Mental Health and Alcohol – the elephant in the room

This post was published on thejournal.ie on the 6th March 2013.

At a time when mental health is finally well and truly a ‘hot topic’, firmly embedded in the public consciousness, I can’t help feeling that we’re quietly omitting a vital part of the discussion – our relationship as a nation with alcohol, and how it affects our mental wellbeing.

The term “mental health” is a wide-ranging one, and it can be argued that at the moment it has somewhat negative connotations and is almost synonymous, in public discourse, with mental ill-health and suicide – something that needs to quickly change. Slowly but surely, however, we are witnessing a realisation that preventative measures and positive mental health promotion, particularly among young people, are ultimately excellent and necessary long-term strategies on which we need to focus as a matter of urgency to tackle the current suicide epidemic.

In the wake of an abrupt economic crash, attitudes have changed rapidly in an adjusting Ireland. While it can be argued that a return to more prudent values is to be welcomed, there is an ongoing struggle to adapt. We have not adequately dealt with the practical reality of the economic fall-out that has decimated employment, household income and consumer confidence. There is evidence to suggest that pressure resulting from economic difficulties is a contributory factor to the increase in the number of suicides we have seen in recent years. To attribute the rise purely to this, however is to simplify the issue greatly. There are biological, sociological and psychological factors at play, and these are often intertwined – just as everyone is different, the individual causes of suicide vary greatly.

But let’s pull back from suicide for a moment, as that’s just one element of mental health we need to look at. Mental “wellbeing” is a term I’d prefer to focus on for now. And while most of us at this stage know that there are steps we can take to look after our emotional health, it’s apparent that our alcohol consumption behaviour and attitudes often directly contradict this. While it’s been touched on by aspects of the media in recent weeks, notably by Breda O’Brien in the Irish Times on Saturday January 26th and also as part of the Frontline discussion on mental health on Monday January 28th, it remains the elephant in the room when it comes to the national conversation we are attempting to have about mental wellbeing.

Our drinking habits and our attitudes towards alcohol in Ireland are what can probably fairly be classified as “extreme”. A recent study conducted by Millward Brown Lansdowne on behalf of Drinkaware.ie, indicated that while Irish people drink less frequently than our EU counterparts, our consumption is three times higher than the EU average. (Drinkaware.ie, interestingly, is an initiative developed by MEAS, a group comprised of various players in the alcohol industry, under the guise of social responsibility. The site contains lots of eye-opening information about the effects of alcohol, including its impact on relationships and mental health.)

In particular, attitudes among our young people are telling. The cross-border survey, “Alcohol Consumption and Alcohol Related Harm in Ireland” published by the National Advisory Committee on Drugs (NACD) last year found that a third of drinkers aged between 18 and 24 consumed the equivalent of nine standard drinks on a typical night out, and regard having at least five standard drinks on a night out as the “norm”. The Department of Health’s recommended weekly low risk drinking limits are 17 standard drinks for a man and 11 for a woman. So right there, that’s half your weekly intake, in one night.

So it’s clear that our attitudes to alcohol and alcohol consumption are somewhat skewed. The vast majority of our social occasions centre around the consumption of alcohol. Take,for example the prevalance of holding nearly every celebration in a licenced establishment, or if it is held in the home, accompanying it with carry-out alcohol. While there is a marked growth in outdoor, health-based activities, it’s not uncommon to celebrate a physical achievement such as a marathon or a triathlon in the pub. Even childhood occasions like christenings and first communions are commonly hosted in pubs.

There’s nothing wrong with this (I’m not writing this to judge) but why not ask why this is? Why the inherent dependence on alcohol to have a good time? Are we lacking so much in confidence in ourselves and our own personalities that we need use of alcohol as a social lubricant in order to let our hair down and truly enjoy ourselves? Alcohol consumption is pervasive. It’s everywhere. It’s practically impossible to avoid it. And the evidence indicates that we actively depend on it. Why, more importantly, are we so uncomfortable admitting this? And why are people who call it out and suggest that it might not always be healthy, dismissed as killjoys?

Minister Roisin Shorthall, during her time in government prioritised a strategy to tackle alcohol intake and abuse, including placing restrictions on alcohol sponsorship of and advertising at sports events, yet met with resistance both from within government and the alcohol industry. Minister for Transport, Tourism and Sport Leo Varadkar expressed concern that banning sponsorship would impact negatively on sports performance across the country – and incredibly, in this he is correct, as we now find ourselves in the questionable situation where our sporting bodies have become heavily reliant on the alcohol industry for funding. It can be argued that this is something of a double-edged sword, given that evidence demonstrates that young people are more likely to be influenced by the advertising of alcohol.

The bottom line in the debate around alcohol and mental health is that alcohol is, beyond a doubt, a recognised depressant. Research has demonstrated that it can have an adverse effect on our mental health, affecting our ability to cope with everyday challenges and bigger traumas. Critically, the connection between alcohol and suicide has been highlighted, and the fact that suicide victims are frequently found to have alcohol in their bloodstream points to a concern that alcohol can lower inhibitions enough for a person to act on suicidal thoughts that they may not have, otherwise. In one of the most damning statistics on alcohol you will ever read, the World Health Organisation estimates that the risk of suicide increases EIGHTFOLD when a person is abusing alcohol, compared to a person who is not.

Yet we continue to blithely ignore this enormous elephant in the room, because, the truth it, it’s easier to blame other factors than it is to look inwards and examine our own attitudes and behaviour. In continuing to place alcohol at the centre of our social interactions, we are all, each and every one of us, complicit in the problem. Harsh? Perhaps, but it’s an uncomfortable truth. We may not all drink to excess; neither might we all abuse alcohol but in failing to question the status quo or actively engage in alternatives to alcohol-reliant social occasions, we are all contributing to this problem. Every time you question someone who is not having a drink, or try to persuade them to “leave the car” when they choose to drive on a night out, or indeed, accept without question the behaviour of a friend who is clearly consistently drinking too much, we are contributing. And crucially, we are propagating and reinforcing these attitudes, because this is what our young people witness as they grow up. Not to mention perpetuating the “drunken Paddy” stereotype abroad, in countries where people mange to live with licensed premises that remain open through the night without turning into rabid binge-drinkers and functioning alcoholics.

So what can we do to change this culture? (Because this is what it is – a culture.) I don’t personally believe that measures such as restricting sales of alcohol, either at pubs and off-licences ultimately tackle the issue. And why should you or I not have the choice to buy a bottle of wine to enjoy at 10.30pm on a Friday night if we want? Or why should I have to leave the pub at 12.30pm on a Saturday night, because the law dictates that at this stage, I’ve had enough to drink? Rather, this change is an attitudinal one and needs to come from within – from within ourselves and our society. I’ve come up with a few suggestions – feel free to add your own in the comments below.

Firstly, let’s think about our reactions. Don’t judge a friend or acquaintance for not consuming alcohol. Don’t make them feel they have to invent an excuse for not drinking, once they make that choice. Don’t ridicule them, or make them feel that they ‘re not actively partaking in the occasion, just because they’re not drinking alcohol. Language is powerful.

Secondly, let’s think outside the box a little. Why the need to celebrate every little event or hold every single get-together in the pub? It’s a little unimaginative, frankly. A friend of mine organises a weekly social run in the Phoenix Park. He extends an open invitation to friends, and it’s well-attended. He doesn’t even go to the pub afterwards. And it’s fun. Imagine! And do occasions that focus on children really need to involve alcohol?

Thirdly, let’s learn to have a little more confidence in ourselves and our personalities. We’re great, we Irish. We have a wit that is rarely equalled, but excessive alcohol consumption doesn’t always make us wittier, or more confident, or more attractive. (Usually the opposite, in fact.) Often, it doesn’t even enhance our enjoyment of a night out. Or the following day, for that matter. I myself can confirm this beyond all shadow of a doubt, having tested the theory more times than I care to recall.

Fourthly – and I say this conscious of the sanctimony it may indicate, but does not intend – let’s embrace moderation. Alcohol consumed in moderation is enjoyable (and sometimes, depending on what you read, pretty good for you). It’s also more inclusive and conducive to drinkers and non-drinkers enjoying a night out in each others’ company.

Let’s look at alcohol a little differently. Rather than a mere inebriant, alcohol’s pretty nice with food. A nice red with a steak being the obvious example, but there are independent brewing companies who are marketing their craft beers as food accompaniments, and it’s another way to enjoy a tipple without making it the focus.

Lead by example. Sure, we’ve no obligation to do so, but our young people are watching, and it’s more important than you think.

Pubs – how about offering some appealing alternatives to alcohol? I’m done with Rock-more-expensive-than-a-pint-Shandy, and there are only so many sparking waters one can drink. How about some decent non-alcoholic beers? Palatable ginger ale? And less of a visible sneer when I ask for a non-alcoholic drink, thank you – smile, be polite and think of the often extortionate mark-up.

If you do want to check out alternatives, check out http://hellosundaymorning.org/ – an international initiative aimed at changing and recreating attitudes to alcohol that has just been launched in Ireland by comedian Des Bishop in conjunction with his RTE TV series, Under the Influence. Hello Sunday Morning is an initiative that says it’s perfectly fine not to drink lots all the time, and while you may not want to give up alcohol, it allows you to take some some “time out” – periods of three or six months are recommended in order to give you time to reflect on your drinking behaviour and reclaim the Sunday mornings that are frequently lost to Saturday night alcohol consumption. Most people return to drinking alcohol afterwards, but ultimately the time out can assist you if you want to change your drinking patterns.

Finally, let’s face up to the truth. If we genuinely do give a damn about the problem that is mental ill-health in this country, and want to be the change, we need to do more than simply call on the government to address the issue. While we urgently need to channel resources towards education and prevention, it’s all too easy to deflect responsibility. Like it or not, most of us are part of the problem, and we need to start taking some ownership – and fast. Examining our own contribution to the problem doesn’t necessarily mean rejecting alcohol, or seeing it as the enemy – merely becoming a little more thoughtful in our attitudes, behaviour and discourse around alcohol consumption. Then, and only then will we start to turn the tide and tackle one of the root causes of the suicide plague that blights our society today.

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9 thoughts on “Mental Health and Alcohol – the elephant in the room

  1. Let me think back few days.
    First, it was publican Michael Healey Rae, who passed motion in local council, that should allow Gardai to increase drink-driving limits in rural areas, so people can go to (his) pub, because drinking in a pub and drink-driving prevents depression.
    The second was just the previous week, when TD Clare Daly drank hot whiskey, knowing, that she will be driving after that? And she was surprised she was over the limit?
    How many results Google shows on “Irish TD drink-driving”? Only about 242,000?
    Yes, it is problem. But nothing unusual, unfortunately. Rules are OK, but when they don't suit us, we just don't follow them. In every single possible way: drink driving, parking on the sidewalk, cycling through red lights, crossing the street wherever we want, not paying taxes, lying in our expenses (yes, Ivor Callely, we do remember, although you are still in the well-paid seat).
    There won't be any change, unless every single person on this island will stand up for following rules and rejects any excuses for intentional breaking of the rules.
    You lie and break the rules for your own personal benefit.
    Where should we get examples, authorities or role models, when churches, politicians and pop-idols failed?
    Taking responsibility for own actions, and respecting the rules. Once that is possible within broader society, there will be even more compassion for other. The “socius” in society will begin to care about more, than “my own house, my mortgage, my insurance for three cars, my payments for private school”. Everybody looks after number one. And after that, they look after more. But more for themselves.
    People who care, and especially who DO something for others are in minority. Therefore thank you for writing this post. It is unbelievable, the hypocrisy of Irish society towards alcohol. Sleeping whole Sunday, after getting completely locked on both Friday and Saturday nights, then fry-up, shower and running for Sunday evening mass?
    More people commit suicide, than die on the roads. How much did government spend on road safety campaign?
    Anyway, I still have hope. Hope for future of your kids. They will only continue on what they see, hear and learn now, and what they take as normal, as standard, as acceptable.
    I hope, I wish and I try to believe.

  2. These suggestions are excellent ones, realistic without being preachy. I am friendly with wine and beer enthusiasts who do exactly what you mention i.e. pair their drink of choice with food and it turns into a lovely, convivial experience, which even I as a non-drinker can be a part of.

    I've had people tell me they don't trust me because of my non-drinker status, 'no offence', that I'm just doing it to prove a point or that I'm making others feel bad. I've been asked if I have a problem with drink or drinkers themselves, if I'm on medication, if I'm pregnant or religious(?). Bear in mind that I don't go up to people telling them, like that hoary old joke about the vegan who doesn't own a tv. They notice I'm drinking a mixer or fruit squash or water and then the questions start.

    My friends, my husband and most of my family don't make an issue of it at all. It was a ten minute wonder at most. In the wider community, it seems to be a problem. It is getting harder as I get older, which I hadn't expected at all. I have to defend my choice a lot more than I once had to. In college it was barely an issue, but in my professional life it keeps coming up. Where is this coming from?

  3. Thanks Vlastik for your comments above. While rules are obviously important, this post isn't about the law of the land. Rather, it's about taking a look at ourselves and acknowledging that there is a significant contributor to mental ill-health that we are currently ignoring, because it's uncomfortable for us to do so. It's also acknowledging that there are things we can change, but the real question is, how badly do we want that to happen?

    Watermemory, thank you. You make a very good point about non-drinkers being able to comfortably partake in these occasions – the many replies I got to this on twitter indicate that this currently is not the case, and that non-drinkers consistently feel excluded or mistrusted, as you say. Ultimately, though this wasn't the point of the post, it would be great if we could as a society reach the point of maturity, where people don't feel this way, and that this just isn't a big deal anymore.

  4. Hi. This article was featured in TheJournal.ie, and at this point (Wed 06/Mar/13 @ 16:00) has 47 comments.

    Well done, what a brilliant article

  5. Pingback: On World Suicide Prevention Day, what can YOU do to prevent suicide? | An Cailín Rua

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