Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Molaim na Teachtaí Neamhspleácha as an rún a chur os comhair na Dála. Is práinneach an cheist í seo agus tá dualgas ar gach duine sa saol poiblí díriú uirthi. Tá díoma orm, áfach, le leasú an Rialtais. Ní leor é agus tá súil agam tar éis na díospóireachta seo go mbeidh an Rialtas féin ag díriú i gceart ar cheist an fhéinmharaithe.

I commend the Independent Deputies for using their Private Members' time to address the very serious issue of suicide. It is an urgent issue about which everyone in public life must be concerned. I wish to pay tribute to Deputy Dan Neville for his courageous and consistent address of this issue over the years of my representation in this House.

The motion sets out the stark statistics. By far the most striking is the fact that suicide is the most common cause of death in Ireland for those in the 15 to 24 age group. We all know the reality behind the statistics and I doubt if there is a Teachta Dála who does not know a young person who has taken his or her own life or a family bereaved by such a tragedy. Indeed, I am sure we all know of multiple cases and the terrible tragedy visited on families and whole communities, and the dark clouds that have come over homes and communities throughout the length and breadth of our country that do not dissipate lightly. I am all too familiar with the grief that is visited on individuals, families and communities by the tragedy of suicide and the extended tragedy of recurring, apparently connected suicides.

All of that places a serious obligation on everyone in politics and in public administration to concentrate on this problem and co-operate in its effective address. Government has a special responsibility as it is in the power of Government to take measures that can directly impinge on this serious issue of our time. Those measures are clearly necessary if the problem is to be addressed in a coherent and effective manner. In that regard, I am disappointed with the Government's amendment because it clearly reflects on the very little that is being done.

We have to place the issue of suicide in the overall context of mental health. While not everyone will be comfortable with that, it is very important we recognise it is the context in which it needs to be addressed though not by any means exclusively. It is in the framework of mental health services that the State needs to address the issue of suicide.

There is an immediate problem in that mental health is by far the most neglected sector in our health services. Despite the fact that one in four people will suffer from some form of mental illness at some point in their lives, the budget for mental health as a proportion of the overall health budget has consistently fallen through the years. The standard explanation is that over the past 40 years we have moved from a model of institutional care, which confined large numbers of people with mental illness and which took a large slice of the health budget to maintain. There has been a very welcome move away from what was, in effect, the imprisonment of the mentally ill. The new care in the community approach spearheaded by those at the coalface of psychiatric services in my constituency of Cavan-Monaghan must be commended as essential and welcome.

The people continuing to develop the service deserve our praise and support. The problem is that a sufficient proportion of funding was not maintained to support alternative mental health services. The fact that there are not comparable numbers in institutional care now should not have meant a decreased budget. We need to maintain services and continue to invest more to mirror and aid the success we have seen. The main concentration must be on the areas of education, prevention and counselling.

Despite advances in treatment and attitudes, there is still a significant social stigma associated with mental illness. People are reluctant to acknowledge to others that they have mental health problems such as depression. There are very few of us who could not put our hand up at some point in our lives and say that to some degree we feel low. We must remove the stigma and provide courage and support to people. The first step to be taken is to be prepared to speak about depression. This is most especially true of young people, especially boys and young men, for whom it is the most challenging step of all.

AWARE addressed the issue in its report on suicide published in 1998. Other Deputies may already have quoted from it, but I am especially taken by it. It is very important to record aspects of the report.

The attitudinal shift that AWARE believes society needs to go through, if it is to effectively address suicide prevention, is only likely to come about by addressing the issue in or before the early teenage years. Development of positive attitudes to mental health coupled with acquiring skills in problem solving and building self-esteem are likely, over the medium term, to result in significant change in help-seeking behaviour by those with psychological distress, and to provide a more positive approach to these problems by people beginning careers in the caring professions.

The key phrase is "significant change in help-seeking behaviour". I have no doubt that many lives will be saved if that is achieved. We hear it said often that many people in our society are voiceless. The tragedy of suicide is often that those who take their own lives feel they are without a voice to speak or a friend to listen to them in their trouble. We must get the message to young people in distress that there is a way forward and provide essential resources for accessible education, advice, counselling and treatment.

AWARE's 1998 report summarises very well the complex, causal factors that contribute to suicide. Psychiatric disorders, usually depression or an intoxicant problem, are present in 90% of people who take their own lives. Not everyone who suffers depression, however, goes through the act of suicide or even attempts it. AWARE speaks of a domino effect with the three components depression and related disorders, dramatic losses in life and, finally, the added depressing effect of alcohol or illicit drug use. AWARE's recommendations, of which I will cite three, are reflected in the number of recommendations of the 1998 task force on suicide.

First, AWARE recommends a dual approach to suicide prevention, an immediate range of interventions focusing on those considered to have a high suicidal risk, a longer term strategy directed at public attitudes to suicide and its causative factors and the development of programmes within schools. Second, AWARE recommends the development of a health partnership whereby the health services, voluntary bodies, the workplace and schools review, monitor and implement preventative strategies in the area of public health, including suicide prevention. Third, AWARE recommends a significant emphasis on addressing public attitudes to mental illness, enhancing awareness of depression and its improved treatment in general practice, reducing the impact of life crises such as employment loss and personal relationship breakdown, including media reporting of suicide events and increasing efforts to address suicide among young men and the elderly.

The national task force on suicide reported in 1998 and made a very wide and comprehensive series of recommendations. That very few have been implemented is very clear from the inadequate Government amendment to the motion. Even in the key area of research on suicide in Ireland, not enough is being done. I commend the issue for address by the widest body of public debate possible. It is an issue that requires open and accessible discussion. Many organisations could consider hosting or sponsoring events that focus greater attention on suicide. I encourage strongly local organisations to give time to this subject.

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