Saturday 21 April 2018

Equal rights, including marriage, can promote better health for LGBT people

Many doctors back such rights because of health problems associated with repressed or stigmatised sexual orientation, says Veronica O'Keane

Veronica O'Keane
Veronica O'Keane

Veronica O'Keane

Professor Patricia Casey's latest contribution to public debate on the topic of suicide is that young gay men who have suicidal ideation or who attempt to harm themselves will not necessarily go on to kill themselves. She has told us that we should not "conflate" the act of self-harm with the completed act of suicide. Her argument is that, although suicidal behaviour is disproportionately more common in LGBT individuals, that the completed acts of suicide may not be higher.

The reality is that every individual who presents with either self-harm or suicidal ideation, regardless of their sexual orientation, is at a greatly increased risk of going on to die by suicide. One in a hundred individuals, whether gay or straight, who present to medical services with self-harm or suicidal ideation will go on to kill themselves in the following year. Presentation with self-harm is the single most important risk factor in the prediction of completed suicide. We have a national programme in suicide prevention that is focused, almost exclusively, on interventions for individuals who present to A&E departments, or to GP surgeries, with self-harm or suicidal ideation.

I practise in Tallaght Hospital and in the HSE community clinics in the Tallaght area. We have set up a dedicated suicide-prevention service, called Ceangail, operating between 5pm and 9am, in recognition of the fact that most individuals who present with suicidal thoughts or behaviours do so outside of working hours. We are now in the final stages of implementing a specialist self-harm assessment programme in GP practices in Tallaght, led by my community mental health team and Professor Tom O'Dowd (Professor of General Practice, TCD and a GP in Tallaght).

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