NSRF News Round-Up; March – May

Author: Fenella Ryan

We have been reflecting on some recent highlights for our latest news round-up!

Journal articles

NSRF researchers have been involved in five peer-reviewed journal articles published since March:

Reports

Our report on the Mental Health of Veterinary Professionals in collaboration with The Veterinary Council of Ireland and The National Office for Suicide Prevention was published in April.

Presentations

Prof Arensman presented a Keynote Lecture at the 10th International Association for Suicide Prevention Asia Pacific Conference in Queensland May 3rd – 5th.

Irish Examiner article

An article published in the Irish Examiner on May 5th Concerns about suicide rates among Travellers due to self-harm presentations at A&E was based on research by NSRF team member Dr Katerina Kavalidou.

EAAD-BEST

On March 24th and 25th, the EAAD-BEST Consortium held their second plenary meeting in Barcelona. A key outcome from this meeting was the preparation of a Ukrainian version of the iFightDepression programme, rolled out in April 2022.

On May 6th, the NSRF launched the Cork-Kerry Alliance Against Depression in collaboration with EAAD-BEST.

A virtual Kick-Off Seminar entitled Preventing suicide and self-harm via improving awareness and care for people with depression was held with speakers including:

  • Mental health and healthcare professionals
  • People with lived experience
  • Resource officers for suicide prevention
  • Researchers

C-SSHRI

On March 29th, the C-SSHRI Network (Connecting Suicide and Self-Harm Researchers on the Island of Ireland) held their second meeting. The get-together focused on self-care and included presentations from Professor Ella Arensman (NSRF & UCC) and Susan O’Mahony (UCC).

Congratulations!

Congratulations to two NSRF team members, Mr Pawel Hursztyn and Ms Almas Khan, who recently graduated from the Master’s in Public Health programme in University College Cork.

Pawel’s dissertation was co-supervised by Dr Eve Griffin and Dr Paul Corcoran and focused on ‘Trends of Hospital Presenting Self-Harm in Cork City area and individual level factors’.

Almas’ dissertation examined ‘Sexual health and Physical Disability: A scoping review exploring the services and supports available to the persons with disability in the EEA and United Kingdom’ and was supervised by Dr Martin Davoren.

Looking ahead

The Summer months ahead are already looking busy! Keep an eye on our Twitter, our Publications and Outputs and our Upcoming Events page for news and updates.

Dispose of Unused Medicines Properly (DUMP) Campaign – March 14th to April 22nd

Author: Dr Caroline Daly

The safe disposal of unused or unwanted medications is a means by which pharmacists can restrict access to means of suicidal behaviour. Unused or out-of-date medicines can build up in the home for a variety of reasons. Storing these medications long-term is not safe and can result a variety of adverse outcomes including accidental poisonings, intentional overdose, inappropriate sharing of medicines and environmental damage.

In Ireland the Disposal of Unused Medication Properly (DUMP) campaign has run successfully in regions including Cork and Kerry since 2007.  In 2007 this campaign resulted in the return of 12 tonnes of pharmaceuticals, and the medicines most commonly returned were those most frequently used as means of suicidal behaviour.  

Louise Creed, HSE Pharmacists highlights the importance of the DUMP campaign “We would strongly urge people to take this opportunity to get rid of out of date or unused medicines. Medication can pose a real hazard in the home, particularly to children or other vulnerable people. Clearing out your medicine cabinet is something that should be done on a regular basis. Check all the dates and remove anything that is out of date or no longer required. Medicines have an expiry date for the same reason food does and out of date medicines could do more harm than good.”

From Monday March 14th until Friday April 22nd almost all pharmacies in Cork and Kerry will be taking part in the DUMP campaign. You can return your unused or out-of-date medicines to any Cork and Kerry pharmacy free of charge within these dates.

  • You can find more important information regarding safe storage of medications here
  • For more information on previous DUMP campaigns please visit here

Our work with the World Health Organisation

Author: Niall McTernan

Following our designation as a World Health Organization (WHO) Collaborating Centre for Surveillance and Research in Suicide Prevention in December 2015 and redesignation for a further four years in 2019, the NSRF has been involved in several exciting projects at the request of the WHO.

What is a WHO Collaborating Centre?

The remit of WHO Collaborating centres is to conduct research and evaluation and provide technical guidance to the WHO. The aim is to enhance countries’ capacity to develop and implement national policies and plans in line with the 2013–2020 global mental health action plan and the UN Sustainable Development Goals for 2030. Mental health promotion, prevention, treatment, and recovery services improved through advocacy, better guidance and tools on integrated mental health service are stated WHO outputs.

How does the NSRF assist the WHO?

The NSRF’s agreed work plan comprises four main activities:

  1. Support WHO in having surveillance systems for self-harm and suicide established in countries
  2. Provide technical advice to WHO in support of its work towards the implementation and evaluation of national suicide prevention strategies
  3. Support WHO in providing technical assistance to countries for the development, revision, implementation and evaluation of national suicide prevention strategies
  4. To inform WHO’s activities on suicide prevention and mental health promotion in occupational settings.

Our primary work has been in assisting the development and implementation of multi-centre self-harm surveillance systems in a range of countries across Europe, Central Asia and South America including Poland, Kazakhstan, Ecuador, Guyana, Suriname, Trinidad Tobago and Russia*.

Moreover, in 2019 the NSRF led the development of an E-Learning Programme for countries to use in setting up a public health surveillance system for suicide attempts and self-harm cases presenting to general hospitals.

NSRF researchers, in addition, have supported WHO in providing technical assistance to Palestine, Namibia, Iran and the Republic of Korea in the development and implementation of their national suicide prevention strategies.

NSRF – Centre of Excellence in Suicide Research and Prevention

We are thrilled to be recognised as a centre of excellence in suicide research and prevention and privileged to support the WHO in increasing awareness of the public health significance of suicidal behaviours. It is paramount that the prevention of suicidal behaviours are high priority considerations on the global health agenda and countries are encouraged and supported to develop comprehensive suicide prevention strategies, with the aim of reducing the incidence of self-harm and suicide globally.

Work completed so far

*Work programme concluded in 2021.

NSRF News Round-Up; January – March 2022

Author: Fenella Ryan

On this first, bright and sunny * day of March, we decided to reflect on some achievements since the beginning of the year.

*in Cork at least!

Journal articles

NSRF researchers have been involved in three peer-reviewed journal articles published since January:

Presentations

Prof Ella Arensman presented on ‘Mental Health and the COVID-19 Pandemic’ at the first UCC School of Public Health Seminar of 2022: Presentations – National Suicide Research Foundation (nsrf.ie)

Niall McTernan presented at a HSE Community Healthcare West Workshop on ‘Safe & Sensitive Reporting of Suicide & Promoting Positive Mental Health & Wellbeing on February 1st.

National Suicide Bereavement Survey

This survey, which launched on October 5th 2021, closed for responses in early February 2022. The team are now analysing data and will have initial findings in the next few months.

SAMAGH

A very successful SAMAGH training day took place in Cork on February 27th. The next training will take place in Dublin in April. Our SAMAGH Training Leaflet may be useful to those working in the area of mental health who are interested in improving supports for individuals who self-harm: Leaflet_SAMAGH-Training_-26-01-2022.pdf (nsrf.ie).  

Policy Submission

The NSRF submitted a briefing to the Department of Justice, Review of Alcohol Licensing consultation on January 21st.

Next up

Our researchers continue to work on a wide number of research projects. Keep an eye on our Twitter and our Publications and Outputs for news and updates.

Are tougher regulations on paracetamol availability justified?

Author: Dr Caroline Daly

Content warning: This article contains sensitive material and mention of self-harm methods, which some readers may find distressing. If you need support, please visit Finding Help.

For many of us paracetamol is never far away. It’s in our bags, kitchens, and bathroom cabinets. If and when we want more, we can restock from our nearest corner shop or supermarket. To me, the availability and accessibility of paracetamol warrants questioning and address, and I will explain why.

I’m a Postdoctoral Researcher at the NSRF with a particular interest in preventing intentional drug overdose (IDO). Through the National Self-Harm Registry Ireland we know that paracetamol is the drug most frequently taken in intentional overdose, accounting for approximately 2,300 presentations each year.1 Most people who take paracetamol in overdose are female and under 25 years old.2 Many of these IDOs are clinically serious, and as a result the risk of liver transplant following paracetamol overdose in Ireland is 6-times the European average.3 These physical consequences occur in tandem with social and psychosocial impacts of IDO on individuals and their wider circles. Worryingly paracetamol IDOs by young people are increasing each year.2

Restricting access to means of self-harm and suicide is the single most effective prevention measure, working best when implemented concurrently with multilevel interventions. Statutory legislation in Ireland since 2001 restricts the sale of over-the-counter paracetamol to a maximum pack of 24 tablets in pharmacies and 12 tablets in non-pharmacy outlets, with authorisation for one pack to be sold per transaction. These restrictions have led to a decrease in deaths involving paracetamol and a reduction in the toxicity of IDOs.4-6 However pack size restrictions have not reduced the frequency of paracetamol IDOs, and Ireland still has one of the highest incidences of such in Europe.7 In addition adherence to existing legislation in Ireland is reportedly poor.8,9

So where can we go from here? In recent years two measures have shown promise in reducing or preventing paracetamol IDO. Paracetamol overdose is significantly lower in countries where the sale of paracetamol is restricted to pharmacies only.7 There are costs to implementing such a measure in Ireland, predominantly to those who use paracetamol safely; however, the benefits in terms of potential reductions in self-harm and overuse of paracetamol are likely to be much greater. In Denmark, confining the sale of paracetamol to those aged 18 and over has also led to significant reductions in their overdose.10 It seems inconceivable that paracetamol can be sold to a child without question, considering its potential harms; especially when we have a justifiable stance against the sale of alcohol to this same subgroup.

With each paracetamol IDO recorded, and every individual affected by these acts, I am assured that further regulations are not only justified but essential to addressing IDO and self-harm here in Ireland. In an effort to address these concerns and supported by robust evidence, colleagues and I have set up an interdisciplinary Working Group to review and implement effective interventions to reduce access to paracetamol in Ireland, in collaboration with government, the pharmacy and retail sectors. I hope that in time and with evidenced measures in place, I might report back with positive news about reductions in paracetamol IDOs in Ireland.

If you have been affected by the content of this article, please visit Finding Help.

  1. Joyce M, Daly C, McTernan N, Griffin E, Nicholson S, Arensman E, Williamson E, Corcoran P. (2020) National Self-Harm Registry Ireland Annual Report 2019. Cork: National Suicide Research Foundation.
  2. Daly C, Griffin E, McMahon E, Corcoran P, Webb RT, Ashcroft DM, Arensman E. (2020) Paracetamol-related intentional drug overdose among young people: a national registry study of characteristics, incidence and trends, 2007-2018. Soc Psychiatry Psychiatr Epidemiol. 56(5):773-81.
  3. Tittarelli R, Pellegrini M, Scarpellini MG, Marinelli E, Bruti V, di Luca NM, Busardò FB,  Zaami S. (2017) Hepatotoxicity of paracetamol and related fatalities. Eur Rev Med Pharmacol Sci. 21(1 Suppl):95-101.
  4. Morgan OW, Griffiths C, Majeed A. (2007) Interrupted time-series analysis of regulations to reduce paracetamol (acetaminophen) poisoning. PLoS Med. 4(4):e105.
  5. Hawton K, Bergen H, Simkin S, Dodd S, Pocock P, Bernal W, et al. (2013) Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. BMJ 346:f403.
  6. Hawton K, Simkin S, Deeks J, Cooper J, Johnston A, Waters K, et al. (2004) UK legislation on analgesic packs: before and after study of long-term effect on poisonings. BMJ 329(7474):1076.
  7. Morthorst B, Erlangsen A, Nordentoft M, Hawton K, Groth Hoeberg LC, Dalhoff K. (2018) Availability of Paracetamol Sold Over the Counter in Europe: A Descriptive Cross-Sectional International Survey of Pack Size Restriction. Basic Clin Pharmacol Toxicol 122, 643-649.
  8. Molloy P, Chambers R, Cork T. (2016) How well are national guidelines relating to the general sales of aspirin and paracetamol, adhered to by retail stores: a mystery shopper study. BMJ Open 6(1):e010081.
  9. Ni Mhaolain AM, Davoren M, Kelly BD, Breen E, Casey P. (2009) Paracetamol availability in pharmacy and non-pharmacy outlets in Dublin. Ireland. Ir J Med Sci. 178(1):79–82.
  10. Erlangsen A. (2019) Rater for Selvmord og Selvmordsforsøg. Available at: http://drisp.dk/wp- content/uploads/2019/01/Rater-for-Selvmord-og-Selvmordsfors%c3%b8g_Jan_2019-1.pdf

Looking ahead in 2022

Authors: Fenella Ryan and Niall McTernan

2021 Reflections

The year of 2021 was tough in many ways, particularly for our researchers as individuals. Like many others, our organisation faced numerous challenges throughout the year, but even in the face of these challenges, we are very proud to have achieved so many goals and to have strengthened our commitment to providing high-quality research related to suicide and self-harm in Ireland.

2021 Highlights

In 2021, our staff members co-authored 22 papers published in peer-review journals, including several high-impact journals and papers relating to the mental health impacts of the COVID-19 pandemic. The team presented more than 45 lectures at local, national and international Seminars and Conferences (virtually) and we were represented on more than 40 advisory and steering groups at national and international level. We hosted several (virtual) Workshops, Seminars and training events, as well as launching our new website. We formed new and close working collaborations, and we optimistically look forward to meeting each other over an actual coffee and scone this year!

A busy year ahead!

2022 is set to be a very busy year for us. As well as the continuation of many projects, including the National Self-Harm Registry, the National Suicide Bereavement Survey and MENTUPP, and the expansion of others such as C-SSHRI and our WHO Collaborating Centre work, we look forward to the launch of exciting new projects such as HRB CDA MHAINTAIN and the establishment of our Lived Experience Panel. We will be adding an overview of these new projects very soon, so please check back in!

Get in touch

Whilst we continue to work from home for now, please know our team can be contacted by emailing infonsrf@ucc.ie. Wishing you a very Happy New Year from all at the NSRF!

First C-SSHRI Member Get-Together

Author: Fenella Ryan

Connecting Suicide and Self-Harm Researchers

Today, the NSRF will host the first (virtual) get-together of C-SSHRI members.

C-SSHRI stands for Connecting Suicide and Self-Harm Researchers on the island of Ireland and the initiative came about through a shared desire by the NSRF, the Higher Education Authority and the HSE National Office for Suicide Prevention, to fulfill Action 7.4.2 in Connecting for Life, Ireland’s national strategy to reduce suicide.

C-SSHRI is a new Network, which aims to bring together those working in the area of suicide and self-harm research, to facilitate closer collaboration and a sharing of findings.

Networking

We may have lost many of our usual networking opportunities recently, but we hope today to get to know others working in the suicide and self-harm research sphere and, through 3-minute ‘rapid’ presentations, hear an introduction to each other’s work. The next best thing to hanging around a conference pastry table!

Want to learn more or get in touch?

Anyone in Ireland, North or South, who is working in the area of suicide or self-harm research, is welcome to become a member of C-SSHRI and to join the meetings. If you would like to read more, please visit C-SSHRI – National Suicide Research Foundation (nsrf.ie) or email csshri@ucc.ie.

National Suicide Bereavement Survey

Authors: Dr Eve Griffin and Dr Selena O’Connell

*Please note this survey is now closed for responses. Thank you to all who participated.

On October 5th, 2021, the first national survey of people bereaved by suicide was launched. The aim of this survey is to examine the experiences of people who have been bereaved by suicide in Ireland. We want to learn about the supports and services that people used following bereavement and if there are gaps or barriers to accessing these supports.

When a person dies by suicide, it affects a number of people around them. While we use the term bereavement, we are seeking to hear from a range of people who have experienced loss to suicide. This includes people close to the person such as friends and family, as well as other people who were affected by the death such as emergency service staff, professionals caring for the person, a passer-by who witnessed the death, neighbours or other members of the community.

The findings of this survey will be used to inform the services for people bereaved by suicide in Ireland. We hope that information on the supports that people find helpful, gaps in services or barriers to accessing to services will be used to adapt future services so that people in Ireland can access the support they need. The outcomes of this research will directly inform actions of Connecting for Life, Ireland’s National Strategy to Reduce Suicide.

Researchers at the NSRF are collaborating with HUGG (Healing Untold Grief Groups) to conduct this survey, funded by the HSE’s National Office for Suicide Prevention (NOSP).

The EAAD-Best project

Author: Dr Grace Gully, Post-Doctoral Researcher, PRISM/EAAD-BEST

“We know enough about how to improve the care of depression and how to prevent suicidal behaviour; we simply have to do it!” [1]

I began working with an inspiring international team of collaborators on the EAAD-Best project in April of 2021. At that point, the European Alliance Against Depression (EAAD) had spent over 15 years developing their four-level community-based intervention that aims to improve the care for people with depression and prevent suicidal behaviour.

The implementation of the EAAD intervention involves bringing together relevant members of health and community organisations to form regional alliances against depression. Together, the members of each regional alliance roll out the intervention activities within their community. To date, the four-level intervention has been implemented in more than 120 regions in 15 countries within and beyond Europe.

Importantly, a substantial body of evidence indicates that the EAAD community-based intervention is an effective and worthwhile approach to suicide prevention.[1],[2] Therefore, the core objective of the EAAD-Best project is to implement the intervention in as many communities across Europe as possible. In Ireland, we are starting with the development of a Cork Kerry Regional Alliance Against Depression and are excited to explore the development of alliances in additional regions over the course of the project. 

An additional objective of the EAAD-Best project is to promote the international uptake of the iFightDepression® (iFD) tool, an online self-management programme for individuals experiencing mild-to-moderate depression, which has been shown to have significant antidepressant effects.[3] As part of EAAD-Best, the iFD tool will be implemented as a core component of the EAAD community intervention and offered for use nationally in primary care, secondary mental health services, and third level student health services.

If you would like to know more about the EAAD-Best project, find out how you can start your own alliance or ask about contributing to an established alliance, contact infonsrf@ucc.ie.

You can also access more information at the following sources:

The EAAD-Best team in Ireland involves Dr Grace Cully, Prof Ella Arensman, Ms Eileen Williamson, Ms Eileen Hegarty, Mr Niall McTernan.

The EAAD-Best project is funded within the Annual Work Programme 2020 of the 3rd EU Health Programme (HP-PJ-2020) (Grant No: 101018325).

[1] Hegerl et al. 2019: PLoS One. 14(11):e0224602.

[2] Hegerl et al. 2013: Neurosci Biobehav Rev 37:2404-9

[3] Oehler et al. 2020: JMIR 22.7: e15361

Welcome to our new website

Welcome to the brand new National Suicide Research Foundation website and our exciting new blog!

Re-design

The NSRF team wanted to create a modern web space where we can easily share our suicide and self-harm research projects, findings and learnings with interested researchers, policy makers, students and members of the public.

After months of re-organising content, editing and designing, we are delighted to share our new-look website with you.

New features

We have added some new features, including this blog. We will use this blog to share updates and information about our research and projects, as well as general NSRF news. So be sure to keep an eye out on our homepage and our Twitter page [@NSRFIreland] for all our latest posts.

Explore

We invite you to explore our new site and to please email infonsrf@ucc.ie with any questions or queries.