Dáil debates

Wednesday, 14 October 2009

Photo of Dan NevilleDan Neville (Limerick West, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this issue. I commend the Irish Examiner on its contribution to the debate on this subject and for its advance over the past days. I am drawing from information received at the 13th Annual Conference of the Irish Association of Suicidology held on 1 October, the theme of which was, Surviving Recession: Promoting Mental Health and Preventing Suicide. The Minister of State was very kind to attend and officially open the conference and to launch guidelines.

Research going back to the 1890s demonstrates suicide and mental illness increase at times of recession. The World Health Organisation, WHO, stated earlier this year: "It should not come as a surprise that we continue to see more stresses, suicides and mental disorders." The director of the WHO also stated: "There is clear evidence that suicide is linked to financial disasters. I am not talking about the millionaire jumping out of the window but about poor people." The potential psychological impact of economic recession on public health is severe. Job loss, job insecurity, job uncertainty, economic strain, loss of income, home repossession and restricted access to credit lead to a reduction in mental well-being, an increase in mental health problems and mental ill-health, increased substance misuse, especially alcohol and drugs, and intimate relationship breakdown and divorce. There is a loss of perceived social worth. There is a loss of purpose and daily structure, reduced social contacts and an increase in social isolation. An increased risk of suicidal behaviour occurs, both non-fatal self-harm and completed suicides.

People who are unemployed are two to three times more likely to die of suicide than those in employment. This high rate is partly because people with psychiatric illness are at a greater risk of losing their jobs. There is an association between unemployment and suicide. However, even among people with no record of serious mental illness, unemployment is associated with a 70% greater suicide risk. Prospective individual level studies show that unemployment has a causal influence on depression and suicidal thinking.

Job insecurity is associated with a 33% greater risk of common mental disorders, mainly anxiety and depression. People with mental disorder are more likely to be in debt than those who have no mental disorder. A United States research document indicates that a loss of income rather than low income was associated with suicidal ideation. In Hong Kong, 24% of all suicides in 2004 concerned people in debt.

Alcohol consumption rises during recessions, and this correlates with suicide. The figure for the 1990s in this country was a 44% increase in alcohol consumption and a 41% increase in suicide.

Analysis of suicide rates in Latvia during a period of massive economic and social change showed that the sudden decline in GDP was associated with a rapid increase in suicide. In Russia, mortality, especially suicide, increased substantially after the economic crisis in 1989.

I put it to the Minister that in times of recession there is a need for the State to respond to this problem. A little over €3 million has been given to the National Office for Suicide Prevention. I put it to the Minister of State that a modest €10 million to meet this crisis is not too much to ask.

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
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I do not want to respond by way of the prepared to reply. I acknowledge the major contribution of Deputy Dan Neville to this area. I attended the conference in Limerick to which the Deputy referred and I saw at first hand the huge amount of respect shown to him for his involvement. I want to say that again publicly, and will continue to say it.

Rather than just read out the reply it is important to tell the House that at long last a director has been appointed to drive forward reform on mental health. I am pleased to tell the House that the person concerned is Martin Rogan. I wish him well. Since coming into this Department I have always believed that a director should be in place. It is also important to say that we cannot hang everything on the director's shoulders in terms of driving the reform programme. All of the issues raised by Deputy Neville are relevant also.

The next process is for the director to sit down with the 14 regional clinical directors throughout the State and drive forward the commitments and the recommendations in A Vision for Change. It has been made clear to me in the Department in recent months that people are not satisfied with the pace of reform, and I want to recognise that also.

The next part of the process must be to put together the capital programme to deliver what is contained in A Vision for Change. It is also important to be proactive, and in January I will be coming forward with a national programme on the issue of stigma. I had intended doing that in December.

I will not give a full account tonight but I am pleased to tell the House that I took up many of the points raised by Deputy Neville when I chaired the health committee, which did a review of the high incidence of suicide levels, the subject of this Adjournment matter.

I accept the point that when we compare the investment in the reduction of suicide levels, and this point has been made by Deputy Neville and many others, to the funding allocated to the road traffic area, for instance, it is obvious that the level of funding is not the same. I have put a proposal before Government for the forthcoming budget on the issue of trying to determine how we can best use the funding of €4.5 million that is currently available; an additional €1 million was dedicated. It is also important to tell the House that on Monday last I was in Trinity College dealing with young people who brought forward their proposals on being more aware of their mental health and mental well-being. I intend involving all of the local radio stations and local print media in a direct localised campaign to deal with the issue of stigma.

I acknowledge the points raised by Deputy Neville. There is no doubt that the recession is putting greater stress on individuals, families and communities. I meet individuals and representative groups every day, and many people have expressed particular concerns and fears about the impact the recession is having on their lives. I welcome the opportunity to debate the issue and to confirm that at the conference organised by Deputy Neville's group, the professor from the United Kingdom who was the first speaker and whose name I forget-----

Photo of Dan NevilleDan Neville (Limerick West, Fine Gael)
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Professor Platt.

Photo of John MoloneyJohn Moloney (Laois-Offaly, Fianna Fail)
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-----went on to show specific and clear evidence of the effect of a downturn in the economy, not just in this country but throughout the world. The figures were obvious. Unemployment and high stress levels unfortunately lead to serious mental health issues.

We are here to discuss the impact a recession and unemployment may have on suicide rates. I will not contradict anything that has been said. Our financial difficulties do not in any way dilute the Government's commitment in the area of mental health reform. Deputies will be aware of the greatly increased funding base for mental health services that has been built up over recent years. Overall spending on mental health services in 2007 and 2008 amounted to an estimated €1 billion annually. I do not intend simply to go through figures in the House because that can be more annoying than anything else but I want to be able to show in the coming two to three months that regarding the Government's commitment to delivering the mental health reform programme, A Vision for Change, I intend doing a public appraisal some time in January.

By way of acknowledging what has been done I will be writing to all the people who had an input into A Vision for Change to ask them to make me aware of the barriers they have encountered in delivering the reform programme. I look forward to giving more information on that in more detail in a future debate.