The 'secret' of suicide is eluding us - says Ireland's first Professor of Mental Health Nursing
Thursday, 14 September 2005

Anne Scott, Head of the School of Nursing, Prof Chris Stevenson, Prof Ferdinand von Prondzynski, DCU President

Statistics produced in the MIND UK report on suicide report show that the ‘secret’ of suicide care is eluding us, according to Professor Chris Stevenson, speaking at her inaugural lecture as Ireland’s first Professor of Mental Health Nursing at Dublin City University today.

Professor Stevenson trained as a psychiatric nurse and was a community psychiatric nurse and facilitator of community mental health teams specialising in working with families. She advocates the importance of nurses working in partnership with people who have experience of mental health difficulties, particularly in the area of suicide.

It is estimated that in 2020 over one and a half million people will die by suicide worldwide and that 15-30 million people will attempt suicide, equal to 1 suicide every 1-2 seconds.

Anne Scott, Head of the School of Nursing said, “The arrival of Professor Stevenson is a very timely appointment in the national context. The health services in Ireland are undergoing major reform and last week the Tanáiste underlined the commitment of her Department and the HSE to the development of the Irish mental health services”.

“Nurses provide the bulk of ongoing, day to day care in mental health. Therefore, their power to make a difference to the experience of people in mental health difficulties is enormous. Mental health nurses need leadership to deal with the challenges that changes in mental health care provision, and expectations about care, bring. Professor Chris Stevenson will provide that leadership”, she said.

Professor Stevenson will examine analyses carried out in the UK, specifically the MIND UK report, which showed that 40% of suicides occurred while people with mental health problems were in psychiatric care or shortly after discharge; 23% committed suicide within three months of being discharged and 25% of people who died by suicide had been in contact with mental health services in the year before their death.

No single intervention seems to contribute to a decline in suicidal behaviour. Thus, the person is physically prevented from committing suicide whilst emotionally remaining in a suicidal ‘place’.

A ramification is that there has been little attention to training professionals on how to respond meaningfully to the experience of people contemplating or attempting suicide and the upshot is professional avoidance in relation to engaging meaningfully with the person.

Given that nurses provide the bulk of ongoing, day to day care in mental health, their power to make a difference to people in mental health difficulties is enormous.

While medication and hospitalisation play a role in the treatment of people who have attempted suicide, it is important that the nurse who works closely with the person helps to facilitate their re-connection with humanity, re-establishes the person’s trust in another being, and helps the person to take their first tentative steps towards reconnecting with the wider community of ‘humanity’.

“At this point, the person does not need ‘instrumental involvement’, either being encouraged to do things or being challenged about her/his perceptions of the situation. Rather she or he needs to experience intense, warm, care-based human to human contact, which implicitly challenges suicidal constructs such as ‘I’m worthless’ by offering the contrary experience of someone being there and being interested and thereby showing their own humanity”, said Professor Stevenson.

Current and future research will make a further important contribution to understanding and caring in relation to suicidal crisis and is necessary because suicide is painful – in its execution, in its failure and in its consequences”, said Professor Stevenson.