Concerns about suicide rates among Travellers due to self-harm presentations at A&E

The research was conducted by the National Suicide Research Foundation (NSRF), with data from the HSE's National Clinical Programme for Self-Harm and Suicide-Related Ideation (NCPSHI), a dedicated mental health programme in 24 adult emergency departments.

Led by Dr Katerina Kavalidou, the research looked at 24,473 presentations for self-harming behaviours across 2018 and 2019 and found 3% of those presentations were by members of the Traveller Community, some 744 patients.

Significant differences were found between the ethnicities, with Traveller people having a high proportion of self-harm acts (61%), compared to the rest of ethnic groups," it stated.

Substance misuse as a contributory factor was also higher in Travellers presenting at the ED than their white Irish counterparts. 

Next-of-kin involvement

As for next-of-kin involvement, 19% of white Irish patients requested no next-of-kin involvement, compared to 28% of Travellers presenting at ED. A higher proportion of Travellers also said they had no next of kin.

"While the biggest proportion of all ethnic groups was not attending any mental health service, Traveller people seemed to be more in contact with mental health care at the time of their ED presentation (34%), compared to the rest of ethnicities," it said, while noting that "a highest proportion of the Traveller group requested no NOK [next-of-kin] involvement, compared to rest of ethnicities".

The pre-print paper concluded: "Male and female Traveller patients older than 50 years of age had the highest risk of presenting with self-harm in Irish EDs. 

"This finding may be associated with the mental distress experienced by the eldest Travellers, due to discrimination or poor physical health. 

The risk of suicide-related ideation was higher for older female Travellers over the age of 50 and for male Travellers between the ages of 30 to 39 years old.

"Our research further supports existing evidence which suggests that there is a high prevalence of alcohol and drug misuse in the Traveller community, while the request of Traveller patients not to involve any significant other in suicide prevention interventions may reflect cultural stigma when experiencing emotional pain."

It also said the high substance misuse prevalence could reflect the social acceptability of alcohol and other factors, such as unemployment, and that the NCPSHI should be available in all 24/7 EDs of Ireland.

Dr Kavalidou said it was positive that Travellers were presenting at EDs with their issues and that more needed to be done to ensure people got the help they needed, and that visits to EDs in such circumstances led to enhanced follow-up supports.

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