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Siobhan O'Neill: There is a need to understand the link between the Troubles and suicide rates... a whole generation was traumatised and saw some terrible things

By Donna Deeney

Siobhan O'Neill, a professor of mental health sciences at Ulster University and an authority on suicide, talks about prevention, lack of funding and why we could destigmatise subject by being more open.

Q. You are known as one of the leading authorities on suicide in Northern Ireland. Can you tell me what sparked your interest in the subject?

A. It actually goes back a long way. I studied psychology at Queen's and then went to university in Galway to do my masters in psychology.

I was a Samaritan volunteer and it was a real eye-opener for me.

I learnt a lot about suicide and trying to talk to people who were suicidal. It is strange that it has come back now that I study this. I was in my early 20s when I did that.

I still have a lot of time for the Samaritans as an organisation. I think they are brilliant. So I guess that was the start of it, working on the ground as a listener on the phone to people who are in crisis.

The Samaritans gave me knowledge of suicide that I never had before and got me interested in it.

In recent years I co-ordinated one of the biggest studies in mental health in Northern Ireland and a section of that study that asked about suicidal behaviour, and I was really interested in those questions and I started publishing from that work.

I was involved in another study in 2010 about death by suicide that involved the analysis of the characteristics of people who died. That was the first time a study with so much detail had been done here, and those led to me becoming more involved in the science of suicide.

The increase in suicide across Northern Ireland has led to a lot of concern about what is happening here so there has been a need for a science of suicide here and an understanding of the link between the Troubles and the suicide rate, and trying to work out what we can do about it.

It has become a bit of a niche for me but it wasn't deliberate. I didn't think I was going to go into this area. It all just happened.

Q. Suicide still has some stigma attached. Why is this?

A. There is a historical stigma. Suicide used to be considered a sin and a crime. For years people didn't want to acknowledge that that was how their loved one had died for those reasons, because it was very much frowned upon.

Now we know that a lot of people feel suicidal and it's not so unusual.

We talk more openly about mental health now so we should talk more openly about suicide, but there is still a stigma.

Families still get upset when people use words like "committed" because it harks back to that era when it was said to be a sin, and of course dying by your own hand is terrible for the family.

There are terrible feelings of guilt around even though it was the person's actions that led to the death; it still makes it difficult to talk about.

Q. What can be done to get rid of this stigma?

A. It is important that if there is a death and it is suicide that we say that is what it is and it is recorded as such, because otherwise we won't have accurate numbers.

The other thing is to talk about feelings. In our Northern Ireland study we found that around 8% of the population had felt suicidal at some stage in their lives, and that really is quite high.

The reality is most people who feel suicidal don't go on to act on those feelings, so we need an honest conversation about how this is a common thing but that most people get through it.

Q. We have talked a lot about suicide, but you are a professor of mental health with the Ulster University. What other areas have a special interest for you?

A. The whole area of Northern Ireland and how we are emerging from the Troubles where we have this legacy of a high level of mental illness generally, and the suicide rates of the next generation and then this risk of passing on those mental health problems to the next generation.

A study of the trans-generational trauma exposure that I did with the Victims' Commissioner put together all new evidence of what it is like to live in an environment where a whole generation has been subjected to trauma, and has seen and witnessed terrible events, and how their offspring can be affected.

Poverty, which is very much a legacy of the conflict in Northern Ireland, also impacts on mental health, so all of these things exist and now we have higher risks of young people self-harming and mental health problems. This is an area that I am very passionate about.

Q. What is the key to good mental health?

A. On a population level, you need to go right back to childhood and what happened during those first 1,000 days, which are absolutely critical.

That is when a child learns how to regulate its stress response, which sets the framework of the child's resilience through its life.

On a personal level, the key to good mental health is learning how to identify and regulate your own emotional responses is a really, really good thing for people to have.

Mindfulness and meditation is basically just becoming practised in self-regulation and controlling your own emotional responses, but it is such a good skill to have.

Stress is inevitable but it is all about how we respond and cope that matters, and that can be taught.

Things like keeping your body healthy and active is also very important to good mental health.

Q. Mental illness is often the poor relation when it comes to funding. Why ?

A. It certainly is the poor relation. When you look at the fact that one in four people will have a mental health issue and we have the highest suicide rate in the UK, this should be an absolute priority.

The Lord Crisp Report last year talked about parity of esteem between physical and mental health - we are nowhere near that, not even close. We need so much more investment. There is so much evidence out there, and in terms of research funding it is really bad.

For every £1 spent on mental health, 22 times that is spent on cancer and 14 times that on dementia.

Common mental health problems aren't researched in the way they should be and as a result of that we don't have the treatments nailed.

People are on antidepressants that for a lot of people don't work; counselling for a lot of people doesn't work. A lot of it is trial and error

I think it is the poor relation because we come back to this stigma and the idea that if you are mentally ill it is a sign of weakness.

It is still seen as something you should be ashamed of and we still don't have people talking about mental health, and so it isn't funded in the way it should be.

Q. Your research has taken you to America and other parts of the world. How does the approach to mental health here compare to other countries?

A. The cliche is true about America and there is a lot more openness about mental health and people are more likely to talk about it and come forward for treatment. I think it is ironic that when you look at Western countries, there are really much higher rates than in Europe.

There is a lot of need. The Western culture of individual competition, the definition of success that is based on material wealth, has led to an increase in mental illness.

Where there is more family focus there seems to be less mental illness, but Northern Ireland is right up there with the Western countries.

Our rates are higher, in fact we are in the top three of most of the mental health conditions across 30 countries including South Africa and Lebanon.

We are certainly the highest in the UK and yet we have a much lower expenditure.

We have this double whammy in that we don't talk about the Troubles and we don't talk about our mental health, and yet we still have all those Western influences of individualism and materialism.

Q. Your passion for improved mental health was evident in December 2015 when you and Professor Paddy Gray took part in the Hike4Hope walk from Londonderry to Belfast. What was that like?

A. That was a notion we had but it was a risky time of the year, coming up to Christmas time. We were lucky we had no snow.

Christmas is a difficult time for a lot of people and we thought we would do this as a gesture and raise some money and raise awareness.

It was a lovely experience but it was really, really challenging. There were a lot of blisters - we weren't the fittest, but it was fun.

Q. Do you still go on marathon-length walks or did that put you off for life?

A. I do like walking but I don't go on marathon-length walks. Walking, particularly outdoors, can be very, very good for you so I try and do as much as I can. It helps that I live in a beautiful area, close to a forest.

QYour day job is very serious and the subject matter very heavy. You above all people know the importance of balance in work and free time. How do you relax?

AWalking and yoga. I used to go to the gym but not so much anymore. Yoga is great for freeing the mind. It can be really challenging because it teaches you to calm your mind. I would also meditate most days.

I also listened to music - Indie music or rock, especially in the car.

I also love to sit in coffee shops with friends and catch up. I have been on a few photography holidays, which are great. Your brain is engaged but you are relaxed at the same time.

Q. You are preparing for motherhood. What are you feelings about becoming a mother for the first time?

A. It is just a joy, I am loving every minute of it, but I am also very apprehensive as well. I am also very conscious as well because of all the work I do in mental health of how crucial a time this is.

I feel the big responsibility that a lot of mothers feel because it is a really important thing.

I am trying to be flexible in my approach and trying not to take anything for granted.

I am having a wee girl - well I have been told it is a girl.

It will be lovely to have a daughter, but a healthy baby will be the main thing.

Q. What about your own childhood? What was life growing up in Co Derry like?

A. I have three sisters, there are four of us and I am the oldest. It is brilliant having sisters and they are just great. We chat nearly every day.

Growing up in the country near Claudy, which I didn't think I appreciated at the time, was incredible.

Looking back at the freedom we had, being able to play outdoors all the time, was brilliant.

My dad had a farm and we helped out, we learned a good work ethic, and still if my dad needed help moving cows or sheep I would be doing that, no bother at all.

We went out picking potatoes, bringing in the turf - all of that. It was great.

Both my parents are still alive and I live near them now, so I am lucky in that respect. I have travelled the world through my job but I feel I have the best of both worlds when I come back home, and it is a joy to be able to live where I do.

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