Dr. Philip Dodd:

Deputy Neville inquired about the high level of suicide in the 2011 period. That is very much reflective of international trends in suicide rates, which are directly related to periods of recession. A direct impact is seen on restrictions in public services and personal income that significantly impacts on people's ability to maintain positive well-being. That is very much reflective of research across the world. In the UK, for example, suicide rates have just been published for 2018, which shows a small increase. Many commentators, both within the research and clinical setting, feel they are directly related to fears around the impact of Brexit on the economy in the UK.

There was also a point about elevated levels of self-harm among young people between the ages of 15 to 19 years. The NOSP funds the national suicide research foundation that is based in Cork. We are lucky in Ireland to have a very important data source, which is the national self-harm register. It is the only national register monitoring self-harm in the world. In fact, its annual report is about to be published tomorrow. It shows a 6% rise in self-harm rates in 2018. There is a rise in self-harm rates across all of the age groups, but repeatedly in recent years there are elevated rates of self-harm in young people. I think that possibly reflects the fact that we are seeing a rise in self-harm rates across many western European countries. We are not necessarily different in Ireland to other countries.

We are probably seeing a change in prevalence rates of mental illness across western European countries. A recent European survey comparing various European countries in rates of depressive illness showed that Ireland, unfortunately, was presenting with a particularly high level of depressive symptoms. The reason is multifactorial; there are lots of different reasons. When one looks at the detail of the self-harm rates, unfortunately, the involvement of street drugs in the 2018 rates is showing a significant increase, including cannabis and cocaine among young men. They are taking overdoses of those street drugs that seem to be associated with a rise in self-harm in recent years. Any discussion associated with the liberalisation of cannabis needs to take into account that in other countries where that has happened, there has been a significant impact on increasing the levels of self-harm rates. In recent years in Ireland we are seeing an increased rate of self-harm associated with cannabis and cocaine use.