June 16, 2009

Experience of being abused in an institution could lead to anxiety over receiving nursing home care in later life, writes MICHELLE McDONAGH

SURVIVORS OF institutional abuse in Ireland may be at a higher risk of suicidal behaviour if they need to receive nursing home care – as many will – in later life, according to the National Suicide Research Foundation (NSRF).

Director of research at the NSRF, Dr Ella Arensman, explained that the experience of being abused in an institution had led to huge anxiety among survivors regarding the possibility of receiving nursing home care in later life.

“This fear of what might happen to them as they grow older must be given appropriate consideration as a risk factor for suicidal behaviour among survivors,” she said.

Dr Arensman said that people who went through the industrial schools were more likely to have been cut off from their parents and siblings and so are more likely to end up in nursing homes.

She highlighted the need for those working in the primary care and nursing home sectors to be aware of the specific difficulties and needs of this not insignificant group.

Although Dr Arensman has been involved in research into the link between institutional child abuse and suicidal behaviour since 2005, with Dr Martina O’Riordan, she said they were overwhelmed at the extent and severity of the abuse revealed by the Report of the Commission to Inquire into Child Abuse.

Their research, which was commissioned by the National Office for Suicide Prevention, has found that long-term effects among survivors of institutional child sexual abuse included social isolation, alcohol and/or drug abuse, depression, post traumatic stress disorder and suicidal behaviour.

“In our study, we came across people who 30 or 40 years later can only sleep with the light on.

“They fear the dark because a lot of the abuse went on at night-time and they still have nightmares. “Many have struggled to build up some level of independence which they did not have for an average of 16 years while they were institutionalised.

“My concern is that these people are at an increased risk of depression and suicidal behaviour when they arrive in a nursing home and have to give up this independence again,” Dr Arensman said.

The trans-generational transmission of mental health difficulties was also indicated by some survivors who raised concerns about their adult children’s own struggles with addiction, anger, depression and suicidal behaviour.

While most people assume survivors of institutional abuse are quite elderly, Dr Arensman pointed out that the last industrial school closed only in 1984 and the reality is that the long-term effects may last for several generations.

A second follow-on study by the NSRF into the risks and protective factors for suicidal behaviour in people who went through the industrial schools is now unfortunately on hold due to a lack of funding.

“It would be a completely paradoxical approach if now when we have five volumes of the Ryan report in front of us, we were to close the chapter on this research.

“I was surprised to read that some politicians consider the Ryan report as bringing a ‘closure’ to a dark period in Irish history. We are far away from any closure, this is only the start,” Dr Arensman said.

  • HSE National Counselling Service: 1800 235 234
  • Connect, the out-of-hours helpline of the National Counselling Service: 1800235235, offers support Wednesday to Sunday, 6-10pm
  • Faoiseamh Helpline: 1800331234, offers support on Mondays and Wednesday from 11am-8pm and on Fridays from 11am-4pm’
  • Samaritans: 1850 60 90 90, offers support 24 hours a day

This article appears in the print edition of the Irish Times