Seán Power (Kildare South, Fianna Fail)

I thank my colleague, Deputy Tim O'Malley, for sharing his time, thereby providing me with the opportunity to speak on the important issues of suicide prevention and mental health promotion in Ireland.

Some time ago I received a copy of the book Echoes of Suicide. It is an excellent read for anybody with an interest in the subject and gives a great insight into the different aspects of suicide and the devastating effect it has on those left behind. I acknowledge the interest in the subject of Deputy Neville, who contributed to this book. He mentioned in his article that it was in the 1990s that we discussed the matter in detail for the first time in the Oireachtas.

I thank the Deputies who have contributed to this debate. There is broad agreement on the need for further development of suicide prevention initiatives and for further improvement in the delivery of our mental health services.

As we are all aware, suicide is a serious social problem. The report of the national task force on suicide, published in 1998, marked the completion of a detailed examination of the incidence of suicide and attempted suicide, and outlined a comprehensive strategy to reduce these in Ireland. The report outlined 86 areas where interventions should be targeted to reduce suicide levels. This highlights the complexity of the issue of suicide prevention. There are no simple solutions.

Taking action to prevent suicide must involve a combination of efforts across many aspects of life, such as improving health and educational services, but also addressing issues such as social exclusion and tackling poverty and inequalities. This action must involve people from a range of different organisations and professions with sustained effort over a long period of time.

With regard to improving health services, the task force report recommended that steps be taken to make mental health services more accessible to the public, particularly young people. Concern was expressed at the risk of suicide in older people. In this regard significant additional funding has been made available to further develop consultant-led child and adolescent psychiatry and psychiatry of later life services to assist in the early identification of suicidal behaviour and provide the necessary support and treatment to individuals at risk.

The level of capital funding which has been made available by the Department for the development of community based mental health facilities has increased significantly in recent years. Community services such as home nursing, day centres, family support, hostels and day hospitals will continue to be developed to make services more accessible to people who may be at risk.

The prevention of illness and the promotion of healthy living is the key to improving the quality of life of all Irish people. The promotion of positive mental health is a vital part of this process. Many people try to buy their way out of the unhappiness brought on by not having enough time to spend with families and friends or doing things they enjoy. Investing in one's mental well-being is as important as looking after one's physical health.

Statistics show that the ratio of male to female suicide is approximately 3:1. However, when we look at the figures from the point of view of depression, far more women suffer from depression than men. We must bring about a major change in this area. From the point of view of depression, if men or women have something like the flu they have no difficulty in seeking medical assistance, but if they suffer from severe depression males are much more reluctant to share those feelings with people much less seek medical help. A major change must take place.

Prevention of illness and promotion of healthy living is the key to improving the quality of life for all Irish people. They must be encouraged to invest in their mental health as much as in their physical health. In this regard, a key task of the health services is not only to treat mental illness but more importantly, using the principles of health promotion, to try and improve the mental health of the population. We are all aware of the pressures on young people such as bullying, emotional distress, addictions, peer pressure and exam pressure. We tend to think people are weak if they suffer from anxiety, depression, inability to cope, or have suicidal tendencies but it is widely acknowledged that one in four women and one in ten men will experience depression during their lifetime. Many are successful people, role models or celebrities whom we all know.

Promotion of positive mental health will also contribute significantly to combating the ignorance and stigma that surrounds mental illness. Better understanding of mental illness encourages people to access professional help sooner rather than later and this facilitates early recovery. Eventually, with time and education, the stigma associated with mental illness may fade further away, allowing sufferers and their families to participate fully in society.

The World Health Organisation's European section, in partnership with the European Union and the Council of Europe have adopted an action plan that will drive the policy agenda on mental health for the coming years. This action plan, signed by Ministers from 52 countries, including Ireland, sets out the commitments and responsibilities of both the WHO and Governments on this issue. It has 12 priority areas, with a strong public mental health focus, including the promotion of mental well-being, incorporation of mental health as a vital part of public health policy, reduction of stigma and discrimination, prevention of mental ill health and suicide and access to good primary health care. The national strategy for action on suicide prevention to which my ministerial colleague Deputy Tim O'Malley referred earlier and the forthcoming report of the expert group on mental health policy will take full account of this plan in its recommendations.

There is increasing awareness and concern among the public about good mental health. The National Health Promotion Strategy, 2000-05, in conjunction with the health strategy, Quality and Fairness - A Health System for You, views good mental health as being equally as important as physical health in the overall well-being of a person. Increasingly, good mental health is being recognised as a major challenge facing health services in the 21st century and my Department recognises the need for positive mental health promotion.

Mental health promotion is a broad concept, as it emphasises promotion of the psychological health and well-being of individuals, families and communities. At national level, priority is being given to education awareness and to promoting a better understanding among the public towards mental health. The stresses and pressures associated with every day life combine in many cases with difficulties in coping with significant life events such as bereavement, unemployment and interpersonal relationship problems. Almost every family in Ireland has had or will experience mental illness. Mental illness does not just affect the sufferer it also affects the person's family, friends, employer and colleagues. To experience a relative, friend or employee who suffers from a mental illness can be confusing and traumatic.

As my ministerial colleague, Deputy Tim O'Malley, stated, the expert group on mental health policy was established in 2003 to prepare a new national policy framework for the mental health services. In the course of its work, the expert group will consider all areas of mental health policy. It will pay particular attention to the areas of mental health promotion and the importance of raising public awareness around the issues of stigma reduction and suicide prevention. The group will make recommendations on these issues when it reports later this year.

As many of the activities in the area of suicide prevention relate to raising public awareness, responding to local needs and providing support in the aftermath of the occurrence of suicidal behaviour, the health services work closely with local voluntary and community groups in a number of ways. It is often the case that people are more comfortable engaging with these local groups. It is, therefore, essential that the statutory services work in partnership with the voluntary groups rather than developing competing services.

I emphasise the importance of voluntary organisations in supporting and promoting positive mental health among the population. My Department is fully committed to working with voluntary groups to promote positive mental health among the public. Close links between the mental health services and voluntary organisations are of the utmost importance and every health area has a development officer who liaises between the statutory health services and the local mental health associations to provide an integrated and comprehensive service. Numerous regional initiatives also focus on mental health issues like stress management, depression, stigma reduction and suicide-related matters.

My Department funds and supports in a variety of different ways the efforts of mental health organisations such as Mental Health Ireland, AWARE, Schizophrenia Ireland and GROW. I pay tribute to the voluntary organisations. Much of their work goes unnoticed. The nature of the work means it must be handled sensitively in private. Many people are giving their time voluntarily as we debate this issue to answer telephones, listen to people's problem and provide them with comfort. Very often, people only want a listening ear so that they can share a problem. It is important that people are prepared to give their time in an unselfish way to assist others who are less fortunate than they are.

My Department also allocates funding, through the national suicide review group, for voluntary and statutory groups engaged in prevention initiatives, many of which are aimed at improving the mental health of the younger age groups. These projects include life skills courses for high risk youth, school-based personal development modules and mental health promotion campaigns. A number of these projects have been positively evaluated and have been proven to enhance the coping skills of the participants. It is anticipated that such campaigns will lead to a reduction in youth suicidal behaviour over time.

The success and effectiveness of the policy to develop a comprehensive community-based mental health service is dependent on the active involvement of voluntary organisations concerned with the welfare of the mentally ill and those at risk of suicide and attempted suicide in the community.

I welcome the opportunity to emphasise the Government's commitment to encourage in any way it can, the activities of our many voluntary organisations both at national and local level. The commitment and dedication of independent, voluntary organisations is to be commended and their input is invaluable, not only in providing support for those most vulnerable in our society, but in heightening awareness of the difficulties encountered by those suffering from mental illness, depression or feeling unable to cope with everyday life.

I assure the House that the Government is committed to addressing the number of suicides. It is a worrying trend and we are fully committed to the further implementation of suicide prevention initiatives and the further development of our mental health services to prevent and reduce further tragic loss of life. I am delighted to have had the opportunity to contribute to the debate. I hope it will send a message to people who are feeling suicidal that suicide is not the avenue to take. While it might seem to people who are in a black hole that it is the only option open to them, unfortunately, suicide creates greater problems than it solves. Groups and organisations are willing to listen them, take their hands and lead them through the difficult time they face. There is always light at the end of the tunnel.

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