate future. Over 20 members of
Howth Coast Guard took part in the ASIST
course, along with representatives from
Drogheda Coast Guard, the local life-
saving club, the scouts and the Gardaí.
Murray recommends the course,
which is available free of charge, to
other emergency services personnel.
“For anybody who may come across this
situation, I would recommend taking part
in the ASIST course. It gives you more
tools to talk to the person and deal with
the situation,” he said. “Early intervention
is always good. Everybody is at risk at

any age, and it is important that there are

people out there whose eyes are open to
the early warning signs.”

LINKED TO DEPRESSION
Figures released by the Central Statistics
Office (CSO) in October 2009, showed a
SEARCH AND RESCUE SERVICES worrying 40 per cent increase in incidents
Established in 1999, Howth Coast Guard (HCG) is a 26-member Cliff Rescue of suicide in the first three months of the
Team that provides search and rescue services in various locations spanning year, compared to the same period in
the north coast of Dublin – from Clontarf to Malahide. 2008. According to the CSO, more than
100 people took their own lives in the
HCG is one of 50 voluntary coastal rescue units of the Irish Coast Guard
three-month period from January to March
funded by the Department of Transport. It works directly with the Gardai
in 2009, including 85 men and 21 women.
Síochána and the local fire services. It is also called to incidents by the Irish
“Over the last few years, there has
Coast Guard Maritime Rescue Co-Ordination Centre (MRCC), a 24-hour co- actually been a marginal decrease in the
ordinating service for all of the country’s coastal rescue units. HCG operates suicide rates, but it seems that figures
cliff and water rescue teams; it uses a pager system to contact members and for the first few months of 2009 show an
has a 10-minute response time. increase on the same period in 2008,
HCG also works with individuals and groups that use coastal amenities. which is, of course, very regrettable,” said
“We are working with anglers following a recent accident and on Dollymount Sandra Hogan. According to Hogan, more
Beach, which is popular with kite surfers. We are working with the Irish Kite than 80 per cent of suicides can be traced
Surfer’s Association to, for example, put identity tags on their gear,” said back to depression.
Fergus Cooney. “We know that many people struggle
with depression alone and never get help
“Every now and again, one of them will lose a kite or a board and, if
with it. Even where people come forward
somebody sees it on the side of a cliff, they might assume that there has
for help, the mental health services
been an accident and call us out.
can fall far short of what they should be
The Irish Coast Guard asks that if members of the public see anyone delivering,” she said. “The impact of the
who they think may be in trouble on the cliffs, beaches, at sea or on inland recession is probably having an impact as
waterways, then please dial 112/999 and ask for the Coast Guard. Do not well. Financial difficulties and concerns
assume someone else has made the call. for the future can lead to increased stress
and anxiety levels.”

ISSUE 35 EMERGENCY SERVICES IRELAND 39


AT-RISK GROUPS
The CSO found that young men, aged
between 15 and 24, accounted for the
majority of suicides recorded in the first
quarter of 2009. Research released
separately by The Department of Health
and Children at the start of November
supported these findings. According
to the Department’s ‘Health in Ireland:
Key Trends 2009’ report, suicide affects
younger people ‘disproportionately’,
particularly young men.
“Suicide is a particular concern in the
young male age group, particularly among
15 to 24-year-olds, but older males, aged
60 and over, are a cause for concern as
well,” said Hogan. In October, Australian
rugby coach Jim Williams launched a
new internet-based mental health service
for young people in Ireland. ReachOut.
com is part of a global network founded in
Australia over ten years ago.
Speaking at the launch of the
initiative, Williams expressed concern
about the high rates of suicide among
men aged below 30. Despite this,
Hogan believes that there is a lack of
available supports for men in this 'at-
risk' category, particularly at a time of
economic instability. “There is a huge
need to address the dearth of appropriate,
properly-resourced and accessible mental
SUICIDE PREVENTION
AWARENESS ABOUT DEPRESSION
Aware provides emotional support and
information to individuals who experience
depression, as well as their families and
friends, and also works to create greater public
awareness about depression.
The national voluntary organisation says
depression affects more than 400,000 people in
Ireland at any one time. “There is a real need for
greater awareness around depression and other
forms of mental health difficulty,” said Sandra
Hogan of Aware.
Depression affects more than 400,000
people in Ireland at any one time. “Knowing the basics about depression
and being able to provide reassurance and
support to a person, who is going through that, can be vital.” According to
Hogan, individuals who experience depression are often fearful of being judged
or labeled. Knowing that others are supportive can be hugely reassuring, she
said.
“The more we are all aware of depression, the sooner our society will change
and become more understanding about this condition and its impact, and that
will ultimately be a good thing as people will feel more able to access the help
and support that is available without fear of being judged,” she said.
Aware services include support groups throughout the country, the lo-call
helpline (1890 303 302) is open 365 days a year; there is an e-mail support
service wecanhelp@aware.ie while free information is also available online at
www.aware.ie, phone 01-6617211 or e-mail: info@aware.ie.
ISSUE 35 EMERGENCY SERVICES IRELAND 41

health services, and this is particularly the
case in relation to younger people. Age-
appropriate care is vital, but it can be very
hard to access in this country,” she said.
PREVENTATIVE TECHNIQUES
The participation of Howth Coast Guard
members in the ASIST course was due
to developments in the unit’s ongoing
Preventative Search and Rescue (PSAR)
programme. As part of its PSAR initiative,
the coast guard deployed a new web
application in April to track rescue
operations. ‘Decisions for Heroes’ is a
reporting and analytics tool that helps
search and rescue teams to prevent
accidents and emergencies by tracking
call-out patterns.
“It is a management information
system that allows us to trend incidents,
including where and when they happen,”
said Fergus Cooney of Howth Coast
Guard. “We can log on from anywhere
and input information like, for example,
whether or not an incident is cliff-related.
We can then look at how many incidents
we have had at a particular spot over the
last quarter, for example, and take action
to prevent further accidents of incidents in
that location.”
This is where the ASIST course came
in as a means to address the issue of
suicide, he added. “The programme
allowed us to quickly identify days and
times that were high-risk. We found that
there tended to be more incidents on
Sunday afternoons.
What we then did was try to get crew
members to do foot or boat patrols so
we could prevent something before it
happened or respond quickly. We are
a voluntary operation so this approach
helps us to plan and to use our resources
effectively.”
More information on ASIST is available
from the National Office of Suicide
Prevention online at: www.nosp.ie.
SUICIDE PREVENTION
PRIMARY LESSSONS TO BE LEARNED
IN WATER SAFETY
IN 2009, Howth Coast Guard Cliff
Rescue Team responded to 66 call-outs.
“We do a lot of Preventative Search
and Rescue (PSAR) work, including
cliff patrols, boat and foot patrols,
particularly at weekends and in the
summer,” said Colin Murray, Howth
Coast Guard. “We visit schools in the
area and bring community groups to the
station to talk about water safety. We
are constantly trying to get the message
out there. It’s a big commitment.
“We have a minimum of two training
exercises every month. Everybody in the
unit comes from all walks of life. There
is no typical coast guard member. We
have a very broad range of people and
that is what you need.”
As part of its PSAR programme, the
team recently completed the production
of a Water Safety DVD called ‘Dopey
Denzel’ for primary schools within
Ireland. The team will visit schools in
the Greater Dublin Area to screen the
footage and hold Q&A sessions, early
this year.
What started out initially as a local
project, thanks in part to the services
of a film production team, it is being
rolled this out nationwide to all 50
Coast Guard stations in Ireland. This
interactive-based DVD is the first of its
kind in Ireland.
The overall aim is to promote water
safety awareness at primary school
level to help give them the “what to do”
and “what not to do” when near the
water. The project was carried out by
Coast Guard personnel in co-operation
with the Irish Water Safety. The DVD can
be viewed on www.howthcoastguard.
com/watersafety
Primary school children get to see ‘Dopey
Denzel’ this year.
ISSUE 35 EMERGENCY SERVICES IRELAND 43