Projects Families Voices Forum Families' Voices blog Families Voices Forum tells Suicide Prevention Committee 'Action is needed NOW' Claire Curran, Chair of Families Voices Forum and Community Support Worker at East Belfast SOS, delivered the following text during a Families Voices Forum presentation at the NI Assembly All-Party Group on Suicide Prevention on Tuesday. The message we will start and end with today will be the same. An increase in suicide rates as a result of the COVID 19 pandemic is not inevitable. Prior to the lockdown, we had learned a great deal of information about how communities and families need to be supported when experiencing suicidal thoughts or actions. That knowledge remains as relevant post pandemic. During lockdown many family members have been participating in ongoing psychosocial research about the effects of the pandemic on their health and valuable information is being gathered about the mental health effects of lockdown, which can be used to plan ahead. The Assembly’s commitment to work together in a cross departmental approach to funding and acting to prevent suicide has never been as important as it is now. The Forum was delighted to hear of the planned appointment of a Mental Health Champion for our region and we now press strongly the hope that dedicated cross departmental support in terms of both policy and finance is now embedded into The Executive moving forward. Current situation Communities across the region do not appear to have experienced a greater than normal level of suicide during lockdown. Families are reporting a mixed response to the measures put in place, with a noticeable divide having developed. Socio-economic chasm This divide heightens the socio-economic chasm within our communities, as those who have been able to continue working or have been furloughed, appear to be having a more positive and supportive response to lockdown and easement measures. Those with financial insecurities, waiting on the promised support or already dependant upon the welfare state, appear to be struggling more, with high levels of uncertainty adding to their mental health struggles. However, as time in lockdown increases, anxiety levels are building across all communities. A major concern is the reluctance to ‘bother’ GPs and fear of attending hospitals for care due to virus worries. Alcohol Alcohol use in the home is increasing and is known to be a significant risk factor in suicide. Some families have noticed the increase in online gambling advertising which encourages destructive addictive behaviours. Domestic violence The Executive will already be aware of the increase in risks for vulnerable children and for victims of domestic violence. And those with severe and enduring mental health problems are finding increasing difficulty in stabilising their mental health as time goes on. Provision of remote support Older age groups Of major concern and much of the focus of response to date, has been the support of those shielding and those vulnerable older people who have been encouraged to isolate at home. The response of community groups and volunteers across the country has been the driving force of the re-emergence and strengthening of community spirit. Although providing remote support, befriending, activity packs, food parcels and prescriptions, one thing cannot be fulfilled currently that is critical to human life and existence. The basic need for human contact - a hug from a loved one, a kiss from your grandchildren, a connection and experience that can never be replicated or replaced by other people no matter how supportive they may be. And in older age lies fear that this may never be experienced again and if not, questions about the value of continued life begin. This need has also been at the heart of distress surrounding bereavement and the inability of families to be present at the point of death or share love and grief at wakes and funerals, such an inherent part of our culture. Some families have been able to use technology to ease the pain of physical distancing, but it is never enough to replace being there, present, in person. Some bereaved families have chosen to continue getting support remotely via telephone or online support groups, whilst others have decided to wait until they are able to meet their group or counsellor again before resuming support. We are not a culture that is completely at the technological advancement of others around us. There are many people who are still unable to get a mobile phone signal without walking down the street. There are many more who are not internet literate or indeed, who cannot afford to have internet installed. And for those who do, there is the problem of unreliable connections and speeds that impede any potential to develop online skills. Younger age groups For our children who are so connected to the online world, different challenges have been posed and discussed with the Executive, but the risks remain similar for their future wellbeing. Isolation from their peers, lack of hope for their education and employment future and the potential of another recession looming. Parents have been increasingly reporting concern about their state of emotional health as time goes by and their fears that they have exhausted anything they might have that could support their children. Post lockdown 'Tsunami' A shared fear across our communities is about not how things are now but how they might be after the lockdown ends. The media have a big role to play in this and only last week a local GP was reported as being: Concerned about the ‘Tidal Wave’ and ‘Tsunami’ of mental health crisis after the lockdown is over Media portrayal of predicted problems to come have not been helpful in alleviating fear and anxiety in our community about the effects of post traumatic stress symptoms on our family members, keyworkers and healthcare staff across the country. There is fear for the future and calls for clarity on what to expect going forward. Most people are largely supportive of the Executive Plan released last week. There are mixed feelings regarding the lack of definitive timescales, and this is most prevalent in those who are self employed or uncertain of continued employment and in parents of those with school age children. We know the negative effects of uncertainty can be challenged by strengthening our resilience skills but in a time when you need to focus upon putting food on your family’s table and keeping a roof over your children’s’ heads, it is very difficult to even consider accessing a wellbeing app on your phone. Reducing the impact of COVID on long term suicide rates So what can be done to support those struggling with their mental health now, reducing the impact of COVID upon our suicide rates longer term? It is timely that public announcements are now being made of the gradual reopening of shops, businesses and that families will be allowed increasing measures of contact. This gives hope. Families would like to see our Executive hold regular announcements, perhaps on a set day of the week giving a public update of what is happening. This is one way of addressing the uncertainty felt whilst acknowledging the wisdom of removal of definitive dates that may be set back again and again if timescales were set. Community strength supported The sense of community strength that has developed in villages, towns and cities needs to be supported longer term and Forum members would like to see an integration by contractual partnership of the community and voluntary sector and statutory organisations to continue to ensure support is given at the point of need. Improve technological infrastructure The country’s technological infrastructure requires vast improvement if we are looking at increasing remote working, remote support and remote communications. In the interim, packs of information should be sent to every household in the country, a task that has been taken up currently by those delivering food parcels or providing other support. There have also been challenges in families who have had to share equipment or have no laptops or tablets to use for homework, therapies and support. Those not connected online should be at no disadvantage in accessing information, help or support and that begins with knowing where to get it. Mitigate post-lockdown PTSD More consideration needs to be given to identifying and developing services that are skilled in evidence-based interventions that address trauma, both for our existing experiences and responses to past trauma and to mitigate the risks of post-lockdown PTSD symptoms. Address physically distant bereavement Support of those bereaved requires longer term interventions to address the issues raised by a physically distant death in the family. This will be a new, short term need, in addition to existing supports. Support those struggling financially Increasing risks of unemployment and financial hardship needs planning for. How do we support the mental health of those who are struggling financially, how do we ensure there is a system in place that allows easy access, reporting, form filling and receipt of money? Address addictions Specific interventions that address an increase in addictions of all kinds need to be publicised and supported. Deliver hopeful public messaging Strong and hopeful public messages need to be given through a variety of media sources to bolster the sense of community hope. Language is key and should be monitored and challenged when unhelpful, perhaps by the new Mental Health Champion. Regular planned updates should be shared with the public by the Executive using their transparent decision-making approach to lockdown easing. Future planning required This doesn’t have to be a catastrophe that ends in increased suicide rates. We know what needs to be done to support our communities and we should start planning and developing it NOW before it is needed. If we wait it will be too late to prevent it. An increase in suicide is not an inevitable result of the COVID 19 pandemic. It requires planning and implementation of new systems, supported by a cross-departmental government approach, implemented by a cross-sectorial community support approach. We urge the Executive to be as brave as each and every member of the community they stand for that has fought this virus with all their strength. They deserve it.