Life moves fast. It often moves too fast to take a step back and consider how this is affecting our lives or that of our loved ones. Society is filled with competition - the great expectation of being perfect, beautiful, wealthy and successful. If you walk into a psychiatric clinic, it is filled with people who have lost their way and dropped off this rather fast multi-track to nowhere. The rest of the population maintain cosmetic façade co-existing with their own demons.
Research shows that men do not seek assistance for psychological difficulties and have lower rates of contact with the health care system when compared to women. Suicide risk factors in males include lack of social support, stress, overwork, family breakdown and employment insecurity combined with substance abuse. It is now becoming epidemic of silent sufferers.
Gary Speed may have been one of those silent sufferers. I listened to the breaking news on the 27 November 2011 regarding the Welsh footballer remembering the many tragic suicides the NHS could never prevent. Speed appeared to have everything- a wonderful career, fabulous looks, financial stability, a beautiful wife, lovely children and wonderful supportive friends. Newspapers reported that he was not depressed . We can only speculate on the reasons for his untimely death. Could he have survived? Well this is what the research tells us
"Whilst case fatality following attempted suicide by hanging is high (around 70%) survival is possible, even after 5 min suspension. The main causes of death amongst those reaching hospital alive are bronchopneumonia, pulmonary oedema and adult respiratory distress syndrome".
The mysterious reasons surrounding the manner he ended his life in such a violent way will probably never be known. Arpad Toth of Oxfordshire has an interesting view about people who resort to hanging
"Men are often angry that they have lost control over parts of their lives. The motivating factor is to gain back control and in some cases to spit in the eye of the authority in order to have their last say".
Mind explained as follows "The high-pressure environment of top-level sport can cause huge levels of stress and, just because someone appears to be able to carry on their usual daily life, it does not mean that they are not struggling in private."
The biggest factor affecting compliance with mental health services is stigma. The stigma of mental illness continues to be unacceptable. Patients often find it difficult enough without added burden of social stigma. Jamison et al wrote
'It was difficult to make the decision to be public about having a severe psychiatric illness.... but privacy and reticence can kill. The problem with mental illness is that so many who have it--especially those in a position to change public attitudes, such as doctors, lawyers, politicians, and military officers--are reluctant to risk talking about mental illness, or seeking help for it. They are understandably frightened about professional and personal reprisals"
So, let's examine Gary's chosen method of suicide in context of the population. The British Journal of Psychiatry describes suicide in Medieval England occurring more commonly in men. More recently, the World Health Organisation paper cited as follows". Violent and highly lethal methods such as firearm suicide and hanging are more frequent among men" . The reasons for the increased lethal nature of suicides in men were speculated in this paper . They summarised the factors affecting men.
- Feeling more hopeless.
- More clearly resolved to die.
- More likely to be intoxicated and thus more disinhibited.
- More willing to carry out actions that might leave them injured or disfigured.
- More unconcerned with consequences because of a high risk-taking orientation.
- More likely to have a greater capacity to enact lethal self-injury.
A 2005 paper cited that hanging is a frequently used method of suicide in many countries. England has about 2000 hangings per year, more commonly seen in older males. Only a small proportion of suicides by hanging (around 10%) occur within the controlled environments of hospitals and prisons. The researchers suggest that hanging may be partly due to substitution from other methods e.g. gas which have become less lethal.
To deal with suicides of this kind, the authors suggest population based initiatives to reduce the popularity of this method. They suggest working with the media to reduce the portrayal of fictional suicides by hanging and reporting of hanging suicides. One issue is certain, further studies are required to understand the preventative approaches to hanging. Some argue that many suicides are rational decisions that cannot be prevented.
Gary Speed's best unintended legacy may be to raise awareness of the silent epidemic that affects men. By doing so he will have saved many individuals in the future.
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