Counselling and Suicide Prevention: A Study on the Effectiveness of MACP

This study explores the effectiveness of Mid Ulster Association For Counseling and Psychotherapy (MACP) in preventing and managing suicidal ideation. It uses qualitative data collection and analysis to understand the client and employee perspective of MACP. The study finds mixed perspectives on the workforce, counseling services, and technology of the organization in preventing suicidal attempts. The article discusses the importance of counseling and psychotherapy services in preventing suicide and managing mental health issues.

Running head: COUNSELLING AND SUICIDE PREVENTION
COUNSELLING AND SUICIDE PREVENTION
Name of Student
Name of University

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COUNSELLING AND SUICIDE PREVENTION
Table of Contents
1. Abstract...............................................................................................................................2
2. Introduction............................................................................................................................5
Research questions.................................................................................................................8
3. Literature review.................................................................................................................9
4. Methodology and data collection method.........................................................................14
DATA COLLECTION.........................................................................................................20
5. Results and Analysis.........................................................................................................20
6. Discussion.........................................................................................................................25
7. Conclusion........................................................................................................................30
Reference..................................................................................................................................33

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COUNSELLING AND SUICIDE PREVENTION
1. Abstract
The three dynamic forces of psychology such as the psychoanalytic approach,
psychodynamic approach and the humanistic approach have provided the medical and
physiological framework of different countries (starting from the first world countries to the
third world countries) – the necessary tools in the field of mental health assessment and
services along with the necessary spectrum of knowledge needed to make the general public
and the professionals aware – about the development of various clinically important mental
conditions and the various ways of dealing with it. Counseling and the talk therapy is one of
the most well-known ways of dealing with the same array of mental health situations where a
person is involved in a self destructive thought, self harm behaviors, delusion, hallucination,
paranoia, fear and a resultant state of deep seated clinical depression. The association extends
its support to mental health patients in management of anger, bereavement, stress, anxiety,
trauma, abuse fears and relationship issues, change and major life events that impact’s one
health and state of well -being plus it leads to the stages of depression. The organization
based on Northern Ireland has dedicated members, staffs, employees, experts and volunteers
to address the social and the psychological parameters of depression amongst the Irish people
and they extend the necessary social and the sociocultural services in management of trauma
and resultant depression amongst the Irish people. Various governmental and non-
governmental organizations has been involved in United Kingdom, to deliver the right
services (mental health services) to the appropriate population which is affected
demographically or developmentally with clinical depression and development of suicidal
ideations. In the United Kingdom, Mid Ulster Association For Counseling and Psychotherapy
has played its part so far in preventing the suicidal ideations and the suicidal events in the
country of Ireland (Doyle, Treacy and Sheridan 2017). The study aims to understand whether
the Counseling and the psychotherapy services actually prevent and manage suicidal ideation

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COUNSELLING AND SUICIDE PREVENTION
effectively and whether the Mid-Ulster Association for Counseling & Psychotherapy
(MACP), who deliver a professional counseling service, located in the Mid-Ulster Council
electoral ward, contribute to the reduction in serious mental health problems, particularly
suicide (Hawton and Van Heeringen 2000). The study uses a qualitative data collection and a
qualitative data analysis method to understand the client and employee perspective of the
Mid-Ulster Association for Counseling & Psychotherapy (MACP) in context to performance
of the organization so far in prevention of suicides (Klonsky et al. 2016). The study finds out
mixed and complex perspectives in terms with workforce, counseling services and
technology of the organization in prevention of suicidal attempts of the concerned people in
the population. A semi structured interview was performed with each participants of each
focus group. Open ended questions were used to help the participants explore their reflection
and ideas without any barriers or boundaries. Two different focus groups were formed in
order to gain an insight into the suicide prevention service delivery system by the Mid-Ulster
Association for Counseling & Psychotherapy (MACP) from the perspectives of the
employees who deliver the services at Mid-Ulster Association for Counseling &
Psychotherapy (MACP) and from the perspectives of those who receive the counseling
services from Mid-Ulster Association for Counseling & Psychotherapy (MACP).

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COUNSELLING AND SUICIDE PREVENTION
2. Introduction
Mental health problems have been increasing throughout the globe and this has been
due to the increase in stress and anxiety of the general population. The mental health is being
affected differently at different age groups and various psychosocial factors has been seen to
play a very important role in the development of these grave mental health diseases from
initial stages to the severe stages (John, Bagley and Hoi-Wah 2018). Stress and anxiety as
already, mentioned being the most basic of clinical affections at the mental levels of human
being and with increase in complexity of human lives and increase in the number of
complexities of resources (Tang et al. 2009) – for which human competition is rising every
day – has also contributed to the elevated number of mental health cases throughout the
globe. The increase in the number of stress and anxiety cases – whether it rises from lack of
employment or lack of perceived love and affection – has made the quality of life much
diminished compared to the full potential with which a life should be dealt with (Hearne,
Geary and King 2017). While mental health professionals across the world has increased their
repertoire of dealing different pathophysiology of neuropsychological and purely
psychological basis – from different aspects and different perspectives of mental health
services – there has also been an increased challenges to the delivery of these services
(mental health services ) which are of economic, financial, social and behavioral origin. In
addition to these challenges (Horgan et al. 2018), various types of administrative and national
level of legal challenges have also presented themselves to the successful or optimal delivery
of these mental health care services in a community or a urban scenario. The level of mental
health affection is different at different social levels that is meant in a social hierarchy way
and the level of mental health diseases or conditions that affects differentially according to
the social determinants of health – is a factor exclusive of many other influences that are
strictly medical or clinical of sense. One of the chief mental health severity that rises from a

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long withstanding case of stress and anxiety that has been left untreated has been often
reported to transform itself to a more dire and severe condition such as sadness which in a
more severe of sense and condition leads to clinical depression in many individuals across
different age groups (starting from childhood depression to old age depression) (Moore and
Donohue 2016). This depression, whether diagnosed or undiagnosed under many situations
(given the low socio economic status, non- accessibility to quality health care centers, low
awareness of mental health diseases and low awareness about the ‘quality of life at different
developmental stages’) has been the prime precursor of suicidal ideations amongst people of
different range of age groups and the development of suicidal tendencies leading to actual
taking place of suicidal events has been greatly influenced and attributed by the disturbed
mental health levels across various psycho social stages of life. Various psychological events
occurring at different stages of life in a broader sense has different impacts on the psyche of
an individual and the overall memory of the event or the fact that the individual is not being
able to overcome it or surpass the feelings of it by the experience into the greater horizon of
understanding, consciousness and holistic understanding of life - has also been attributed to
be as the perfect ideations towards suicidal thoughts and the actual happening of suicidal
event (Black et al. 2015). The three dynamic forces of psychology such as the psychoanalytic
approach, psychodynamic approach and the humanistic approach have provided the medical
and physiological framework of different countries (starting from the first world countries to
the third world countries) – the necessary tools in the field of mental health assessment and
services along with the necessary spectrum of knowledge needed to make the general public
and the professionals aware – about the development of various clinically important mental
conditions and the various ways of dealing with it. Counseling and the talk therapy is one of
the most well-known ways of dealing with the same array of mental health situations where a
person is involved in a self destructive thought (Hearne and Galvin 2015), self harm

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behaviors, delusion, hallucination, paranoia, fear and a resultant state of deep seated clinical
depression. Various governmental and non-governmental organizations has been involved in
United Kingdom, to deliver the right services (mental health services) to the appropriate
population which is affected demographically or developmentally with clinical depression
and development of suicidal ideations (Shaffer et al. 1991).
In the United Kingdom, Mid Ulster Association For Counseling and Psychotherapy
has played its part so far in preventing the suicidal ideations and the suicidal events in the
country of Ireland. The association extends its support to mental health patients in
management of anger, bereavement, stress, anxiety, trauma, abuse fears and relationship
issues, change and major life events that impact’s one health and state of well -being plus it
leads to the stages of depression. The organization based on Northern Ireland has dedicated
members, staffs, employees, experts and volunteers to address the social and the
psychological parameters of depression amongst the Irish people and they extend the
necessary social and the sociocultural services in management of trauma (Cerel, Jordan and
Duberstein 2008) and resultant depression amongst the Irish people. They have the right set
of organized people and workforce to go with the right blend of technology to assist the
mentally ill patient bordering on emotional and personality disorders to prevent them from
the incidents of life threatening events and suicidal impacts. The organization addresses
psychologically challenged young males and females or the ones affected with
psychosocially adverse situations with career and trauma informed psychological care. Loss
of personal family member or loss of a loved one through death and expiry can lead to
depression and a bereavement support becomes essential to the addressing of these cases and
Mid Ulster Association For Counseling and Psychotherapy extends the right support in these
circumstances as well. The Mid Ulster Association For Counseling and Psychotherapy
provides purpose to the subjects who lacks hope and meaning in the pursuit of life and the

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association based in Northern Ireland finds or rather considers it as a rather important marker
for suicidal ideations. Thus, on most occasions to takes up a psychological aspect of care that
is of humanistic perspective and shifts the counseling and therapy sessions into a rather
meaningful experience where an individual start once again with new hope and faith in life.
While handling the trauma cases – the Mid Ulster Association For Counseling and
Psychotherapy focuses to make sense of the event that has caused a lot of trauma to a subject
and the trauma incident is presented by the counselors and therapists at Mid Ulster
Association For Counseling and Psychotherapy as more meaningful life experience for
growth or rather a more meaningless experience which has been held on by the individual for
too long and that it is time (Krysinska and De Leo 2007) – for a much needed release from
the same now. In other words, over the years now – the \mental health service delivery
organization has been healing and curing the ‘dissociative states’ which are identified or
rather recognized as the important precursor behavior in the ideation of suicidal behavior and
attitudes. The organization works through a collaboration of psychiatrists, clinical
psychologists, therapists and the counselors to deliver the best of mental health services to
community living people of Northern Ireland and even to urban living people (Blumenthal
1990).
Research questions
1. Does Counseling and the psychotherapy services actually prevent and manage
suicidal ideation effectively?
2. Does the Mid-Ulster Association for Counseling & Psychotherapy (MACP), who
deliver a professional counseling service, located in the Mid-Ulster Council electoral
ward, contribute to the reduction in serious mental health problems, particularly
suicide?

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COUNSELLING AND SUICIDE PREVENTION
3. Literature review
The Mid Ulster Association For Counseling and Psychotherapy has the right servicing
team along with the volunteers and the fundraising team who network in the right appropriate
way to service the mentally ill and mentally affected subjects from North Ireland and the
nearby regions. The Mid Ulster Association For Counseling and Psychotherapy has also
arranged the charity programs for traumatized individual and in the way of altruism and
philanthropy as well, the organization has grown over the years, in service of the trauma care
and mentally suffering people. The teen ager and the youngsters who are into alcohol and
other drugs abuse and who have been passing through the dire disturbing state of adolescent
and in company of people who are not in any way, well equipped and just equipped to
address the developmental needs of these teenagers and adolescents – are the major cardinal
reasons that lead to ideation of euphoria, delusion and ecstasy led suicidal attempts amongst
the teen agers and adolescents. The ‘death ecstasy’ and risky psychosocial behaviors are the
reason that the people of this sensitive age group of adolescence or even early adolescence
pass through the very stages of risky and life threatening behavioral change and under the
modern circumstances – when the parents are either at work ( both the parents in many family
circumstances and in order to earn more amount of money to stabilize the socio economic
status of a modern day middle class family striving through a highly competitive age ) – these
aggressive and violent alcohol and other drugs related behaviors becomes activated – under
the lack of supervision and mature peer support. Violence and the various types of aggressive
behaviors as well as the conception of anti-social behavior amongst the young teens and the
young adults is common due to the engagement with alcohol and other drugs effect and these
violence and aggression in the developmental stages, if incorporated by any finest means of
chance, might escalate a new problem both the teen or the adolescent and his or her family
and friends as well. The Mid Ulster Association For Counseling and Psychotherapy in

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Northern Ireland identified peer support as an important and critical tool in shifting the
behavior of an adolescent to a more positive and acceptable note and social observational
learning along with the vicarious learning are also used by the Mid Ulster Association For
Counseling and Psychotherapy as cardinal interventional tools to address the humanistic and
developmental needs of the adolescents, adults and the teens. Both fundraising and the
networking to get the right mix and proportion of people working towards the common goals
of helping, assessing and righting the trauma mediated depressive situations is critical to the
success of any non-governmental organization in the prevention of suicidal acts and ideations
(Gask et al. 2017).
The esteem and belonging needs of a person is a very critical to the developmental
needs and growth of a person and it is very critical that the developmental needs of a person
is taken care by the family, relatives, neighborhood and the teachers, seniors, peers that forms
the social framework around the person. The trauma received at childhood, adolescence and
the adulthood of the person is critical to his feelings of security, esteem, love and belonging
and any mismatch or under fulfillment of any of these ‘needs’ can lead to faulty or deficient
emotional growth in the individual. The various types of needs that are mentioned above in
addition to the other humanistic needs play a very important part in shaping of the human
character and the human personality in relation to the various facets of human emotion
development. The overall understanding of a person’s one’s own situation comes from self-
monitoring and self-awareness and this actualization of one’s truest self lead to the
compassionate understanding of one’s own desires and acceptance of other people’s behavior
without judgment. While person’s interaction with his or her own self in addition to the social
and cultural interactions with others in the near and immediate environment play a very
critical role in ideation of suicidal behaviors – the internal derangements in terms of traits,

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wishes, emotions, motives and feelings also sum onto the construction of positive and
negative feelings around the living of life by an individual (Cullinan, Veale and Vitale 2016).
In a study performed on the perception of the mental health conditions persistent at
Northern Ireland – the researchers found out that in addition to the socio economic and
emotional connection plus bonding within a family – the overall social environment in which
an individual lives also have a strong effect on the development of mental health condition in
the individual (Monteith et al. 2013). The study used a more quantitative approach such as
general health questionnaire to understand the mental health state and the general perception
of the people living in Northern Ireland and their very conception about their own mental
well-being and that of their family (Langille 2018). While the study aims to understand the
major two social determinants of health – it also finds out important and the most vital
correlation about the overall effect of individual mental health on the state of living of the
entire family and the whole area – in a broader perspective – given there is a psychological
morbidity related to a history of trauma and violence in the respondent’s area and the related
socio psychological disruptions immensely occurring in the given area. Hence, in this study
‘Mental health in Northern Ireland: have “the Troubles” made it worse?’ by O’ Reilly and
Stevenson (1997) – the impact of civil unrest has been found to have a greater impact in
terms of violence mediated depression, paranoia, behavioral and personality disruptions due
to the underlying the psychological and sociological disturbances. The economic, socio
economic and demographic factors were seen to plan a very vital role in the initiation of these
mental condition leading to suicidal ideations and suicidal events (Nadorff et al. 2014)
McLafferty (2018) focuses to understand ‘The moderating impact of childhood
adversity profiles and conflict on psychological health and suicidal behaviour in the Northern
Ireland population’. The trauma received at the childhood days and the impact of post-
traumatic stress disorder in the later psychosocial developmental stages of life is directly

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COUNSELLING AND SUICIDE PREVENTION
proportional to the level of severity of the mental health disease which affects an individual
during the later stages of the life. The overall impact of psychopathology – as determined by
the conflicting scenarios and the adversity profile is directly related to the suicidal behaviour
and as reflected upon by the study’s researchers – the childhood experiences ( in accordance
with the traumas (Nadorff et al. 2014). Repressed memories and desires) is very synchronous
of the resurfacing of forgotten memories into the stages of depression development.
According to the study, the very conflicts of interests by the family with the child, is one of
the cardinal reasons of the mental health disturbance and rise of suicidal tendencies in the
very later stages of the life. The overall influence of conflicts if not resolute by the family or
the more knowledgeable others, continues to grow in an individual – thus leading to the
development of psychopathology of suicidal ideations and lack of apt coping mechanisms can
always degrade the quality of living of the individual and the family – that in turn leads to
suicidal event on conflict exposure and risk exposure. The study uses a latent class analysis
and a risk analysis profile to understand and analyse the same. According to the very study –
the high to severe levels of adversity experienced at childhood negatively influences the
psychopathological developments. In northern Ireland, as the study recognizes – the conflict
exposure has negative effect on the psychopathological developments of suicide. Moreover,
on the contrary though – the study finds out that the moderate levels of childhood experiences
of adversity and conflicts can have a very protective effect against the self harm behaviours
in the later stages of life.
McLafferty et al. (2015) focuses to study the ‘Childhood adversity profiles and adult
psychopathology in a representative Northern Ireland study’ by doing a latent class analysis
and finds out that the low risk class, poly adversity class and economic adversity class are the
three main categories of interest that are influenced in context of the suicidal ideations,
anxiety and substance abuse and high range of mental health problems. The study used the

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logical regression models to understand and analyse the overall impact of suicidal behaviours
on quality of life of an individual and how the same assessment can be used to formulate the
treatment and the interventions in the prevention of the suicidal ideations of Irish adolescents
and the Irish adults.
Conway et al. (2018) focuses to understand ‘Client personal recovery and recovery
orientation of an Irish suicide intervention charity’ and finds out that recovery as in the
mental health recovery process is of major importance when it comes to treatment of the
suicidal ideations and the suicidal behaviours. Several factors were identified by the study
such as willingness of an individual to ask for help from the others, the personal level of hope
and confidence and the overall level of availability to choices of life and overcoming the
symptoms of suicide ideating psychological conditions – has been reported by the study to
have played an important part in the formation of resilience against all conflicts and
adversities of the life. The setting of life’s goals and the conscious effort of achieving it
through the aid of a counselling and talk therapy has been identified as important factor in the
mental health self recovery process.
Long et al. (2018) aims to understand and study ‘Knowing that I’m not alone”: client
perspectives on counseling for self-injury’ and finds out important correlations in context to
self injury and ideations of suicidal behaviors in prevention or facilitation of the same. The
various types of social and therapeutic spiritual correlations has been identified in terms of
healing of self by healing of others, by building of trust and compassion, by the extensive use
of human contact and the undertaking of recreational activities and by integrating meaningful
experiences through the act of counseling and the group therapy and by treatment of the
behavioral and cognitive derangements.

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Betts and Thompson (2017) aims to study ‘Mental Health in Northern Ireland:
Overview, Strategies, Policies, Care Pathways, CAMHS and Barriers to Accessing Services’
and finds out the various types of psychotherapy and counselling services delivered by the
non-governmental and the governmental organisations to be very helpful in the prevention
and management of suicidal ideations and the suicidal behaviours. The various types of
therapies as in psychotherapies identified to be useful by the research study are cognitive
behavioural therapy, trauma therapy and dialectical behavioural therapy. The overall context
of the suicidal behaviours amongst the people of Ireland attributed to unemployment,
deprivation of social and financial rights, age and gender inequality, abuse as in sexual and
physical abuse plus alcohol and other substance abuse in addition to the financial and family
support concerns and also the long standing incurable physical illnesses. Age and gender
specific reasons are identified by the researchers of this study – using the general health
questionnaire and the scores were compared against the various nations of United Kingdom
such as Wales, England, Ireland and Scotland. A very strong and significant correlation has
been found by the researchers of the study in context to refugees, homeless and the asylum
seekers in the country of Ireland and various suicidal attempts has been attributed to the
history of past trauma (often received at the age of childhood or adolescence) and also
correlated to the history of self harm and self destructive behaviours. Several important steps
were identified by the researchers of this study to prevent the ideation of suicide in Ireland
and United Kingdom and these steps are reform in the mental health legislation, increased
promotion of the positive mental health and continuous shift to the community based mental
health care psychotherapy services from the hospital treatments and expensive stay.
4. Methodology and data collection method
The overall care of the suicidal conditions (which is found in various mental health and
physical health comorbid conditions) has been performed by the organization – after

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countering a lot of barriers and challenges to a fair degree of both success and failure. The
Mid-Ulster Association for Counseling & Psychotherapy (MACP) studies the collective
social behavior against the individual social behaviors in order to understand or rather gain a
complete picture of the overall social scenario prevalent in Northern Ireland. The group level
forgiveness and the likelihood of a subject to become a victim is strongly determined by the
Mid-Ulster Association for Counseling & Psychotherapy (MACP) to understand the very
prevalence and persistence of a pro social and the anti-social behavior. The health condition
of an individual in addition to the social and economic condition of an individual is equated
against the various social determinants of health – to understand and decipher the
underpinnings of mental health condition (especially axis 1 and 2 ) that is so prevalent in
regions of Northern Ireland is critically assessed by the Mid-Ulster Association for
Counseling & Psychotherapy (MACP) in order to deliver the best of quality services to the
people with suicidal ideation in the regions of Northern Ireland. Collective memories,
political unrest and the civil condition based on the sociodynamics of the Irish population has
also been reported to play a very critical role in the ideation of the suicidal attempts in the
regions of northern Ireland and Mid-Ulster Association for Counseling & Psychotherapy
(MACP) provides even free counseling the people in its area and to the people in the other
regions of country as well through its extended network and Mid-Ulster Association for
Counseling & Psychotherapy (MACP) believes the importance of counseling and
psychotherapy as the main means of preventing the suicidal attempts of individuals and
subjects against the odd situations of life and life’s experience which adverse and unfulfilling
(Murphy 2017).
Various organizations – both governmental and the non-governmental organizations has
played or rather have attempted to play an important role in the suicide prevention amongst
the Irish population based in northern Ireland and the nearby regions of United Kingdom. Not

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only, the various sociological and the demographic plus the environmental factors play a
cardinal role in the prevention and the development of suicidal tendencies amongst the
young, middle aged, males and females of old ages even – but it rather plays a very cardinal
role in shaping the mindset of the persons who in future – is about to pick up a more
dangerous self harm and self destructive range of behaviors. From the various initial stage of
life, there are certain indicators that can be significantly indicative of the development of
suicidal ideations and with proper knowledge mediated power of awareness – the distorted
suicidal patterns of thought and the cognitive distortions can be measured and prevented at
the right, approximate time (Dowling and Doyle 2017). The non-governmental organizations
that has intended to deliver a more viable mental health service to prevent the development of
suicidal behaviors – has come across various complex psycho social and administrative
challenges to the delivery of these mental health services (Testa et al. 2017). The
administrative challenges included the lack of very skilled workforce who are educated
enough to handle or rather assess the population condition well and lack of technological plus
the right audit systems to counter the lacking areas in the field of mental health
administration that is designed with the very ideation of suicide control and population’s
mental health management (Holt et al. 2017). The overall running of the seminars, workshops
and the awareness campaigns play a huge role in the management and prevention of suicide
acts and the suicidal prevention and this in fact, has been presented with different levels of
challenges – at social and the economical level, chiefly due to the problems with fund raising
and networking. It is also very critical, as focused and determined by various number of
researches (Monteith et al. 2013) – that not only the knowledge but rather the level of
experience and expertise of the working professionals and the supportive staffs is vital to the
success of the mental health delivery campaign and the overall impact of a mental health
delivery campaign – may it be in form of seminars or workshops, individual or group therapy

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– the most important facet is to understand the needs of the population and in this case – the
Mid-Ulster Association for Counseling & Psychotherapy (MACP) has indeed played a very
part in understanding, assessing and delivering the right mental health interventions – to the
Irish population in the north of Ireland and the nearby regions and the Mid-Ulster
Association for Counseling & Psychotherapy (MACP) has done it so far, by understand the
exact needs of the situation, dynamics and the population (O'Connor and Pirkis, 2016). The
very organization in the context, has put a special focus on the collective guilt and shared
imaginations of the affected people to design the right and apt workforce and technological
support framework in delivery of the mental health care delivery services.
Sampling
Cluster sampling method was used:-
Total number of participants – 20
10 participants formed the Focus group A
Inclusion criteria
Employees who has worked in the Mid-Ulster Association for Counseling & Psychotherapy
(MACP) for not less than 4 years
Age group of the participants – 30 to 50 years
Experience – has relevant experience of more than 5 years with suicidal prevention and
psychotherapeutic management.
Exclusion criteria
Employees who has not worked in the Mid-Ulster Association for Counseling &
Psychotherapy (MACP) for at least 4 years

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Age group of the participants – less than 30 or more than 50 years
Experience – do not have relevant experience of more than 5 years with suicidal prevention
and psychotherapeutic management.
10 participants formed the Focus group B
Inclusion criteria –
Experiences – the participants of focus group B must have received trauma therapy, talk
therapy, individual therapy, interpersonal therapy, anxiety and stress management or any
other form of counseling or psychotherapy for suicidal prevention from the Mid-Ulster
Association for Counseling & Psychotherapy (MACP) for at least 6 months
Age group – participants must be 20 to 60 years of age
Exclusion criteria –
Experiences – has not received trauma therapy, talk therapy, individual therapy, interpersonal
therapy, anxiety and stress management or any other form of counseling or psychotherapy for
suicidal prevention from the Mid-Ulster Association for Counseling & Psychotherapy
(MACP) for at least 6 months
Age – less than 20 or more than 60 years of age
Two different focus groups were formed in order to gain an insight into the suicide
prevention service delivery system by the Mid-Ulster Association for Counseling &
Psychotherapy (MACP) from the perspectives of the employees who deliver the services at
Mid-Ulster Association for Counseling & Psychotherapy (MACP) and from the perspectives
of those who receive the counseling services from Mid-Ulster Association for Counseling &
Psychotherapy (MACP).

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Ethical considerations
1. Informed consent – an informed consent was taken by the researchers of this study –
from all the participants. All the participants of this study was given the right to
withdraw the research at their own will or whenever they were not comfortable. All
the participants of this research participated at their own will and there was not force
or influence applied whatsoever by the researchers of this study, on the participants.
2. Equity – the resources of the research was distributed with equity and justice and
there was no bias presented by any researcher involved in the undertaking of this
research study.
3. Beneficence – As the research dealt with a sensitive area of depression and other
delicate mental condition in relation to suicidal ideations – care was taken to apply
only the moral principle of beneficence in all aspects of the research, while addressing
the needs and situation of the participants.
4. Disclosure – The information about the purpose of the research was not hidden or
kept from any participant and the same was disclosed at subsequent stages – to do
justice to the participants of the research and empower their autonomy.
5. Dignity – the esteem and the dignity needs of participants were maintained.
The syncytium of hope, desires and the level of emotions associated with the experiences
gained at every point of life is very much synchronous to the growth or deconstruction of a
personality and this, impacted by the experiences of the social and the socioeconomic
environment spanning the surrounding of an individual influences immensely the act of living
of a good life. Any fine derangement in the finer aspects of emotional and experiential
growth is directly proportional to the severity or degree of mental health that is affected by
the clinical, medical, social, cultural or the biological, demographic factors. Unfulfilled
emotions, feelings, desires and wishes leads to the formation of internal conflict complexes

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and this in addition with the inferior feelings of identity, self-image and self-concept has a
massive catastrophic effect on the experiences of life.
DATA COLLECTION
A semi structured interview was performed with each participants of each focus
group. Open ended questions were used to help the participants explore their reflection and
ideas without any barriers or boundaries. The interview duration was 15 minutes for each
participant and the interview was video recorded and a code was applied to each interview
after its completion.
5. Results and Analysis
A transcribed verbatim was performed and the data analysis was done until a
consensus was reached on the coding tree. Finally, after the researchers of the study
performed the thorough scrutiny of the responses of the focus group interviews in terms of
similarities and differences and a thematic analysis was done. Four themes were revealed by
the researchers of this study. The first two themes were derived from the analysis of Focus
group A and third and fourth theme was derived from the responses of the focus group B.
theme 1 ‘lack of the right workforce’ – in this theme, the participants of focus group A
pointed to the less or inapt numbers of specialist dialectical behavioral therapists and trauma
therapists in the organization that has led to the diminished quality of services provided by
Mid-Ulster Association for Counseling & Psychotherapy (MACP). Theme 2 ‘Lack of modern
day technology in assessment of suicidal tendencies’ – under this theme, the employees of
Mid-Ulster Association for Counseling & Psychotherapy (MACP) identified the misbalance
between the human workforce and the right blend of modern day technology in
psychotherapeutic assessment and management of suicidal tendencies. Theme 3 ‘Lack of
humanistic needs understanding’ – the participants of focus Group B identified an area of

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COUNSELLING AND SUICIDE PREVENTION
lack of empathy and lack of exact humanistic needs from their perspectives by the counselor
or psychotherapist at Mid-Ulster Association for Counseling & Psychotherapy (MACP) –
which has impacted the overall level of mental health care delivery in prevention of suicidal
behavior and improvement of the quality of life. Theme 4 ‘ Lack of proper assessments’ – the
clients of the Mid-Ulster Association for Counseling & Psychotherapy (MACP) have pointed
to less amount of therapy time and very less assessments being conducted by the
psychotherapists and counselors at Mid-Ulster Association for Counseling & Psychotherapy
(MACP) and this has been identified as one of the major factors in decreased or diminished
quality of suicide prevention services delivered by the Mid-Ulster Association for Counseling
& Psychotherapy (MACP).
The Mid Ulster Association For Counseling and Psychotherapy has also organized
and still organizing the various workshops, seminars and social dinner to strengthen its reach
and network that ideates towards controlling and managing of mental health cases and
prevention of suicidal cases. As a matter of fact, exploring into the understanding of
childhood traumas leading to development of suicidal tendencies, clinical depression and
suicidal ideations and exploring further into the understanding of post-traumatic stress
disorder which is popularly abbreviated as PTSD (Slovak, Pope and Brewer 2016) -has given
or rather provided the scientists and researchers of this field with the various explanations
into and about the re – emergence of painful and agonizing memories ( challenging the self-
concept and self-identity of an individual, many years after) that actually leads to the
inception of self harm or self destructive behaviors have been very much reported to be
associated with the suicidal ideations. This is where the association and research into the
childhood memories of an individual in relation to painful or traumatic memories has been
explained by the psychoanalytic theory to be major precursor and predisposition into the
development of depression, behavioral and personality problems leading to the development

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COUNSELLING AND SUICIDE PREVENTION
of suicidal tendencies (Janetius and Govindarajan 2017). As for psychodynamic theory – the
unconscious drives such as hidden motives, fear and wishes – pass through a repressed
phases before surfacing and resurfacing under same or similar type of circumstances with the
similar social or psychological – intrinsic or extrinsic stimulus has been able to trigger or
retrigger the long forgotten emotion associated with the past experience (Allchin, Chaplin
and Horwitz 2019). This then modifies or alters the human behaviors and actions to the
immediate surroundings, under the present current scenario with new set of people around but
the old, past sets of experiences – reemerged under the influence of an old memory or a
related old trauma. This can surely be handled by the right set of people and the right mix of
educated and experienced professionals who has the right skills and knowledge to address the
emotional and behavioral needs of a person. The various types of interventions such as talk
therapy, interpersonal therapy and individual therapy has been used as a wide range of tools
to get rid of the suicidal behaviors in addition to the addressing of the behavioral and the
emotional needs of the person.
This research study finds out that although there has been various development in
terms of psychotherapy and in terms of the sheer motive that organizations like Mid-Ulster
Association for Counseling & Psychotherapy (MACP) which has intended and as matter of
fact delivered sound and innovative counseling and talk therapies in prevention of suicidal
attempts amongst the Irish people in the nearby regions – but there has been various levels of
challenges and barriers to the delivery of these sociological and psychological interventions
by the Mid-Ulster Association for Counseling & Psychotherapy (MACP). Starting from the
workplace and workforce disruption to the untested ways of program delivery has impacted
the level of quality services by the organization itself. The institution needs to increase its
networking and the connections with the other similar organizations in order to provide the
much needed impetus in terms of mental health awareness amongst the Irish people residing

23
COUNSELLING AND SUICIDE PREVENTION
the nearby regions and other distant places as well. according to the participants who took
part in the study and these participants who are either worked for the Mid-Ulster Association
for Counseling & Psychotherapy (MACP) or has received services from the Mid-Ulster
Association for Counseling & Psychotherapy (MACP) has elucidated the same fact that the
modern day psychotherapy services must be coupled with the folk medicine ( that is
complementary and alternative ) CAM system of Ireland in order to incorporate and integrate
the mental health services to the people with suicidal ideations and attempts (Darvishi et al.
2015). The focus groups also made a point about the right mix of skilled workforce that has
diversity in terms of psychotherapeutic services and the sociological services, they have to
offer - as an important method of treating the suicidal ideations amongst the people of
concerned population in the right way. According the above mentioned study about United
Kingdom and the north of Ireland – the axis 2 disorders are also the major precursor in the
development of suicidal ideations and the suicidal misconducts amongst the people of
Ireland. Although as per the revelations of the participants focus groups - Mid-Ulster
Association for Counseling & Psychotherapy (MACP) has somehow being able to able to
manage the axis 1 disorders more effectively than the axis 2 disorders of DSM and this
marked difference in the management of mental health conditions amongst the Irish
population has created a certain imbalance in the overall management or service delivery
impact on the total incidents of suicidal ideations from trauma, post-traumatic stress disorder
and other deep seated emotional or rather from a age related psychosocial problems (Ewing et
al. 2018). The administrative challenges included the lack of very skilled workforce who are
educated enough to handle or rather assess the population condition well. The social
determinants of health – indeed play a very pivotal role in development of these mental
health diseases and especially education, the level of awareness about a prevention of specific
disease in addition to the overall accessibility to the level of health service ( quality health

24
COUNSELLING AND SUICIDE PREVENTION
service received) actually play a great role and a very vital role indeed in the persistence and
severity presentation of these dire mental health condition and diseases leading to suicide and
self harm conditions. There was revealed by the researchers of this student that lack of right
technological support and the overall audit systems to counter the deficient areas of mental
health administration – has impacted the suicide control and population’s mental health
management in a very negative and in an adverse way. The research also identifies other
factors such as social and cultural conflicts amongst the people of the concerned population
as the major reasons in the undercurrents of deteriorating mental health status of a certain
social group and of all the individuals who are a part of it. Political unrest leading to civil
unrest has been also identified as critical barriers in the delivery of mental health care
services by the Mid-Ulster Association for Counseling & Psychotherapy (MACP). As
elucidated by many members of the Mid-Ulster Association for Counseling & Psychotherapy
(MACP) who participated in the research study – the right workforce with the right mix of
sociologists and psychologists are required and regular trainings must be provided to the
employees and the direct workforce as an important means of staff development in
prevention of suicidal attempts amongst the concerned population, in a more clinical way.
The mental health professionals across the world have increased their repertoire of dealing
different pathophysiology of neuropsychological and purely psychological basis. The
increase in the number of stress and anxiety cases – whether it rises from lack of employment
or lack of perceived love and affection – has made the quality of life much diminished
compared to the full potential with which a life should be dealt with. The organization helped
the population of Northern Ireland and nearby regions with family support and the right
approximate social intervention support to the development and incorporation of a self-
righting and self-healing process. Other than the specialist psychological and counseling
services – the Mid Ulster Association For Counseling and Psychotherapy delivers the right

25
COUNSELLING AND SUICIDE PREVENTION
socio cultural framework support to attain correction of human behaviors and remodeling of
the right cognitive patterns.
6. Discussion
The researchers of this study recommends increased research uptake by the
administrators of this Mid-Ulster Association for Counseling & Psychotherapy (MACP) in
order to perform the ‘assessment’ and find out the rather important assessment needs in
context with the different mental health conditions associated with physical comorbidities or
persisting alone without any physical co-morbidities. Not only the psychological and
humanistic needs of different age groups of the population are to be determined but also the
social and financial needs of people with suicidal ideations are to be strengthened by the Mid-
Ulster Association for Counseling & Psychotherapy (MACP). The social and framework of
the individual undergoing traumatic life changes or following a bereavement experience –
needs to be strengthened by the Mid-Ulster Association for Counseling & Psychotherapy
(MACP) and for this activities and services – more social workers who are culturally
competent, more social activists and sociologists and counselors are to be recruited by the
Mid-Ulster Association for Counseling & Psychotherapy (MACP) organization to makeshift
the suicidal ideation prevention and management amongst the concern population of United
Kingdom that has been referred to – continuously in this research study. The study transfers
its findings to higher researches and different other populations for confirmation of its
validity and for improvement of social situation in relation to attempts of suicide and
development of depression disorders amongst the people of a certain population. While the
Mid-Ulster Association for Counseling & Psychotherapy (MACP) excels in management of
the behavioral and social disorders but it lacks the right services and the right skilled
workforce and technology in management of personality and developmental, as revealed by
the study. hence more developmental and child psychologists has to be recruited and trained

26
COUNSELLING AND SUICIDE PREVENTION
in a social context – by the Mid-Ulster Association for Counseling & Psychotherapy (MACP)
in order to better the quality of their services and have a more better social impact.
The social determinants of health – indeed play a very pivotal role in development of
these mental health diseases and especially education, the level of awareness about a
prevention of specific disease in addition to the overall accessibility to the level of health
service ( quality health service received) actually play a great role and a very vital role indeed
in the persistence and severity presentation of these dire mental health condition and diseases
leading to suicide and self harm conditions. According the above mentioned study about
United Kingdom and the north of Ireland – the axis 2 disorders are also the major precursor
in the development of suicidal ideations and the suicidal misconducts amongst the people of
Ireland. The DSM axis 2 disorders consists of the major personality disorders such as the
anti-social ideations, the narcissistic disorders and the developmental mental health disorders
like the Attention deficit hyperactivity disorder also known as just ADHD and mental
retardation which is often considered more medically as a neuropsychological disorder or the
condition leading to disruption of sane, logical through proves, cognitive distortions and more
severe mental health afflictions like suicidal and the self harm tendencies. The study also
draws a correlation or rather a clinical research based correlation between the age of the
individual and the chances or probability of affection with the mental health disorder as given
in axis 1 or axis 2 of the DSM categorization of mental health disorders (Sun 2016). The
study based on Northern Ireland and the nearby regions identifies that the suicides due to the
axis 1 disorders occurs generally in males after the age of 3 years and that those of same
gender under or less than the age of 30 years is more likely due to the axis 2 disorders (that is
chiefly due to the personality and the more complicated developmental disorders).
Personality disorders, has also been elucidated by the study to occurring at an age of
14 years or even lesser and this has an deleterious effect on the awareness of living of a well

27
COUNSELLING AND SUICIDE PREVENTION
thrived life and the counseling, talk therapy and the joint collaborative support of the teachers
and the seniors, parents play a very critical role in prevention of the suicidal tendencies at and
around this sensitive and delicate developmental age of 14 years and lesser (Wilkinson et al.
2018). The trauma, abuse and the post-traumatic stress disorder are some of the most focused
areas of care – delivered by The Mid Ulster Association For Counseling and Psychotherapy.
In Northern Ireland – the rate of suicide has shown increased number of cases in the recent
era – due to increase in the number of mental health disorder predispositions and related
dysfunctions plus derangements. According to a study by Foster, Gillespie and McClelland
(2018) – there are some interesting facts revealed about the Irish population in north of
Ireland and these were that ninety per cent of suicidal ideations and suicidal events taking
place in the country of Ireland has a direct correlation with DSM axis 1 and axis 2 disorders.
DSM axis 1 disorders include the major symptoms of depression (Selby et al. 2010),
obsessive compulsive disorder, cocaine and other substance abuse and the history of
bereavement and alcohol substance abuse (Kleiman, Law and Anestis 2014). Now, these
mental health condition are to be considered as the major situations that are involved in the
general public – given the psychosocial tension and the psychological distress – an individual
or a group of individual (such as a social group) has to go through, on a daily day to day
living – given the high level of competition for resources of living and a better type of well-
being. The behavioral plus the emotional state of mental condition as shown in the axis 1 of
DSM is common not only in the population of north Ireland but in the whole of united
kingdom in addition to the whole of the globe as well and this has been strictly raised due to
the fact that there is an increased level of conflicts between the every two individual or two
social group in a more complex social and sociological dynamics prevalent in the modern
societies of modern world.

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COUNSELLING AND SUICIDE PREVENTION
The various types of traits and characteristics involved in the behavioral and personal
development of an individual are the various important facilitators and barriers in phases of
human development and they act as important ‘accelerators’ in progress or decline in the pace
of the life. This affects the overall quality of life and the stress plus anxiety play a very
critical role in countering the positive experience of life. The various psychological programs
at school, university, organizations, community and urban levels are nowadays run by the
service providers and the administrators of the organizations to maintain and heal the mental
health condition of the students, employees and the general citizens of the country. In United
Kingdom, the number of depression, anxiety and stress is increasing and the cases of Mental
Health diseases have been increasing in the states and community areas of United Kingdom.
The work related stress, developmental and lifestyle incidences occurring as daily day to day
events and the increase in the sociocultural framework complexity of class, power and
hierarchy has challenged the experience of life at different levels and has deteriorated the
overall awareness of happiness and satisfaction associated with the spending of life. The
financial, economic and social status of the family in which an individual lives or the
individual is a part of - affects immensely the perception of happiness, sadness and
satisfaction plus the very experience of the living of a good life. The suicidal tendencies
affect not only the life of an individual but of the individuals around the suicidal ideated
person and the quality of life of theirs as well. In the study ‘Mental disorders and suicide in
Northern Ireland’ - The psychiatric comorbidities are another set of important clinical
correlations that are associated with the development of suicidal tendencies and the suicidal
ideations in young adolescents or the young teens who are more likely to be affected by the
alcohol and other drug affections at around this age group. Hence, the methodology of the
study is directed at understanding the developmental needs of individuals and its relation with
suicidal ideation (Leong and Leach 2010).

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COUNSELLING AND SUICIDE PREVENTION
Taking more on the humanistic side of psychological therapy - Mid-Ulster
Association for Counseling & Psychotherapy (MACP) has helped thousands and hundreds of
civilians so far to grow through the most negative and adverse situations of life – without
attempting to taking their own lives or falling into the darkness of emotional sadness and
depression related mood and personality disorders. The Mid-Ulster Association for
Counseling & Psychotherapy (MACP) works to the optimum and maximum level of effort
and positivity with its relentless effort of fund raising and donations and grants from and by
involving the right people who have an endeavor for the social service and the one who has
the right motive of helping the people out of depression, behavioral and personality issue to a
better living of a quality life (Soomro et al. 2015)
According to Maslow’s hierarchy of needs which is the humanistic needs theory of
psychology – there are physiological needs such as food drives, thirst drives, sex drives
which represents the base level of humanistic theory is followed by the safety needs for
security, property and economic stability and this level is followed by the love and belonging
needs (which includes friendship, intimacy, family and the sense of connection) and this is
the stage, which has been reported by many researches – where the derangements in
emotional context begins although it can occur at other levels as well. This stage of
Maslow’s hierarchy of needs is followed by the drive or rather a quest of self-esteem, respect,
status, recognition, recognition, freedom, authority and the strength and this is stage where
males have been reported to be more involved in social and socio – emotional derangement
than the overall population of females and this stage where emotional derangement to suicide
occurs – is more proportional and dependent on male or masculine traits than the feminine
traits. The overall Trait theory in addition to the psychodynamic and the humanistic theory
play a very critical role in the emergence of counseling styles designed chiefly to address
either the humanistic, behavioral or personality needs in addition to emotional, esteem or

30
COUNSELLING AND SUICIDE PREVENTION
cognitive distortion in a very particular and a very differentially specified way. The last stage
of humanistic needs – is self-actualization where a person becomes fully cognizant of his full
abilities and identifies the potential of his actual self and the very actualization of this state is
itself therapeutic to many mental health diseases including depression, sadness, anxiety and
self-image distortions leading to the suicidal ideations and many other complex psychosocial,
psychological and neuropsychological problems persistent and present in an individual. The
purpose of the research study is to understand the gaps left in the humanistic services
delivered by the Mid-Ulster Association for Counseling & Psychotherapy (MACP).
7. Conclusion
Hence, it can be concluded saying that the stress and anxiety are one of the most complex
clinical precursor of psychological involvements of individuals and with increase in intricacy
of human lives and increment in the quantity of complexities of assets – for which human
challenge is rising each day – has likewise added to the raised number of emotional and
psychological cases all through the globe. The expansion in the number of stress and
personal, behavioral impairment cases is being managed by the Mid-Ulster Association for
Counseling & Psychotherapy (MACP). The counselors and mental health experts over the
world has expanded their range of services in managing of distinctive pathophysiology of
neuropsychological and severe levels of mental health distress – from various viewpoints and
alternate points of view of psychological well-being administrations – there has likewise been
an expanded difficulties to the conveyance of these administrations (regulating the physical
and emotional well-being of individuals) which are of monetary, money related, social and
conduct birthplace. Notwithstanding these difficulties, different kind of managerial and
national legal barriers have presented themselves to the effective or ideal conveyance of these
psychological well-being care benefits in a network or an urban situation.

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COUNSELLING AND SUICIDE PREVENTION
Various psychological events occurring at different stages of life in a broader sense has
different impacts on the psyche of an individual and the overall memory of the event or the
fact that the individual is not being able to overcome it or surpass the feelings of it by the
experience into the greater horizon of understanding, consciousness and holistic
understanding of life - has also been attributed to be as the perfect ideations towards suicidal
thoughts and the actual happening of suicidal event. Counseling and the talk therapy is one of
the most well-known ways of dealing with the same array of mental health situations where a
person is involved in a self destructive thought, self harm behaviors, delusion, hallucination,
paranoia, fear and a resultant state of deep seated clinical depression. Various governmental
and non-governmental organizations has been involved in United Kingdom, to deliver the
right services (mental health services) to the appropriate population which is affected
demographically or developmentally with clinical depression and development of suicidal
ideations.
The three dynamic forces of psychology such as the psychoanalytic approach,
psychodynamic approach and the humanistic approach have provided the medical and
physiological framework of different countries (starting from the first world countries to the
third world countries) – the necessary tools in the field of mental health assessment and
services along with the necessary spectrum of knowledge needed to make the general public
and the professionals aware – about the development of various clinically important mental
conditions and the various ways of dealing with it (Foster et al. 2015)
It has been seen and reported by the researches of this study that increased networking by
the Mid-Ulster Association for Counseling & Psychotherapy (MACP) and increased
recruitment of skilled workforce in terms of trauma care specialists, dialectical behavioral
therapists and interpersonal therapists is increasingly helpful for increased quality service by
the Mid-Ulster Association for Counseling & Psychotherapy (MACP). Mid-Ulster

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COUNSELLING AND SUICIDE PREVENTION
Association for Counseling & Psychotherapy (MACP) needs to take care of the social needs,
economic needs and the humanistic needs of the client from a very client-centered individual
therapy perspective in order to deliver more meaningful experiences to the clients who has
suicidal ideations. The organization based on Northern Ireland has dedicated members, staffs,
employees, experts and volunteers to address the social and the psychological parameters of
depression amongst the Irish people and they extend the necessary social and the
sociocultural services in management of trauma and resultant depression amongst the Irish
people (Ribeiro et al. 2016). Loss of personal family member or loss of a loved one through
death and expiry can lead to depression and a bereavement support becomes essential to the
addressing of these cases and Mid Ulster Association For Counseling and Psychotherapy
extends the right support in these circumstances as well. They have the right set of organized
people and workforce to go with the right blend of technology to assist the mentally ill patient
bordering on emotional and personality disorders to prevent them from the incidents of life
threatening events and suicidal impacts. The organization addresses psychologically
challenged young males and females or the ones affected with psychosocially adverse
situations with career and trauma informed psychological care. Mid-Ulster Association for
Counseling & Psychotherapy (MACP) must also incorporate and integrate its services with
the traditional Irish medicine in order to counter the suicidal developments in the concerned
population and the address the exact needs of the people. According to the needs depicted in
the thematic analysis of the study – the assessment needs are to be fulfilled by the workforce
of the Mid-Ulster Association for Counseling & Psychotherapy (MACP) in order to deliver
more holistic, more meaningful suicidal prevention and increased quality of life experience to
the clients at Mid-Ulster Association for Counseling & Psychotherapy (MACP).

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COUNSELLING AND SUICIDE PREVENTION
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