Kathleen Lynch (Cork North Central, Labour)

I thank Deputy Neville for raising this important issue. It is not the first time he has done so and given his commitment to the subject, I dare say it will not be his last. At the outset, I note that just this morning, the Minister for Agriculture, Food and the Marine, Deputy Coveney, and I launched a leaflet on behalf of Shine and the IFA in respect of farm stress. While one sometimes is inclined to think of this issue as only pertaining to one particular group, it affects everyone in all sectors of society.

Over the years, all Members have been aware of deliberate self-harm but few realised the extent of the problem. It is difficult to imagine that 9,630 individuals, representing 11,966 presentations, presented to emergency departments in 2010 having self-harmed. It also is worrying that one fifth of all deliberate self-harm presentations were due to repeated acts. It also is important to recognise the aforementioned figures do not include those who engage in self-harm but who never present to an emergency department. Deliberate self-harm is a serious issue and it is hard for many people to understand the despair of a person who engages in deliberate self-injury. International studies have found self-injury to be one of the most significant risk factors associated with suicide and those who engage in self-harm are 20 times more likely to die by suicide eventually. Moreover, studies have shown that at least one third of all suicides have a history of self-injury. I believe early intervention with people who engage in deliberate self-harm would prevent some people from continuing to self-harm and could prevent some deaths by suicide. Several initiatives are ongoing and in development that take account of the recommendations of the recently published national registry of deliberate self harm report for 2010.

The National Office for Suicide Prevention, NOSP, is working to progress a more unified and consistent response to self-harm presentations in emergency departments. A self-harm awareness training programme is also being developed which will be rolled out nationally in the coming years, beginning next year. The HSE clinical care national lead on mental health is working with key stakeholders to develop a uniform approach to self-harm assessments in emergency departments in order that all those who present will receive the most appropriate care and treatment. In addition, a pilot project is under way in the Cork Hospital Group to train all appropriate clinical staff in self-harm and suicide management and it is planned that in due course this will be rolled out to other hospitals. The NOSP has also funded a number of suicide community assessment nurses, SCAN, who work primarily with GPs to provide early intervention services jfor clients in suicidal crisis and thus avoid admission to hospital. A number of voluntary organisations also provide services for those who self-harm.

The total annual funding available to support suicide prevention initiatives is in the region of €9 million. This includes the annual budget of €4.1 million for the national office, with the balance of €5 million used to fund resource officers for suicide prevention, self-harm nurses in hospital emergency departments and the development of local suicide prevention initiatives. The additional €1 million provided for the national office this year is being used to develop the number and range of training and awareness programmes, improve and standardise the response to deliberate self-harm, develop the capacity of GPs to respond to suicidal behaviour and ensure helpline supports for those in emotional distress are co-ordinated and widely publicised.

I acknowledge there is great commitment in many sectors to tackle this serious health and social issue. The Government's commitment to the development of mental health services in line with A Vision for Change and Reach Out was clearly shown in the programme for Government which provides for the ring-fencing of €35 million annually within the overall health budget to develop community mental health services, ensure early access to more appropriate services for adults and children and implement Reach Out, the suicide strategy within A Vision for Change. We must all continue to work together - researchers, policymakers and service providers - to identify people at risk and ensure appropriate services are in place to provide the help and support needed. Everybody recognises that this is a crisis issue within communities and the Government will do its very best to address it.

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