Seán Ó Fearghaíl (Kildare South, Fianna Fail)

I congratulate the Minister of State, Deputy Kathleen Lynch, on her appointment to the Department. In her years in this House she has been one of a number of Members who have demonstrated a clear and genuine commitment to the area of disability and mental health issues. I agree with the point she made at the outset, that this is an area where we need to build consensus across the political divide. In the Joint Committee on Health and Children, of which she, Deputy Neville and I were privileged to be members in the last Dáil, this was an area where consensus existed. We should not lose that and must build on it.

In this House we have spent hours discussing the banks and the financial crisis which is, of course, both worthwhile and necessary. However, there is a human side to the recession which is entirely tangible. Suicide rates have increased and for people touched by such a tragedy its effects will stay with them for much longer than will those of the financial crisis. That is why it is imperative that suicide prevention remains a key pillar of public health policy

Most of us know a person who has died by suicide or we have a friend or relative who has lost someone close to them by suicide. Recently, at a very small social event in my constituency, I looked around and was conscious there were three families present who had lost young sons through suicide. In the past week in my constituency clinics I met two families in which two members of the same family had been lost. For those left behind there is sometimes guilt, always anguish and, in many instances, very many unanswered questions.

People take their own lives for many reasons but they do so because they are in intense pain and they want that pain to stop. There are a number of myths current about suicide that need to be dispelled. These include the idea that if someone wants to take his or her life there is nothing that can be done. Research clearly shows that medical assistance and professional intervention can help those in crisis and can deter them from taking their own life.

Another myth is that if a person develops suicidal tendencies he or she will forever be suicidal. That is not true. Many people take their own lives on impulse and suicidal feelings can be short lived. The EU consensus paper on prevention of depression and suicide states that, "adequate treatment of major mental disorders ... decreases the risk of suicide and is an effective way to prevent suicide in healthcare". Those struggling with depression and anxiety sometimes feel that their death would bring relief for themselves and their loved ones. Nothing could be further from the truth. Suicide is the ultimate waste of precious human life. The bereavement it causes shatters the lives of those left behind.

Suicide is a massive public health issue throughout the world. Globally, a person dies from suicide every 40 seconds. The National Office for Suicide Prevention has not released statistics for last year but we know that, officially, 527 people took their own lives in 2009, an increase of 24% on the previous year. It is probably reasonable to assume an increase will be recorded in 2010, given the impact the financial crisis has had on people and also because of the impact of pervasive negativity in many elements of the national media on people in their day to day lives.

In 2009, 78% of those who died by suicide were male. Although Ireland has the sixth-lowest rate of suicide in the EU among its total population we have the fourth-highest rate of youth suicide in the EU, behind Lithuania, Finland and Estonia. Young men between the ages of 16 and 34 are the highest risk category and this is deeply worrying.

Contrary to many people's perceptions, depression is a very common condition that affects one in ten people at any one time. It does not discriminate in age, gender or background. Depression impacts how a person thinks and feels as well as on energy and behaviour. It can have a dramatic affect on a person's home and working life and personal productivity. Many people who experience a period of depression will get the help and support they need and will move on with their lives. Others feel isolated, do not discuss their problems with anybody and cannot imagine ever feeling better again.

Some months ago The Irish Times weekend supplement had a series of articles from people who had lost loved ones to suicide, for which I compliment the newspaper. One story in particular caught my eye and deeply affected me. It was by a middle-aged lady who had married her college sweetheart. This man had started to experience depression relatively late in life and, with the encouragement of his wife, had sought help. However, the prospect of going into hospital to seek medical help as recommended by his GP was so disturbing to him that eventually he took his own life.Commenting afterwards, his wife remarked he would have felt no shame had he needed treatment for heart failure, cancer or any other condition. It is deeply worrying there is still such stigma in Irish society around depression.

The former Minister of State with responsibility for mental health and disabilities, John Moloney, worked tirelessly to champion the issue of suicide and mental health and I believe his work was recognised. During his time in office he introduced the See Change campaign, referred to by the Minister of State, Deputy Lynch. This is an alliance of organisations working together to bring about positive change in public attitudes and behaviour towards people with mental health problems. See Change tackles stigma through a targeted community-driven approach, designed to change how mental health problems are perceived. As part of the campaign, figures in the public eye have come forward and talked openly about their experiences with depression. I commend the public figures who have participated and led this initiative. The campaign has also involved television advertising, townhall meetings, seminars and public meetings and involves local groups and first-person accounts of mental illness.

There is no better example of this within the world of politics than that of the former Norwegian Prime Minister, Kjell Magne Bondevik, who addressed a cross-party group on mental health in the Oireachtas some years ago about his own depressive episode while in office in 1998. Mr. Bondevik left office for a number of weeks in order to deal with his illness. He then returned to work and went on to win a second term as prime minister, with increased electoral support. In his own words he had "hit a wall" and he decided to take the unprecedented step of being up-front about his illness. Explaining the background to it, he indicated his incident was related to his inability or failure to deal with significant bereavements within his family and social setting. Mr. Bondevik took this brave decision in order to avoid speculation about his condition and to combat the stigma surrounding mental health issues in general.

I congratulate the new Minister of State on her recent appointment and I hope that she will continue to support the See Change campaign. It is vital that we create an environment where people are more open and positive in their attitudes and behaviour towards mental health. We all need to connect with young people, young men and boys in particular, in their communities, in sports organisations and in schools, to encourage them to be open and talk about their emotions and to look after their individual mental health. Fianna Fáil in government established the Office for Disability and Mental Health, which has a remit across four Departments. Likewise, we set up the National Office for Suicide Prevention, which is responsible for overseeing and implementing "Reach Out", a national strategy for action on suicide prevention which runs over a ten year period.

There is no single problem that causes people to take their own lives, likewise there is no single approach that will in itself tackle the problem of suicide in Ireland. We need a whole series of approaches by a range of actors. Reach Out involves coordination and cooperation between statutory, community and voluntary groups and individuals and requires Government to ensure that its targets are met. It means a multi-sectoral approach to the prevention of suicidal behaviour to foster cooperation between health, education, community, voluntary and private sector agencies. It is vital there is cooperation and coordination between the many players in the voluntary sector and those who have a statutory function.

Despite the very challenging economic environment we faced, funding for mental health and disabilities was largely preserved in the last budget. This is commendable, especially when one considers the scale of the cuts across many Government Departments. In recognition of the seriousness of the problem, an extra €1 million was provided in the last budget for the National Office for Suicide Prevention to fund training and awareness programmes to reach the most vulnerable and for helplines for those in distress. It was also designed to develop the capacity of primary care to respond to suicidal behaviour and consider new models of response. The Minister of State is aware of the work of the last Oireachtas Committee on Health and Children and Deputy Neville in strongly advocating for the roll-out of a network of primary care facilities across the country. We were all ad idem that mental health services must be at the centre of those primary care centres.

A Vision for Change has been our template for reforming and reconfiguring the mental health service. This document has received cross party support and I was delighted to learn the new Government will continue to implement this strategy. It is estimated that the total cost of implementation is €150 million; perhaps the new Minister of State will outline how they will fund this policy in future given the enormous demands on the health budget.

I commend the Minister of State for continuing the last Government's commitment to placing those with mental health problems into more appropriate community settings. For a long time, there was talk of putting those with mental health difficulties into a community care setting but for many in the early stages of that process, it meant abandonment in the community. Significant progress has been made in this regard. There are no longer acute admissions to the outdated facilities of St. Brendan's in Grangegorman and St. Senan's in Enniscorthy and these will be replaced by modern and more appropriate facilities. Work is also due to commence on a new psychiatric unit in Beaumont Hospital and another unit in Clonmel.

International evidence shows that good community-based mental health services are linked with lower suicide rates when compared with traditional hospital-based treatment. Cooperation will be needed, therefore, between the new Minister of State with responsibility for primary care and the Minister of State if we are to make progress in this area.

The issue of placing children in adult psychiatric facilities has been in the press recently. Again, progress has been made in this regard. Work is due to start this year to increase the number of beds in St. Vincent's Hospital in Fairview and work is already underway on the Linn Dara child and adolescent mental health facility in Cherry Orchard. Bed capacity has increased from 12 beds in 2007 to 52 at present and will reach 58 beds by 2012. The recommendation under A Vision for Change is for 108 adolescent beds but this target is being reconsidered given the emphasis on community-based care. Perhaps the Minister of State can tell us if she is committed to delivering 108 beds as recommended.

As the Chairman of the Oireachtas Committee on Health and Children in the last Dáil, I can say with confidence that the subcommittee on suicide prevention worked extremely well and I am sure the members, Deputy Dan Neville, former Deputy Charlie O'Connor and Senators Mary White and Phil Prendergast would agree with me. There is a strong case to be made for something similar to be set up in the new committee structure which will be announced next week. I call on the Minister of State to ensure a subcommittee on suicide prevention is established under the auspices of the committee on health.

I conclude by praising the work of the voluntary sector in this area. Organisations like Aware, Amnesty, Grow and many more provide an amazing service on the frontline to those suffering from depression and their families. Without them communities and the HSE would be lost. I also commend Deputy Dan Neville, who has championed this cause for many years now and who has ensured that it has remained on the political agenda. The Oireachtas and the country owe Deputy Neville a debt of gratitude for his enormous contribution to the mental health debate and for his work in suicide prevention.

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