Suicide rates in Northern Ireland have doubled since the signing of the Good Friday Agreement, shock new research has found.
A study by Queen's University has found that with the peace process, the number of suicides here has conversely risen from 8.6 per 100,000 of the population in 1998 to 16 for every 100,000 people in 2010.
The author of the report, Professor Mike Tomlinson, said as paramilitary violence has become less acceptable, cases of self-harm, suicide, substance abuse and mental ill-health have become more common as people struggle to cope with the legacy of the Troubles.
"We seem to have adjusted to peace by means of mass medication with anti-depressants, alcohol and non-prescription drugs," he said.
"The transition to peace means that cultures of externalised aggression are no longer socially approved or politically acceptable. Violence and aggression have become more internalised instead."
The two-year study of suicide rates in Northern Ireland over the last 40 years also uncovered a startling figure -- the highest suicide rate is in men between 35 and 44 years old -- dispelling the notion that young men in their teens and early 20s are most at risk of dying by suicide.
Prof Tomlinson (below) said his research has highlighted the need for Government to revise its suicide strategy to target people who grew up during the worst years of violence between 1969 and 1978.
"It may well be missing the target by over-emphasising interventions with younger age groups and failing to focus on those who experienced the worst of the violence," he said.
"We have created a bit of a myth about suicide. Evidence does show the number of younger people dying by suicide is increasing, but so too are women and older groups.
"I think we have underestimated the challenge of tackling suicide.
"We have to look hard at our suicide prevention strategy. We set ourselves a target in 2006 to achieve a 10% reduction in suicides over the next couple of years and then a further 5% reduction by 2011.
"We have missed that target massively. The number of suicides has continued to go up.
"Had we achieved the target there would be 366 people alive today who have died by suicide since 2006.
"Northern Ireland's suicide prevention strategy has so far made little impact on the upward trend."
Prof Tomlinson said more work must be done to tackle suicide in general and called for more funding for mental health services in Northern Ireland.
His comments come just a day after the Belfast Telegraph revealed a suicidal woman waited eight hours in A&E before being turned away because there were no hospital beds available.
"We are really very bad at emergency response," he continued.
"If you compare how we respond to a physical accident, such as a car accident, I believe we should apply the same resources to situations where someone is in a state where they may be thinking of or actually harming themselves. However, at the moment we just don't have the infrastructure to pick that up.
"Mental health services are very much the Cinderella of the health service. We need to do so much more in terms of mental health services."
A spokeswoman from the Department of Health, Social Services and Public Safety (DHSSPS) said a refreshed Protect Life strategy is due to run until 2014, but work to develop suicide prevention policy is ongoing. She said the research carried out by Prof Tomlinson will be considered as part of this work.
Levels of self-harming in Derry twice as high as rates in Dublin
Londonderry is the self-harming capital of the UK and Ireland, new research has concluded.
A study of the number of people going to hospital after self-harming has revealed the rate was almost twice as high in Derry as in Dublin.
It was also higher in Derry than in Manchester, Leeds, Oxford, Limerick, Cork, Galway and Waterford.
The research, carried out by Queen's University Belfast, found that the city had the highest number of people seeking hospital treatment after self-harming -- with 611 per 100,000 of the population in 2009 attending hospital compared to just 352 per 100,000 in Dublin during the same period.
It has also been revealed that children as young as eight years old and pensioners in their 80s living in the city have self-harmed in recent years.
The problem has been blamed on a range of factors including alcohol dependency, the recession and the legacy of decades that were blighted by paramilitary violence.
Noella McConnellogue, director of clinical services at Zest -- a Derry-based support group for people who self-harm -- said: "There is the misconception that it is only young people who self-harm, and that certainly isn't the case.
"The youngest person we have seen was eight and the oldest person was 80.
"It does not discriminate by age or sex, and with more people experiencing financial problems, losing their jobs and their homes, more people are self-harming as a way of coping."
Ms McConnellogue said a great deal of work has been done in the city to address the issue and cases of self-harm in Derry have reduced in recent years. "Last year there was a 15% reduction in self-harming," she said.
However, she stressed that more can be done to address the issue -- particularly in relation to alcohol abuse.
A Derry GP and member of the British Medical Association, Dr Tom Black, also said that the culture of drinking has contributed to the problem of self-harm in the city.
"That can only be tackled through schemes such as the introduction of minimum-pricing for drink," he said.
"We are also seeing more people coming in to us worried about losing their job and their home and that is also contributing to the problem," he added.