Tim O'Malley (Limerick East, Progressive Democrats)

I welcome this opportunity to discuss the report of the Joint Committee on Health and Children, The High Level of Suicide in Irish Society, and to outline the measures which are being taken by my Department, in conjunction with the Health Service Executive and the many community and voluntary organisations involved, to address the issue of suicide in Irish society.

The joint committee sets out detailed recommendations that have been based on written submissions to it, as well as presentations by a range of statutory and voluntary groups, academics and researchers. These recommendations, 33 in all, include practical interventions and research priorities. Suicide is a serious problem in this country. Data from the Central Statistics Office indicates that between 2000 and 2003 there were, on average, 495 deaths by suicide in Ireland annually, peaking at 519 in 2001. In 2004 there were 457 registered deaths by suicide and in 2005 there were 431. This represents a rate of 11 per 100,000 population. Of particular concern is the rate of youth suicide in Ireland, which was the fifth highest in the European Union for 15-24 year olds in 2004. Sadly, the rate is even higher in Ireland among young men in their 20s and early 30s.

Deliberate self-harm is also a significant public health problem. According to the National Suicide Research Foundation, more than 11,000 cases of deliberate self-harm present to Irish accident and emergency departments each year. Deliberate self-harm rates are highest among women and the younger age groups, peaking for girls aged between 15 and 19 years and for young men aged between 20 and 24. The joint committee recognised the need for the provision of nurse-led liaison psychiatric services in A&E departments. I am pleased to inform Deputies that the National Office for Suicide Prevention made additional resources available in 2005 to put in place experienced psychiatric nursing staff in A&E departments to respond to deliberate self-harm presentations. Further investment is being made in 2006 to ensure all A&E departments have a service to respond to such presentations.

The joint committee report suggests that suicide is a societal problem and that those that are, or who perceive themselves to be, disenfranchised or marginalised are at greater risk. The report identifies the close relationship between suicide and mental illness, especially those with psychotic illnesses who have a 10%-15% risk of dying by suicide. The role of alcohol in suicide and suicidal behaviour is highlighted. These findings are echoed in Reach Out — A National Strategy for Action on Suicide Prevention, which was launched in September 2005.

The joint committee recommends that young people be consulted about mental health services and service development. This area was also identified in Reach Out. The National Office for Suicide Prevention is exploring ways of reaching young people through e-mail, texting and instant messaging, in order to develop a sustainable programme of action which can be funded in late 2006-07 onwards. The national office will consult young people, voluntary organisations and those using technology to reach out and provide services. This work is currently being scoped and will be reported on later this year.

As regards the putting in place of a sustainable anti-stigma and positive mental health promotion campaign, which is also recommended in the joint committee report, I am pleased to inform the Dáil that the National Office for Suicide Prevention is planning a national mental health promotion campaign to take place early in 2007. The aim of this campaign is to address the stigma relating to suicide and mental health which are serious barriers to seeking help. The campaign will be whole population based initially, but as it develops over time more targeted and local campaigns will be initiated. The National Office for Suicide Prevention has looked at the Scottish "See Me" campaign which is beginning to have an impact on public views of mental health.

The joint committee recommended a target of reducing Ireland's overall suicide rate by 20% by 2016. As part of the Reach Out strategy, consideration was given to the setting of an overall target for the reduction of our national suicide rate as an outcome measure of this strategy. At this stage, it has been decided that a specific target will not be set because the priority is to establish the accuracy of suicide mortality in Ireland. The range and inter-play of factors that influence the suicide rate mean that a direct cause and effect relationship between prevention programmes and a change in the overall population rates is virtually impossible to establish.

Nevertheless, there are undoubted advantages to setting targets for an overall reduction, not least that it focuses the attention of those working at all levels of suicide prevention. An overall target for the reduction of suicide rates will be set by the Government, on the advice of the Minister for Health and Children, when suicide rates have been accurately determined.

As we are all aware, there was in the past a reluctance to even discuss the issue of suicide. Thankfully, this situation has now changed. In Ireland, the level of discussion and openness on mental health issues, including deliberate self-harm and suicide, has increased significantly in recent years. This is a very welcome development. However, we must ensure that public discussion and media coverage of suicide and deliberate self-harm remains measured, well-informed and sensitive to the needs and well-being of psychologically vulnerable and distressed individuals in our society. In particular, we need to continue to work as a society to create a culture and environment where people in psychological distress feel able to seek help from family, friends and health professionals. A strategic framework is required to assist all of us in identifying actions we can undertake in a co-ordinated way, through partnership between statutory, voluntary and community groups and individuals, supported by Government.

Reach Out builds on the work of the National Task Force on Suicide and takes account of the efforts and initiatives developed by the former health boards in recent years. It recommends a combined public health and high risk approach. This approach to suicide prevention is also advocated by the International Association for Suicide Prevention and is in keeping with the European action plan for mental health which was signed and endorsed on behalf of ministers of health of the 52 member states of the European region of the World Health Organisation at the ministerial conference on mental health in Helsinki, Finland in January 2005. The Health Service Executive is taking a lead role in overseeing the implementation of the strategy, in partnership with those statutory and voluntary organisations that have a key role to play in making the actions happen.

Following the publication of the strategy, the HSE established the National Office for Suicide Prevention. The role of the national office is to coordinate suicide prevention activities across the State, consult widely in relation to the planning of future initiatives, and ensure best practice in suicide prevention.

The report of the expert group on mental health policy, A Vision for Change, which was launched in January 2006, highlights the importance of mental health promotion in the prevention of mental health problems through the development of coping and problem-solving skills, help-seeking and resilience. It also recommends that mental health promotion should be available for all age groups to enhance the protective factors and decrease risk factors for developing mental health problems. The recommendations in the report have been accepted by Government as the basis for the future development of the mental health services. In the region of €800 million will be spent on mental health services in 2006, up from €433 million in 2000.

This year an additional €26.2 million funding was provided to further develop our mental health services. This included €1.2 million specifically for suicide prevention initiatives. In addition, earlier this week the Government approved the allocation of almost €1 million from the dormant accounts to fund 20 projects providing suicide prevention supports. The key objective of this funding measure is to provide interventions and supports to strengthen community based initiatives, particularly, although not exclusively, those targeting young men under 35 years of age. The intention of the funding is to support locally-based initiatives supporting suicide prevention. The projects approved are varied and include the provision of early intervention measures for those at risk and also the provision of services for those bereaved through suicide.

This Government shares the public concern about the levels of suicide. I thank the members of the Joint Committee on Health and Children for their work in preparing the report on the high level of suicide in Irish society. We all have our part to play in helping those who may experience and face adverse events in life, and emotions and feelings so strong that they consider taking their own lives. We must aim to provide accessible, sensitive, appropriate and, where required, intensive support.

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