Tim O'Malley (Limerick East, Progressive Democrats)

I welcome the opportunity to make a statement in this House concerning the level of suicide in Irish society. Suicide is a serious social problem in our country. In 2003, the number of registered deaths in Ireland attributed to suicide was 444. This high incidence of suicide in the population is not confined to Ireland but is a growing global problem. A disturbing feature is the male suicide rate which accounted for 80% of deaths from suicide in 2003. In particular, young males and older males aged 65 years and over have shown an increase in the rate of suicide. These are trends which require further research so that strategies can be developed to help people who are particularly at risk.

As the suicide figures began to increase back in the early 1990s, my Department became aware of the need for reliable and concrete information on which to build a national strategy to address the problem of suicide in Ireland. The national task force on suicide was therefore established in 1995 to address the growing prevalence of suicide in our society. The task force comprised 15 individuals from a range of backgrounds, including the coroner service, the Garda Síochána, nursing, psychiatry, psychology, public health and many voluntary organisations.

In September 1996, the task force published its interim report. It contained a detailed analysis of statistics relating to suicide and attempted suicide in Ireland and a preliminary analysis into the factors that could be associated with suicidal behaviour. The task force's final report was published in January 1998 and marked the completion of 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. The report also identified the various authorities with jurisdiction in suicide prevention strategies and their respective responsibilities.

While the level of suicide among our young people continues to give cause for concern, it is important to point out that youth suicide in Ireland is not the highest in the European Union. The most recent analysis suggests it is fifth highest. In terms of the overall suicide rate, Ireland ranks 17th in the European Union. Recent figures suggest that the rate has stopped rising, but it is correct that we probably experienced the fastest rising rate in Europe during the 1980s and 1990s, albeit from a low base rate.

The key components of the overall strategy recommended by the national task force in 1998 included the implementation of measures aimed at high risk groups, provision of information, training on suicide prevention for relevant professionals and organisations and the improvement of services which would benefit those at risk of suicide and those who attempt suicide. Since the publication of the report of the national task force, there has been a positive and committed response among both the statutory and voluntary sectors towards finding ways of tackling this tragic problem.

Significant progress has been made in a number of different areas, including the appointment of a suicide resource officer in each Health Service Executive area; the establishment of the national suicide review group, the National Suicide Research Foundation and the national parasuicide registry; the appointment of liaison psychiatric nurses to accident and emergency departments in many general hospitals; the provision of training for relevant health care personnel with regard to suicidal behaviour — this training is ongoing in all Health Service Executive regions; the enactment of legislation restricting the availability of medications which can be used to overdose; the development of a social and personal health education, SPHE, programme which is now compulsory for all junior cycle students in secondary schools; the publication of a directory of services in each Health Service Executive area for those who may be at risk of suicidal behaviour; and the development of a new form 104, which is the form on which the Central Statistics Office figures are based. A Garda inspector within each division has been nominated to oversee the use and completion of the form.

These are just some examples of the progress which has been made to date. Much more detail about various initiatives under way throughout the country can be found in the annual reports of the national suicide review group which are laid before the Houses of the Oireachtas each year. Many of the recommendations of the task force require continual development, particularly in the area of training and in the enhancement of our mental health services.

The Health Service Executive, in particular, has a major role to play in co-ordinating efforts to help reduce the level of suicide and attempted suicide. Resource officers have been appointed in all the health service regions with specific responsibility for implementing the task force's recommendations. Their responsibilities include the provision of staff training in risk assessment, production of information literature and events aimed at raising public awareness of suicide and parasuicide.

Another important aspect of suicide prevention has been the establishment of the national suicide review group. Membership of this group includes experts in the areas of mental health, public health and research. Its main responsibilities are to review ongoing trends in suicide and parasuicide, to co-ordinate research into suicide and to make appropriate recommendations. The group's researchers also collate existing research materials, both national and international, examine the effectiveness of intervention programmes and liaise with local co-ordinators.

Ongoing strategies and prevention programmes throughout the country are regularly reviewed by the national suicide review group and routinely commented on in its annual report. This report meets the requirement of the Health (Miscellaneous Provisions) Act 2001 which provides that the Minister for Health and Children will make a report each year to each House of the Oireachtas on the measures taken by health boards in the preceding year to address the problem of suicide.

The Department also allocates funding through the NSRG to 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 the 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 health strategy, Quality and Fairness — A Health System for You, included a commitment to intensify the existing suicide prevention programmes. I am pleased to report that work is well under way on the preparation of a national strategy for action on suicide prevention. The strategy, which is being prepared by the project management unit of the Health Service Executive in partnership with the national suicide review group, is supported by the Department of Health and Children. Work on the development of the strategy was initiated almost two years ago. Almost 700 people have attended regional and national consultation meetings since then and submissions have been sought in the national press. A national and international expert group of 16 people reviewed the strategy during the last two weeks of April and their analysis is being incorporated in the strategy.

The national strategy for action on suicide prevention that will emerge from the consultation process will take account of the input of external reviewers and the dedicated writing team. It will be of a high quality, it will focus on action and it will be based on evidence. It will highlight some actions which should be of immediate priority. The strategy will set targets for implementation over the next five years, as well as long-term objectives for suicide prevention and mental health promotion. I have met Dr. Rosaleen Corcoran, who is leading this process, on a number of occasions. I am pleased to inform the House that the strategy will be published in September of this year.

The national strategy's fundamental aims will be to prevent suicidal behaviour, including deliberate self-harm, and to increase awareness of the importance of good mental health among the general population. The strategy will emphasise the need for ongoing multidisciplinary research of a high quality. Research findings are of greatest value when they inform and stimulate action and service development. The strategy will identify expected outcomes and set targets which can be measured, monitored and revised. Continuous quality control and ongoing modification and improvement will be central to the implementation of the strategy.

Deputies may be aware that the President, Mrs. Mary McAleese, recently hosted a forum in Áras an Uachtaráin for groups and stakeholders working on suicide prevention. The theme for the gathering was integration and partnership, in acknowledgement of the increasing fragmentation in the suicide prevention field and the need for leadership and coherence at national level. Such issues will be addressed in the context of the new national strategy. A document that summarises the discussion at Áras an Uachtaráin, Suicide in Ireland — Everybody's Problem, was launched earlier this week. It was compiled by Dr. Tony Bates, who acted as rapporteur at the event. The theme of the report, as its title suggests, is that co-operation and involvement across the entire community is required if we are to reduce suicidal behaviour. The President has expressed her interest in continuing to support efforts in this regard. I welcome her involvement.

If we are to reduce the number of suicides, it is essential that people with life crises get appropriate support. In that context, expenditure on suicide prevention programmes has increased significantly in recent years. The Department of Health and Children has given special attention to the resourcing of suicide prevention initiatives in the last few years. The level of funding provided by the Department of Health and Children for suicide prevention is more than 20 times greater than it was in 1999. Since the publication of the report of the National Task Force on Suicide in 1998, more than €17.5 million has been provided for suicide prevention and research aimed at improving understanding of the issue. That figure does not include funding provided by other Departments, including the Departments of Education and Science, the Environment, Heritage and Local Government and Justice, Equality and Law Reform, which were identified in the National Task Force on Suicide's report as having a role to play in suicide prevention.

Additional funding has been given to the National Suicide Research Foundation, a multidisciplinary research centre that informs health service developments and policy formulation. The foundation, which was established in January 1995 by the late Dr. Michael Kelleher, consists of a multidisciplinary research team of professionals from a broad range of disciplines, including psychology, psychiatry and sociology. The primary aims of the foundation are to define the true extent of the problem of suicidal behaviour in Ireland, to identify and measure the factors which induce and protect against suicidal behaviour and to develop strategies aimed at preventing such behaviour.

To date, most of the National Suicide Research Foundation's work has involved the monitoring of parasuicide. Annualised data on every suicide and undetermined death registered in Ireland is sent to the foundation by the Central Statistics Office. The statistics are analysed to produce up-to-date age-specific and age-standardised suicide rates, with respect to demographic variables. Such information about suicide is provided in response to the numerous requests the foundation receives from professional bodies, students and the public.

The promotion of high levels of self-esteem and self-confidence among young people will take place as an important aspect of the suicide prevention programme. We need to ensure that such people develop personal and social skills. I welcome the debate on this issue. It is important for public representatives to discuss mental health issues and the incidence of suicide. That people are aware of the problems which exist is a sign of the wonderful advances which have taken place in our country. I compliment the many voluntary organisations throughout the country — I will not name them because there are so many of them — which contribute enormously to the positive mental health scene.

I was present in the Seanad for its recent comprehensive and constructive three-hour debate on mental health and suicide. I look forward to the contributions of my Dáil colleagues during this debate. It is healthy to discuss this matter, especially as the stigma and taboo which attached to suicide prevented people from talking about it in the past. If we work together to prevent suicide and promote positive mental health, we will make a greater collective contribution to ensuring that suicide levels stop increasing, as they have already done. When the expert group publishes the national strategy later this year, I hope it recommends measures which will ensure the levels of suicide decrease. There is a need for much more recognition of the importance of positive mental health in the community.

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