"It's time to come together to begin to tackle these issues"

Our complex relationship with alcohol shows we need a concerted response to tackle the inequalities in suicide, says James Jopling.
We’re lager drinkers, artisan gin connoisseurs and single malts lovers. Whatever your preference, we’re often considered a nation of drinkers. Whether it’s a glass of wine after work or a pint at the weekend, as a social lubricant, as a way to relax and as a ‘reward’ at the end of a hard day, we have a close and complex relationship with alcohol. 
The way a person drinks is influenced by a number of factors. Where you live, your social networks and what you learned about drinking as a young person all impact upon on how you approach alcohol. Whether you’re conscious of it or not, our social conditions impact upon our relationship with alcohol – just as they impact upon our risk of suicide. 
At Samaritans, our recent research report, Dying of Inequality, found that those experiencing inequality and disadvantage were at an increased risk of suicide. We identified a range of factors, from poor housing and debt through to heavy drinking. 
As with many of the other factors identified, the reasons behind the link between alcohol and suicide in disadvantaged communities are complex. Our report notes that unhealthy behaviours by people living in socioeconomically deprived communities are consistently explained as coping mechanisms or forms of escapism. It’s a way people can ‘mute’ stressful life events – which you are more likely to be experiencing if you’re also experiencing other disadvantage. If you’re living in unstable housing, struggling to pay the bills or facing the prospect of unemployment then it’s not surprising that you might feel the desire to try and mute your emotions with alcohol. 
Crucially however in this context, excessive alcohol use can increase impulsive behaviour and reduce inhibitions, increasing the likelihood of a person acting on suicidal thoughts. Thanks to the National Confidential Inquiry into Suicide and Homicide, we know for example that almost 60% of those who die by suicide in Scotland have had a history of alcohol misuse. 
In making links like this clear, our report allows us to identify what needs to change. To begin to tackle these immensely complicated issues however we need a concerted response, across agencies, government and sectors. We need to talk to those who can influence change in housing, stigma, lifestyle behaviours and many of the other factors highlighted in the report. Samaritans alone can’t save these lives. 
Alison Douglas, Chief Executive of Alcohol Focus Scotland, said: 
“Dying from Inequality is a really important report which very clearly demonstrates what contributes to suicide risk in disadvantaged people and communities. 
Inequalities in alcohol-related harm persist in Scotland, with those living in the most deprived areas, especially men in their 40s and 50s, having the highest rates of alcohol-related deaths. 
Of course, further action is required to prevent alcohol harm rather than simply treating the symptoms.
At the societal level, the drivers of Scotland’s high alcohol consumption include cheap prices, widespread availability and big-budget marketing campaigns. The pressure to drink is everywhere. It is unacceptable that a bottle of vodka containing 26 units of alcohol is available in any supermarket for around £10. Minimum unit pricing will bring significant health benefits, but the Scottish Government must also include action to regulate the availability and marketing of alcohol in its forthcoming alcohol strategy refresh.
Closing Scotland’s health inequalities gap requires a coordinated approach to tackling health-damaging behaviours and socioeconomic disadvantage.”
The unacceptable reality is you’re three times more likely to take your own life if you live in Scotland’s most deprived communities than in the most affluent. That’s a difference in the length of life that results from being less affluent. It is avoidable, unfair and unjust. Our report sets out why that is; but that’s just the start. 
Dying of Inequality is a call for all of us to care more and for those organisations and decision makers who can make a difference, to do so. It’s time to come together to begin to tackle these issues, such as the clear connection between heavy drinking and increased suicide risk. Together, we can begin to address what is an issue of life and death. 
Anyone can contact Samaritans. Whatever you’re going through, call for free any time from any phone on 116 123 (this number is FREE to call and will not appear on your phone bill), email jo@samaritans.org, or visit www.samaritans.org to find details of your nearest branch.
You can find out more about alcohol service via the Alcohol Focus website: http://www.alcohol-focus-scotland.org.uk/alcohol-information/find-an-alc...
First published in The Scotsman, 5 April 2016.