howth coast guard - training in suicide prevention skills, emergency services ireland magazine

TRAINING IN SUICIDE PREVENTION SKILLS

SUICIDE PREVENTION

ISSUE 35 EMERGENCY SERVICES IRELAND 36

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.


SUICIDE PREVENTION

A unique Applied Suicide Intervention Skills Training (ASIST) workshop, hosted by Aware, is teaching

the skills necessary to intervene in situations where suicide is a possibility. Aware trainers deliver these two-day interactive workshops to groups of up to 30 participants, including voluntary, community and youth workers, Gardai, teachers and members of the clergy. A group of 20 members of Howth Coast Guard Cliff Rescue Team participated in the Aware workshop in September, 2009. For Howth Coast Guard member Colin Murray, participating in the ASIST course provided invaluable help in understanding the psychology behind suicide. “The course helped us to understand the mindset of people who contemplate suicide and what they are going through,” said Murray. “It is difficult to deal with. All emergency services personnel deal with suicide at one time or another, and often all you have to fall back on is the training you receive and how to work with it. “Attempted suicide is a problem we 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 SKILLSHogan believes that suicide intervention skills are particularly important for emergency services personnel. “Where someone is suicidal, they may engage in suicidal action or self-harm, and in some

cases, emergency service personnel may be among the first people on the scene,” she said. “Being able to deal with the situation in a sensitive and appropriate way is important, as is understanding why a person may end up in such a situation. It is also very important to work to make that person safe and then, if possible, to identify other supports that may be available for them.” ASIST trains participants to understand what a person, at risk of suicide, may need from others to help them to see beyond their situation. It encourages honest, open and direct talk about suicide. Participants are also asked to consider how their personal attitudes and experiences might affect their approach. Active participation is encouraged, using audio-visual aids and small work groups. “It is quite an intensive course,” said Colin Murray. “It teaches you what to do when you come across potential suicides – it's about connecting with people who may be considering suicide and getting to know them. It is about finding out why they

are there and what their intentions are. Approaching them the right way, and asking the right questions, can be difficult.” Direct, straightforward communication is the often the best way to forge a connection, Murray said. “Being upfront in asking people about their intentions is important. We sometimes tend to skirt around the issue, but often, if you ask the person straight up what their intentions are, they will let you know. You must try to understand and engage with them,” he said. Helping people to envisage a way out of their situation, and to seek further help, is another core element of the ASIST programme. “There are three stages: connecting, understanding and assisting. Once you find out what the situation is, you then try to protect the person from it happening again,” said Murray. “You learn to assist them

Howth Coast Guard Cliff Rescue Team pictured during a recent training exercise on the cliffs in Howth


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,

SEARCH AND RESCUE SERVICESEstablished in 1999, Howth Coast Guard (HCG) is a 26-member Cliff Rescue Team that provides search and rescue services in various locations spanning the north coast of Dublin – from Clontarf to Malahide. HCG is one of 50 voluntary coastal rescue units of the Irish Coast Guard funded by the Department of Transport. It works directly with the Gardai Síochána and the local fire services. It is also called to incidents by the Irish Coast Guard Maritime Rescue Co-Ordination Centre (MRCC), a 24-hour co-ordinating service for all of the country’s coastal rescue units. HCG operates cliff and water rescue teams; it uses a pager system to contact members and has a 10-minute response time. HCG also works with individuals and groups that use coastal amenities. “We are working with anglers following a recent accident and on Dollymount Beach, which is popular with kite surfers. We are working with the Irish Kite Surfer’s Association to, for example, put identity tags on their gear,” said Fergus Cooney. “Every now and again, one of them will lose a kite or a board and, if somebody sees it on the side of a cliff, they might assume that there has been an accident and call us out. The Irish Coast Guard asks that if members of the public see anyone who they think may be in trouble on the cliffs, beaches, at sea or on inland waterways, then please dial 112/999 and ask for the Coast Guard. Do not assume someone else has made the call.

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 DEPRESSIONFigures released by the Central Statistics Office (CSO) in October 2009, showed a worrying 40 per cent increase in incidents of suicide in the first three months of the year, compared to the same period in 2008. According to the CSO, more than 100 people took their own lives in the three-month period from January to March in 2009, including 85 men and 21 women. “Over the last few years, there has actually been a marginal decrease in the suicide rates, but it seems that figures for the first few months of 2009 show an increase on the same period in 2008, which is, of course, very regrettable,” said Sandra Hogan. According to Hogan, more than 80 per cent of suicides can be traced back to depression. “We know that many people struggle with depression alone and never get help with it. Even where people come forward for help, the mental health services can fall far short of what they should be delivering,” she said. “The impact of the recession is probably having an impact as well. Financial difficulties and concerns for the future can lead to increased stress and anxiety levels.”


SUICIDE PREVENTION

AWARENESS ABOUT DEPRESSIONAware 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. “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 [email protected] while free information is also available online at www.aware.ie, phone 01-6617211 or e-mail: [email protected].

Depression affects more than 400,000 people in Ireland at any one time.


AT-RISK GROUPSThe 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

PRIMARY LESSSONS TO BE LEARNED IN WATER SAFETYIN 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

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 TECHNIQUESThe 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,

Primary school children get to see ‘Dopey Denzel’ this year.

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.

howth coast guard - training in suicide prevention skills, emergency services ireland magazine

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