Alcohol, Suicide and Mental Health (Ireland) (Alcohol Action 2012)

1. Alcohol, Suicide and Mental Health (Ireland)
Alcohol can contribute to the development of mental health problems
as well as exacerbating pre-existing mental health difficulties.
Alcohol affects our ability to cope, manage and overcome everyday stresses and
significant life events. It contributes to the development of mental health
problems as well as exacerbating pre-existing mental health difficulties. It can
also reduce inhibitions enough for an individual to act on suicidal thoughts
which they might never have done if not under the influence of alcohol. Suicide
is the leading cause of death among young Irish men aged 15-24. In 2011, 525
suicides were registered, an increase of 7% – 439 of those who died were
men[i].
There exists a consistent trend for drunkenness when drinking among Irish
young people, a trend that sets them apart from the majority of their European
counterparts [ii]. Children and young people are particularly vulnerable to
alcohol-related harms and risks due to the fact that their brains and bodies are
still growing and developing:
Biologically teenagers’ brains are still developing – alcohol particularly
affects the areas of the brain responsible for memory and impulse control.
Adolescence can be a challenging time as young people navigate new
experiences and stresses for the first time: alcohol is being added to
situations where there is no pre-existing “road map” and may render the
individual particularly vulnerable to exploitation or danger.
Behaviour patterns that can last a life time are being established during this
formative period. Adult heavy drinkers generally established their drinking
patterns in their teens
Many people drink alcohol to help them cope with emotions or situations they
would otherwise find difficult to manage. In other words, they drink to change
mood or mental state. Alcohol is also used to self-medicate, to relieve the
symptoms of anxiety and depression. In the UK, a country with similar drinking
patterns to Ireland, a study found that stressed mood leads to increased alcohol
consumption. Relaxation was also a key reason cited for people drinking [iii].
Tolerance of alcohol increases with use, so that an individual needs increasing
amounts of alcohol to decrease their anxiety or to medicate their depression.
Secondly, when self-medicating with alcohol it is difficult to know how much is
enough. Following the initial feeling of well-being from the first drink, alcohol
acts as a depressant, and feelings of anxiety and depression can quickly
resurface. Alcohol use can exaggerate underlying feelings, which is why some
people become angry, tearful, or aggressive after a few drinks.

2. Despite the contributory role alcohol plays in worsening or developing mental
health problems, little research has been done in Ireland to explore the reasons
why we drink and how this might link with rates of mental health problems such
as anxiety, depression and self-harm.
The role of alcohol marketing is one that needs to be tackled. Alcohol marketing
promotes positive, risk-free images of alcohol and its use 24/7 through
sponsorship, pricing, product placement, branded merchandise and many other
forms of promotion. Deeply discounted alcohol is widely available from
numerous and varied outlets.
Marketing can shape youth culture by creating and sustaining expectations and
norms about how to achieve social, sporting or sexual success, how to
celebrate, how to relax and how to belong. Extensive scientific research has
established that alcohol marketing influences young people to start drinking and
if already drinking, to drink more [iv].
Although many factors are involved in suicide, the link between alcohol use and
suicide has been well established, alcohol consumption considered to be a
significant influence on the suicide rate of young men in particular [v]. Suicide
is the leading cause of death among young Irish men aged 15-24 years with
more than one in three deaths in that age group as a result of suicide.
A national study of youth mental health found strong links between excessive
drinking and suicidal behaviour. The same study provided clear evidence that
excessive drinking is associated with poor mental health and low self-esteem
[vi].
The connection between alcohol use and suicide has been highlighted in
numerous reports, both Irish and international. One Irish study of people from
three counties who died as a result of suicide, found that more than half had
alcohol in their blood; those aged less than 30 were more likely to have had
alcohol in their blood at the time of death [vii].
The World Health Organisation has estimated that the risk of suicide when a
person is currently abusing alcohol is eight times greater than if they were not
abusing alcohol [viii]. Closer to home, a report from the UK Mental Health
Foundation states that as many as 65% of suicides were related to excessive
drinking, and identifies alcohol problems as one of the highest risk factors for
suicide [ix]. That report identifies a strong link between alcohol use and thoughts
of suicide, suicide attempts and completed suicides among young people under
the age of 24. Alcohol use can act as a factor in suicide in a number of ways [x]:

3. A HSE report xi
states that “alcohol can facilitate suicide by increasing
impulsivity, changing mood and deepening depression”
Self-harm or suicide can take place after just one drinking session. A person
doesn’t have to be a heavy drinker or even a regular drinker: just one
occasion of heavy drinking can reduce inhibitions enough to self-harm or
act on suicidal thoughts
Alcohol initially produces feelings of happiness and well-being but can lead
to a significant lowering in mood hours after use or in the following days, an
experience which is sometimes accompanied by feelings of hopelessness. If
someone is already experiencing a degree of depression, the fall in mood
can lead to suicidal ideas. xii
Ongoing abuse of alcohol is itself a major contributory factor in depression
and suicidal behaviour. xiii
What needs to happen?
In order to reduce the negative impact of alcohol on mental health and suicide,
levels of alcohol consumption need to be reduced. The Steering Group Report
on a National Substance Misuse Strategy makes a number of recommendations
which would reduce the harms caused by alcohol. Alcohol Action Ireland calls
for the recommendations of the Steering Group to be implemented in full. Key
recommendations include the following:
1. Increase the price of alcohol over the medium term to ensure that alcohol
becomes less affordable through excise duties and minimum pricing.
2. Introduce a statutory framework with respect to the volume, content, and
placement of all alcohol advertising in all media in Ireland.
3. Progress the recommendations in A Vision for Change: Report of the Expert
Group on Mental Health Policy.
In addition, Alcohol Action Ireland recommends the following action so as to
provide consumers with information on the effects of alcohol on mental health:
4. Develop and launch a national social marketing campaign informing
consumers of the negative impact of alcohol on mental health so as to
facilitate consumers to make informed choices about how and if they drink.
Theresa Lowry-Lehnen
RGN, BSc (Hon’s) Nursing Science, PGCC, Dip Counselling, Dip Psychotherapy,
BSc (Hon’s) Clinical Science, PGCE (QTS), H. Dip. Ed, MEd,
PhD Student Health Psychology

4. References
[i] www.cso.ie Vital Statistics: Fourth Quarter and Yearly Summary 2011
[ii]Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi A and
Kraus L (2012) The 2011 ESPAD report: substance use among students in 36 European
countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs
(CAN) and the Pompidou Group of the Council of Europe
[iii] Cheers? Understanding the Relationship between Alcohol and Mental Health (2006)
Mental Health Foundation: UK
[iv] Scientific Opinion of the Science Group of the European Alcohol and Health Forum
(2009) Does marketing communication impact on the volume and patterns of
consumption of alcoholic beverages, especially by young people? – a review of the
longitudinal studies Anderson, P. et al (2009) Impact of Alcohol Advertising and Media
Exposure on Adolescent Alcohol Use: A Systematic Review of Longitudinal
Studies. Alcohol and Alcoholism, pp.1-15, 2009
[v] Walsh, Brendan M and Walsh, Dermot (2011) Suicide in Ireland: the Influence of
Alcohol and Unemployment. Economic and Social Review, 42 (1). pp. 27-47
[vi] Dooley, B. & Fitzgerald, A. (2012) My World Survey: National Study of Youth
Mental Health in Ireland. Headstrong
[vii] Bedford D, O’Farrell A, Howell F. (2004) Blood alcohol levels in persons who died
as a result of accidents and suicide in Cavan, Monaghan and Louth in 2001 and 2002.
North Eastern Health Board
[viii]WHO Global Status Report on Alcohol (2004) Geneva: WHO]
[ix] see [iii]
[x] Journal of the American Medical Association, October 26, 2005 – Vol.294, no.16
[xi] Hope, A. (2008) Alcohol Related Harm in Ireland. HSE – Alcohol Implementation
Group
[xii] Farren C.K (2005) Presentation on Suicide and Alcohol to Joint Oireachtas
Committee on Health by Dr. C.K. Farren, Consultant Psychiatrist and Director of Dual
Mood and Addiction Program at St Patrick’s Hospital, Dublin
[xiii] Department of Health and Children (2005) Reach Out: National Strategy for
Action on Suicide Prevention 2005-2014. Dublin: HSE
© Copyright 2012 Alcohol Action Ireland
Butler Court, 25 Gt Strand Street, Rear, Dublin 1, T: 00353 1 878 0610, F: 00353 1 874 9934 - Charity Number, CHY 15342
Theresa Lowry-Lehnen
RGN, BSc (Hon’s) Nursing Science, PGCC, Dip Counselling, Dip Psychotherapy,
BSc (Hon’s) Clinical Science, PGCE (QTS), H. Dip. Ed, MEd,
PhD Student Health Psychology