Dáil debates

Thursday, 14 April 2011

Suicide Prevention: Statements (Resumed)

 

11:00 am

Photo of Mary Mitchell O'ConnorMary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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The incidence of suicide presents a real and growing problem. There were 527 deaths by suicide in 2009. This figure shows a worrying trend and represents a real tragedy in homes throughout the country. Unfortunately, this trend increased in 2010. Figures for the second quarter of 2010 show there were 127 deaths by suicide. This may only represent a small increase of 4% on the figure for the same period in 2009, but it is an increase nonetheless and each individual suicide represents a tragedy for a family and a community. Our focus must be on reducing the figures as a matter of urgency.

There is a need to address the underlying problems that lead to suicide such as alcohol and drug abuse, bullying and eating disorders. A recent UNICEF study of young people in Ireland found that more than half of teenagers between the ages of 16 and 20 years had experienced bullying. While I acknowledge many of our schools are running excellent anti-bullying courses and Professor Mona O'Moore from Trinity College has been highlighting the effects of bullying among young people, much more needs to be done in our schools, homes and communities.

While the suicide figures are shocking, the incidence of suicide is vastly under-reported, due in large part to the stigma surrounding mental health issues. In April 2010 See Change commissioned MillwardBrown Lansdowne to conduct a study of Irish attitudes towards mental ill health. One of the findings highlighted the problem of stigma. While seven out of ten Irish people believe anyone can develop a mental health problem, one in two would not want others to know if he or she had such a problem. The stigma around mental health issues is especially important for young people, many of whom are afraid to talk to someone about their problems.

In that context, I commend the new initiative by O2 and Headstrong, a community-based youth mental health service. The project is called Share a Happy Thought and encourages young people to share positive thoughts on Facebook and Twitter. For every happy thought O2 will donate €1 to support the provision of mental health services for young people. This is a worthwhile initiative both in terms of funding - the project could raise up to €200,000 for mental health services - and also being a great way to use social networking to raise awareness among young people of mental health issues and the services available to help them.

Much has been written about how the current economic climate has increased the risk of suicide. Unfortunately, this theory is confirmed by the 2009 figures for deaths by suicide which show a 15% increase on the figures for 2007. We need a multifaceted approach to dealing with suicide and depression. The programme for Government aims to reduce the pressure on families which are struggling to meet mortgage repayments. The upcoming jobs initiative is designed to reduce the very high unemployment figures which are, no doubt, contributing to high rates of mental health problems. However, our main focus must be on providing access to mental health services for communities.

Amnesty International has welcomed the Government's plans to prioritise mental health. One of the issues Amnesty International highlights is the importance of dealing with mental health in the community setting. It calls on the Government to deliver on its commitment to improve access to modern mental health services in the community. Amnesty International cites international evidence which shows that treating mental health problems in the community setting, rather than in a hospital setting, has a much higher success rate. Many of the key barriers to mental health treatment, such as cost and stigma, could be reduced if someone suffering from mental health problems could avoid going to hospital and instead be treated in familiar surroundings in their own area. Amnesty International highlights that both the 1992 Green Paper on mental health and the 1995 White Paper, A New Mental Health Act, called for legislation which would enable the health service to provide access to comprehensive community-based services. We can no longer leave reports such as that gathering dust on shelves. We must act now to make the recommendations of those papers a reality.

There are already many excellent organisations working to prevent suicide in the community and voluntary sector across the country, alongside primary care teams and local health offices. One of the agencies supported by the National Office for Suicide Prevention, Mental Health Ireland, has its head office in my constituency of Dún Laoghaire. It is a national voluntary organisation overseeing 104 local mental health associations throughout the country run by health professionals and lay people providing care and support for the mentally ill within the community setting. The Dún Laoghaire-Rathdown outreach project also does great work in supporting individuals, families and communities affected by substance misuse - one of the major contributors to suicide in this country. Organisations such as those need our support. We must set up a co-ordinated approach to providing mental health services in community settings.

Before I refer to the Government's plan I wish to acknowledge the excellent work done by my colleague, Deputy Dan Neville, in this area for many years. He is president of the Irish Association of Suicidology. He has long been an advocate of greater supports for those affected by suicide and a stronger effort on suicide prevention. The programme for Government has committed to ring-fence funding of €35 million to develop community mental health teams and services. Part of the funding will be used to recruit additional psychologists and counsellors which will be integrated within primary care services.

Another positive development is the commitment by the Government to ensure that a comprehensive range of mental health services will be included in the standard insurance package under the planned universal health insurance scheme. Early intervention is key to reducing the risk of suicide and these measures will go a long way towards supporting community-based initiatives in treating mental illness and preventing suicide. I hope that the proposed reforms will take account of the organisations already working locally such as the ones I have mentioned in Dún Laoghaire. They are the people with the experience on the ground, who know intimately the mental health needs of the communities which the plans in the programme for government hope to serve.

Photo of Seán BarrettSeán Barrett (Ceann Comhairle; Dún Laoghaire, Ceann Comhairle)
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We now move on to the Technical Group. Deputy Flanagan will speak first, followed by Deputy Murphy, Deputy McGrath and Deputy Wallace. They are sharing time and have approximately four minutes each.

Photo of Luke FlanaganLuke Flanagan (Roscommon-South Leitrim, Independent)
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Thank you, a Cheann Comhairle, for giving me the extra 15 seconds. I could have sat down and done a massive amount of research on the subject and come to the House with figures but I decided to talk about my experience and that of my community, what suicide has done to it, what seems to have caused it and perhaps what are the solutions.

One often hears experts in this area talk about nature versus nurture. With the significant rise in the amount of suicides in recent years it is clear that the nurture aspect of the issue is the problem at the moment in this country. It is not a problem of nurture within the family; the problem is the lack of nurture from the State. The consequences of society falling apart socially and economically are that more people feel they do not have any choice but to take their lives. There are a variety of reasons for that, such as financial, due to the economy falling apart. People are afraid they are going to lose their house and that they will not be able to put food on the table. That makes people miserable and leads to a downward spiral.

One of the major problems in this country in terms of suicide is due to the thinking that is prevalent around the world that style is more important than substance and that if one is somehow different that one is fair game to get abused. We had an example of it in the Dáil Chamber today. When Deputy Boyd Barrett made a comment, a retort was made from the other side of the Chamber to the effect that his style of dress was not even good enough for a council chamber. What does it matter about how one looks, how big or small one is, how long or short one's hair follicles or what type of clothing one wears? That is irrelevant. It is a rotten message to send out from the Chamber.

We are all different. Some of us are a little bit more different. When I was going to school I was a little more different - perhaps I still am. So be it. I had to put up with jibes from people. It put pressure on my life and made me feel insecure about who I was as a person. Fifteen years ago I went to the doctor and told him I was feeling a little depressed. I could not really work out what was wrong. Since then I worked out that perhaps many people in society did not accept me for what I was. Fortunately, I have grown up since then and I do not really give a damn about what society thinks. I am who I am and I am proud of it. A lot of young people should take encouragement from that. One can be who one is. One does not have to be who they say one has to be in those stupid bloody magazines. Excuse my language but I hate them.

Photo of Seán BarrettSeán Barrett (Ceann Comhairle; Dún Laoghaire, Ceann Comhairle)
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That is unparliamentary language.

Photo of Luke FlanaganLuke Flanagan (Roscommon-South Leitrim, Independent)
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I am sorry about that. Apologies. I do not like the magazines. I cannot think of a word to describe them without going outside the parameters of parliamentary language. They tell people on the front page that it is all right to do this, that or the other but when one opens up the magazine a contradictory message is given. On the front page they say it is all right to be fat but on the inside page they say it is not. They give a lot of mixed messages and confuse people.

What are the solutions? We are not going to find them today but I hope that over the five year term of this Dáil we look for real solutions. We will not solve all the problems but we should adopt the policy of vive la différence because we are all different and we should respect that. If abuse is constantly thrown at Members because of the way they look, that will send a signal to young people that if they do not look the same as everyone else then there is something wrong with them when there is not.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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I too am very concerned about suicide. It behoves all of us to make a real and sincere effort to get to the root of the problem. I compliment Deputy Neville for his arduous work over many years in this area.

Suicide has touched many lives and is a tragedy for both the victims and survivors. It permeates through the wider family and into the community. Suicide is all too prevalent. Eight out of ten suicides in this country this year will be males. That is what the statistics tell us. I do not have great confidence in statistics because, as the previous speaker indicated, statistics on role models, for example, do not help the situation. Perhaps we need to have more humanity and understanding. We must ensure a greater appreciation of the importance of the human being no matter what role they take in life. We should value all people from a young age to those in old age.

The dominant fact of Ireland's suicide death toll is that it is overwhelmingly male. Any suicide, whether it is male or female, young or old, is a tragedy, but suicide on this island is mainly a killer of men, usually young men. I am concerned about the incidence of single vehicle road traffic accidents. Not enough investigation has taken place into them. Some of the deaths may be from suicide, especially where there are strange types of accidents.

We are very aware of the despair being caused by unemployment. This has been the case for decades. The Tipperary hurling team was buoyant after winning the all-Ireland final last year. Afterwards many of the players returned to unemployment, which was unheard of in previous years. We will have to tackle this in many areas. People who are idle may have too much time to think and may get into a rut and not mix with friends.

We must have campaigns that aggressively target depression in young men. The Choose Life campaign in Scotland has met with no small degree of success in reducing that country's suicide rate. It is good to see O2 and other organisations coming on board to make an effort. Given that young people spend so much time on social networks, it is good to see the benefits of social networks being explored.

A counselling centre in Peter Street in Clonmel opens on the first Wednesday of every month. It should be open for many more hours. I compliment the counsellors involved. Services such as theirs are needed in every town and in rural areas. There is much work to be done. In this regard, we should join Deputy Neville in trying to make a serious effort in this Parliament to address this most sad issue.

Photo of Catherine MurphyCatherine Murphy (Kildare North, Independent)
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The first step in resolving any problem is to acknowledge it. It is very important to have this debate. The interest in the debate has been an indication of the concern in all our communities. There is not a Member in the Chamber who cannot describe the impact of suicide on a community, particularly where a young person is involved.

We know young men between 18 and 24 are the most likely to commit suicide. We must bear in mind, however, that suicide is not confined to young people or one gender. Suicide does not just occur in poor economic circumstances because there was a very high rate of suicide during the better times. It is, therefore, a much more fundamental problem than might be supposed.

In 2009 in north Kildare, there was a series of tragic deaths by suicide. As it happened, the victims were mainly girls between 12 and 14. There was a complete sense of panic when the suicides occurred. There was profound sympathy for the families who were and still are coping with the tragedies. They will continue to do so. The suicides had an impact on the community. They occurred during the local election campaign, during which time we were going from door to door and could measure the precise impact. It was important for people to feel there was a measured response and that the situation was not being made worse. It is very important, therefore, that we proceed in a thoughtful and measured way.

For all the criticism the HSE, it did in other guises, put together a response. It had a health promotion day shortly after the aforementioned tragedies. I found this very useful. A group was formed on foot of the promotion day to promote mental health and minimise the risk of suicide. A youth drama project was launched that gave young people the space to articulate their emotions. Very often they feel there is no vehicle for them to do so.

I was very impressed with the north Clondalkin Community Action on Suicide group, which came to the promotion day and made an effort. It felt it gave people the space, confidence and freedom to talk, which is important.

Should it be a surprise that there is a stigma attached to suicide? One need only consider what was done in the early years of the State and prior to its foundation. People were often incarcerated, frequently by their families, when they had a breakdown. There is much work to be done to deal with stigmatisation, which is at the heart of why people are unwilling to talk about mental health issues. This must be addressed, including at community level, in a very meaningful way.

Photo of Mick WallaceMick Wallace (Wexford, Independent)
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The more one considers suicide and the various opinions on how we should better deal with it, it becomes pretty obvious there is considerable divergence of opinion on how we should do so. There are no easy answers. One gets the impression that the psychologists and philosophers have divergent views right across the board.

Three of my young under-16 players in Wexford, whom I knew well, committed suicide over the years. Two people who worked for me committed suicide. The most common characteristic of the five was poor communication skills and the inability to express oneself sufficiently. We need to work on this. There are no easy fixes. The manner in which youths are prepared for life is central to how they perform in life and deal with the problems that arrive on their plate.

Depression comes in many forms and we are told it is strongly linked to the decision to take one's own life. In a two-and-a-half-year period in Wexford, during which time two of my players committed suicide, 45 youths under 25 took their own lives in the county. Of those, 44 were boys and one was a girl. Research shows that girls suffer a little more from depression than males, yet they are much better at dealing with it. Girls have greater skills than boys in dealing with emotional problems and expressing their feelings. We need to concentrate on this issue. Boys must be taught to be more open and must learn to express themselves better. A problem shared becomes lighter. I note from my own children that girls are much quicker to cry and open their hearts to their friends when they have a problem. This area deserves attention, with particular focus on the early years of childhood. There is a need to develop skills in the areas of problem solving, communication and seeking help in an effort to prevent social isolation, frustration and hopelessness.

There is no doubt that the abuse of alcohol and other drugs is not helping matters. There is a good chance this is linked to the increasing suicide rate because the level of abuse has increased during my lifetime. We must examine this issue.

Schools need information on managing the concerns of young people. It is sad that, for the sake of the few million euro being saved, the number of resource teachers and learning support teachers is being cut. I am not saying any of us knows best how to deal with suicide but surely taking away good teaching facilities and much-need extra supports from young children cannot be positive.

Photo of Seán BarrettSeán Barrett (Ceann Comhairle; Dún Laoghaire, Ceann Comhairle)
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I ask Deputies to ensure their mobile phones are switched off because they interfere with the recording of the proceedings.

Photo of Brendan  RyanBrendan Ryan (Dublin North, Labour)
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As this is my first statement to the House, I wish to extend my profound thanks and gratitude to the people of Dublin North for their support in the general election and for the trust they have placed in me. I will endeavour to repay this trust during the lifetime of the 31st Dáil.

I have chosen the issue of suicide prevention on which to make my maiden statement to the House as I strongly believe, as I know all in the House do, that the task of suicide prevention needs increased attention from all sections in our society, including all in the House.

I wish my colleague, the Minister of State, Deputy Kathleen Lynch, well in her work ahead. I thank her for the comprehensive introduction to the debate which she made last Thursday. I also wish to acknowledge the work of Deputy Dan Neville in this area, and the great work in this area of the previous Minister of State, Deputy John Moloney, which I saw at first hand when I was a Member of the Seanad.

For too long, suicide has dwelled at the very edges of our national comfort zone. We are on the verge of changing our approach to this entire issue, and I know it is a priority for the Government to fundamentally improve how we tackle the issue of suicide and suicide prevention. There is no doubt we are experiencing an emergency with regard to suicide. Between now and when we sit in the Chamber next Thursday, a further ten people will have lost their lives to suicide in this country. I am sure all Members will agree that ten people a week, more than one person every day, is a shocking statistic. Even more worrying is the belief that this figure is likely to remain this high, if not climb even higher, given the hardship placed on so many of our citizens by the recent economic crisis.

It remains true that many instances of suicide occur in people with no previous history of mental illness or depression. Rather, it may be the circumstances of life that conspire to leave people in such a distressed state that suicide becomes the best option they can see. The loss of one's job, the breakdown of a relationship, sudden separation from family or circle of friends and other related factors can all lead a person on a path where suicide is contemplated.

We need to arrest the rise in suicides now. In the limited time I have, I would like to discuss three possible areas where I think the Government's suicide prevention strategy can focus. These are as follows: primary care within the community; raising awareness among children and especially teenagers through direct education in schools; and tackling the stigmatisation of suicide.

With regard to primary care in the community, it is vital, as set out in the programme for Government, that we ensure people have access to psychologists and counsellors in the primary care setting. This will require strengthening the services offered in GP surgeries and local clinics throughout the State. Modernising and improving our health service in local communities will be the front line in our suicide prevention strategy. The deconstruction of the old system of acute cases being sent to asylum-era institutions, such as St. Ita's in Portrane in my constituency of Dublin North, needs to be accelerated. It will be one of my priorities during the lifetime of the Government to ensure Ministers stick to their promises in this regard, and I believe they will. I know the Minister of State, Deputy Kathleen Lynch, will drive this agenda.

It is also vital that we harness and support the important work done by voluntary organisations such as Pieta House. In its short lifespan of five years, Pieta House has counselled more than 3,000 people struggling with suicidal thoughts. Pieta House is just one of many organisations voluntarily providing care to people suffering with suicidal thoughts. We need to include such organisations in our suicide prevention strategy to create a joined-up plan for harnessing the care and compassion these organisations provide.

With regard to education, there must be a commitment from the Government to deliver on the education of young people on the issue of suicide awareness, and schools can play a key role in this regard. There are a number of initiatives we could implement in the short term to raise awareness and to provide a support structure in schools for students who may be at risk of suicide. These include curriculum-based presentations to students, self-reporting for students and school-wide screening for identification of at-risk individuals. Teachers can play a key role, but they must be provided with adequate skills and therefore there must be increased in-service training for primary and post-primary teachers on suicide prevention. It may be asking a lot of teachers to spot every behavioural characteristic of every student. However, if we give our teachers a better chance of identifying a potential child at risk through improved training, then we will save lives.

With regard to destigmatising suicide, we need a change of culture around suicide. We need to treat suicide with care, understanding and support. For too long, suicide has been a dirty word in Ireland. It is a cause of shame, when it should be a cause for empathy and compassion. Our local and national media outlets have a responsibility in this regard to report on suicide with due understanding and intelligence. I must commend the national campaigns launched by the National Office for Suicide Prevention, including some very powerful national TV advertisements aimed at young people, and the development of the letsomeoneknow.ie website.

The Government needs to continue to support such campaigns which confront the stigma surrounding suicide. Only through understanding and care at all levels, from the personal to the political, will we ever be able to successfully tackle suicide. I wish the Government well in this regard.

Photo of Gerald NashGerald Nash (Louth, Labour)
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I welcome the opportunity to make a contribution on this important debate. I wish my colleague, the Minister of State, Deputy Kathleen Lynch, well in the task ahead. I know she has a deep personal interest in this matter. I also pay tribute to the groundbreaking work done by Deputy Dan Neville over the years on highlighting this issue. I recall approximately 15 or 16 years ago when I was involved with the students' union in UCD I invited Deputy Neville to speak to students and he made a very interesting and inspiring presentation.

Suicide rates in this country have reached disturbing levels. A national consensus is required on a determined, forthright and inclusive national effort to save lives in the face of this crisis. The CSO records that in the second three months of 2010, 127 people took their own lives. The deeply troubling rates of suicide continue to climb each year. On its website, the National Office for Suicide Prevention refers to these climbing figures as a "worrying trend" and I completely agree. It is, frankly, a national emergency which requires those of us in positions of responsibility to build towards a comprehensive national response.

What makes the situation particularly disturbing is the fact that the frequency of suicide is highest among men in their 20s. We are all aware of the emerging trend whereby suicide occurs at a much younger age than was previously the case. This is a deeply troubling fact which requires the attention and focus of all of us.

In terms of mortality rates, recorded incidents of suicide exceed the number of deaths on our roads, and this has been the case for a number of years. When we switch on the news on a Sunday morning, it is not uncommon to hear of multi-vehicle car crashes throughout the country claiming multiple young lives. That same weekend there may have been several cases of people having made the tragic decision to take their own lives. Suicide is a different matter entirely; it is a relatively silent, but equally painful phenomenon and experience for those who have been left behind. We do not hear about it the same way as we do about road crashes. It is treated differently by the media for very legitimate reasons. I want to acknowledge the responsibility shown by the national and local media throughout this country in terms of the sensitivity demonstrated and expressed and the care and professionalism shown in general in coverage of incidents of suicide, its aftermath and how the matter in general is dealt with.

An enormous amount of work is done by the National Office of Suicide Prevention and organisations such as the Save Our Sons and Daughters organisation based in my constituency. They are all dedicated to dealing with this multi-faceted and complex social challenge.

As a public representative, since this deep recession hit I have seen a sharp increase in the number of people experiencing serious distress and mental health difficulties. Some have confided that they have at one stage or another considered taking their own lives. Public representatives are in the front line. It is important that Deputies and all public representatives are guided by the relevant agencies to be able to identify people who are at risk and in difficulty, and in so far as is practicable, given the confidential nature of the relationship Deputies have with their constituents, to direct them to those who can support them best. It would be more than useful if agencies made themselves available so we could all work together to try to develop a model and framework in which we would be better equipped to deal with the issue ourselves and ensure we could direct people the relevant support and agencies.

We need to break the silence and tackle the stigma around mental health. We must engender a culture of openness and frankness in which discussing one's mental health is seen in some respects as a strength rather than a weakness, as has unfortunately been the case in Irish society until now.

There will soon be an opportunity to embark on a review of the Mental Health Act 2001 and we should use that to do some simple and straightforward things. We must emphasise the need for mental health services to be brought into the open and we must resource community-based organisations to better engage with those who need mental health service support. I accept that progress has been made already in this regard but far more must be done. I look forward to working with the Minister of State and Members of the House who have an interest in this issue on progressing this and ensuring we have the best possible services for those who need them most.

Photo of Anne FerrisAnne Ferris (Wicklow, Labour)
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I welcome the opportunity to speak on this important issue, which has long been subject to stigma in society in general. I congratulate my colleague, the Minister of State, Deputy Kathleen Lynch, on her appointment. I am delighted she has responsibility for this area.

To say the number of people who commit suicide every year in Ireland is a national emergency is an understatement. Indeed, this is illustrated by the 527 men and women who took their own lives in 2009, an increase of 24% over the previous year. Based on the latest figures available for the first quarter of 2010, it appears there has been a further increase on the 2009 figures. It is clear that the ever-increasing numbers can be correlated to the deterioration in economic conditions. Many thousands of people have lost their jobs and their homes. Many more are struggling to hold on to what they have, while they see friends and family leave their community for foreign shores. This is certainly true for the communities in my constituency. From my conversations with representatives of the chambers of commerce in County Wicklow, it is clear that companies are on a knife edge as they struggle to stay in business and keep their employees in jobs. Far too many companies have been forced to close down and this has put a huge burden on local people.

The depression and despair these losses have caused have not been met with adequate support services. The previous Government not only failed to look after the economic well-being of the nation, but also failed to provide the funding and joined-up thinking necessary for proper mental health facilities. Sadly, the soaring numbers of those who have taken their own lives do not take account of the number of failed attempts, which is estimated to be ten to 20 times the number who have died. Indeed, even the most recent official figures available are likely to under-report the numbers. Sourcing accurate data is undermined by many factors, including insufficient evidence to determine intent and concealment for religious reasons, fear of stigma and for life assurance.

It was also startling to learn that in most European countries more people die from suicide than from road accidents. The reason there is such an increase in the incidence of suicide can certainly be attributed to the economic downturn. The previous Fianna Fáil Government left an economic mess that must be dealt with as quickly as possible. The number of unemployed has reached 14.7%. The last time unemployment reached that level was in April 1994. More businesses are seeking credit lifelines as they seek to keep their heads above water. This downturn, coupled with job losses, has left many families struggling to pay mortgages. Indeed, the negative equity that home owners face has become impossible to ignore.

Problems in the mental health services sector were always an afterthought in the Celtic tiger economy. Gross income inequality was allowed to grow unhindered and, perhaps, it is no surprise that Dickensian hospitals sufficed as modern mental health infrastructure. It is also no surprise that other necessary resources, from establishing prevention programmes to training front line professionals, have gone by the wayside. The challenges faced by the new Government, therefore, are not small. Equally, however, they are not insurmountable.

The programme for Government contains a range of measures that will go some way towards reducing the number of people who take their own lives. Recommendations incorporated in the A Vision for Change programme will be followed. Among the measures in the programme for Government is the introduction of universal health insurance, which will ensure that mental health services will be included as part of the standard insurance package offered. The services that people can access will also be of greater value due to the commitment to ensure that general practitioners will have better training in mental health issues. Access to these and other professionals such as psychologists and counsellors will hopefully decrease the startling suicide figures. Unsuitable psychiatric institutions will also be closed and more appropriate community based facilities will be developed.

Organisations such as the Wicklow Mental Health Association in my constituency are swimming against the tide, but still manage to provide much needed services. In April and May this year it is providing training programmes, and information on these can be accessed on the association's website. Another organisation, Suicide or Survive, provides the Eden programme. It is to be congratulated on this as well. Amnesty International has put forward recommendations in this regard and I urge the Minister to take them on board. Support and acknowledgement of national programmes such as See Change Ireland, which challenges the stigma surrounding suicide, is also important.

We must deal with the despair and depression engendered in people as a result of losing their jobs and homes and seeing the effect of emigration on their friends and family. The programme for Government provides commitments in this regard, not least the jobs initiative which is due to be launched in May. Overall, these strategies demonstrate the joined-up thinking that is necessary for meaningful reform, and meaningful reform is needed. Suicide is preventable, perhaps not 100% of the time but a significant reduction can be achieved. If the same resources that have been put into reducing the number of road deaths were put into reducing the suicide rate, there would be fewer suicides and fewer families would have to suffer.

Photo of Seán BarrettSeán Barrett (Ceann Comhairle; Dún Laoghaire, Ceann Comhairle)
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I congratulate Deputy Brendan Ryan on his maiden speech. I call Deputy Browne.

12:00 pm

Photo of John BrowneJohn Browne (Wexford, Fianna Fail)
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I thank the Minister of State, Deputy Kathleen Lynch, for putting this issue on the agenda for debate. I also wish her well in her new office. She has a deep interest in many issues and I am sure she will do a good job in this area.

The first line in the document See Change speaks about changing minds about mental health problems in Ireland. Minds have been changed in recent years. I grew up in Enniscorthy town where St. Senan's Psychiatric Hospital is located. When I started attending the local CBS school the hospital was surrounded by huge walls. Many of us young children at the time said the hospital was where the mad people were. It was only when we grew older that we realised it was not where mad people went but where people with a mental illness went. The nurses and doctors in the hospital worked hard, in difficult times, to try to change the perception of mental illness in that area of County Wexford. They also tried to work on cures for people. If one has a physical illness, one can get a cure and it is important to convey the message that if one has a mental illness, there are people to help one on one's way back into being part of society.

As Deputy Wallace mentioned, Wexford has experienced its share of suicides in recent years. It probably has one of the highest rates of suicide in the country. It is very alarming. In the past four months nine people, most of them young, have died from suicide. It is a great concern. The county has also experienced some terrible tragedies in the last two years in which entire families died. That engendered a doom and gloom in the county. Among many communities there was a huge sense of hopelessness and of not knowing what to do. People were seeking answers as to why such tragedies happened.

It is important to realise that suicide knows no boundaries. An analysis of the suicides that occurred in Wexford show that some of the people came from very well off families while others were from families that were not so well off. The people concerned were both young and old. There is no real pattern, which is, perhaps, one of the reasons it is so difficult to deal with the problem of suicide and to find solutions. The one pattern that emerges is that suicide occurs mainly in the male population. That is the case in County Wexford and I am sure it is the case in other counties also.

I acknowledge the work Deputy Dan Neville, both as a Senator and Deputy, has been doing in this area through the years. In this House he has single-handedly tried to raise awareness of the issue of suicide. We must also confront the fact that a stigma was attached to suicide in the past and we are trying to get away from that. It certainly was not good. It nearly turned people and families into outcasts in communities where suicide was involved and this was an unfair way of dealing with the issue.

St. Senan's hospital is now more or less closed, although it is not closed in the way we wanted it to be and I hope the Minister will do something that the previous Minister from my party did not do. We had many arguments and rows about the closure of St. Senan's hospital and the lack of an acute admission unit for those suffering from depression in the county. A Vision for Change spoke of facilities within the local area, but in recent months in Wexford, given that St. Senan's is closed, patients must now go to Newcastle in Wicklow or to Waterford. We fought the good fight with the then Minister of State, Mr. John Maloney, and we were not successful. The matter needs to be revisited, and I do not say that in any political way. As a group of Oireachtas Members, we made a strong case for the retention of the admission unit in Wexford. A new 50-bed unit is to be built at Wexford hospital over the next year or two and I ask the Minister to look seriously at providing what we were promised - a designated unit within the county where people can go. It is a long way from north County Wexford, or, indeed, from any part of Wexford, to Waterford. In addition, the Waterford building is totally unsuitable. Already in the past couple of weeks those referred to Waterford have been returned within an hour or two without getting the treatment they deserve.

With the Ceann Comhairle's permission, I will refer to a letter I wrote recently to the HSE in Wexford on behalf of a mother who contacted me about her daughter, who was recently a patient in Wexford General Hospital because she was suicidal. She was sent home without any proper care or backup support from the HSE. She was informed leaving the hospital that a HSE liaison officer would call to see her on the Monday - I think she went into the hospital on a Friday. That did not happen despite the fact that she was still very ill. Eventually, after a number of telephone calls to the HSE in Wexford, the family were informed that she would be seen on 14 April, that is, two weeks after she was admitted to Wexford hospital because she was suicidal. The family are concerned that the hospital would send her home in her condition and that the HSE personnel in Wexford ignored their calls for help. They are seeking an explanation and that is what I wrote to the head of the HSE in Wexford. This is a common complaint in the south east, that people are not getting A proper service from the HSE.

Depression does not stop at 5 o'clock on a Friday evening. I am not criticising the new Government because we did not deal with it either, but every county needs some kind of contact point, available 24 hours a day, seven days a week, where those suffering from depression or suicidal tendencies would have a form of backup service. General practitioners and Caredoc do their best to provide some kind of service, but it is important, if somebody is admitted to a hospital and is sent back home, that there is some contact point within the HSE so families can express their concerns or a matter can be dealt with as quickly as possible.

A number of organisations have been set up in recent years because of the situation in Wexford. These include Touched by Suicide in Enniscorthy, a voluntary group which set up its own good-as-new clothes shop. It raises funds and helps out families, making moneys available for those visiting hospitals, etc. It also raises awareness. Each month, or every two months, it holds an all-night candle-lit vigil on Vinegar Hill to make people aware that there are groups and organisations to which they can turn to talk and seek help.

The mental health association is another voluntary group in Wexford - I am sure it is right across the country - led by Mr. Joe Casey, the former director of nursing at St. Senan's hospital. It does tremendous work promoting mental health and a renewal model. Representatives visit schools, organisations and groups to talk about mental health and the need to see it as something that should not been hidden away but brought to the front, and also that if one has a problem, help and support is available.

They have also led the way in closing wards in St. Senan's, placing people in communities and asking local authorities to provide houses. This is where I and other politicians in Wexford have been deeply involved, particularly as members of the county council and the town councils. I remember everyone was dumbfounded when the first request was made to Enniscorthy urban council to provide two houses to the mental health association for patients who wanted to leave St. Senan's. We took the decision to make the two houses available in the town, in a place called Moran Park, and the former patients fitted into the community. As a result, we have houses in Oilgate, Glenbrian and different parts of the county where people reside in independent-living accommodation, having left St. Senan's. People realised the former patients were not some kind of monsters, but ordinary individuals who wanted to live in the community. With the backup of the outreach nurses, they are able to live in and become part of the community. They are involved in the local GAA clubs, go out for a drink and participate in whatever other social activities they want. Great credit is due to the mental health association in that area, and particularly to Mr. Casey and others who have been working almost full-time since they retired from St. Senan's to ensure these people are looked after. They also ensure that such houses continue to be built and allocated by local authorities and also that land is made available for the mental health association to build houses.

I was struck by the recent announcement of President Mary McAleese when she set up a social initiative with the GAA and the president of the GAA, Mr. Christy Cooney, a Cork man - although, in fairness, the IRFU, FAI and GAA have also been working flat-out to help people in this area. I am glad to say that my club in Enniscorthy, Rapparees Starlights, was one of the first to implement the social initiative for older men, although the women were not happy that there was a men-only section within the club. The 100 people at the social initiative launch in Enniscorthy were each presented with certificates. They were all over the age of 50 and they have held a number of meetings since then. Last week, they went to Croke Park by bus and then went for tea in the afternoon with President Mary McAleese. The group meets on a regular basis and some of them have rejoined the club they left a number of years ago. They are now coaching young people and being actively involved again.

We need to promote such initiatives. I would like to see the FAI, the IRFU and the GAA coming together to launch a campaign similar to the road accident prevention campaigns. We are very much aware of deaths due to car accidents, but figures in recent years show that the number of people dying from suicide is probably 100% greater than the numbers killed on the roads, but there is not the same awareness. That is an issue we need to deal with and there needs to be more television programmes about it. We need more high-profile persons involved in raising the problems of suicide and depression because it is an issue that can be dealt with. It is important that we send out the message that there is always someone there to talk to. In our own small way, we try to do this in GAA, soccer and rugby clubs and other organisations. If one speaks at a function, one says that people should remember that there is always someone there to talk to. We need to get that message out.

Many Deputies have outlined the facts and figures and I will not go through all of those.

The stark reality is that 527 deaths by suicide were registered in 2009, which is probably twice the number killed in road accidents. We need to highlight these issues and we must be able to tell those who suffer from depression that help is available for them. Carn House in Enniscorthy does a tremendous job but we also need to consider developing a 24/7 service through out country. I accept that would be expensive but perhaps it could be developed in conjunction with funding from pharmaceutical companies and the other organisations which are making huge amounts of money from the Department of Health and Children. The service could be rolled out as a public private partnership.

Some people believe there are too many individual organisations working in this area and perhaps we need to pull them together but we can deal with this issue if we take the right attitude. Suicides bring great heartache to communities. I do not have all the answers but we can work together to solve the problem and I look forward to hearing the Minister of State's views. It is important, however, that a 24/7 service within the HSE be considered.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Deputy Paudie Coffey will be sharing time with Deputies Brian Walsh and Anthony Lawlor. The Deputies have five minutes each.

Photo of Paudie CoffeyPaudie Coffey (Waterford, Fine Gael)
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I welcome the opportunity to contribute to this important debate on suicide. I carefully chose this subject for my maiden speech in the Dáil because it has a huge impact on many families. I am sure many of my colleagues have had personal contact with families that suffered from suicide.

I thank the electorate of Waterford for putting their trust in me to represent them in Dáil Éireann. I will do my utmost to promote the best interests of Waterford and the country in this House at every opportunity I get. I congratulate the Taoiseach and his Cabinet, as well as the Minister of State, Deputy Kathleen Lynch, who has a deep interest in mental health issues, and wish them the very best as they confront the serious economic challenges we face as a country. We are all behind them and we are ready to assist and support them in their work.

When discussing suicide, we need to take a careful look in the mirror in terms of how we developed as a society over the past several decades. When I was growing up in the 1970s, my mother was a public health nurse and I recall many occasions when people from our community knocked on our door to seek my mother's help. They were looking for a listening ear rather than the medical assistance for which my mother was qualified because they were often suffering emotional turmoil from crises such as family break-ups. When public health nurses, teachers, doctors and gardaí lived amongst the community, they offered strong and accessible leadership. We no longer see that in our society.

We can only imagine how desperate people feel when they reach the point of suicide. I have lost close friends to suicide and I have often asked myself what I would do if I had been around at that moment. Would things have been different if my friends had access to a listening ear? Today, many people's doors are closed to their neighbours and residents of many housing estates do not know who lives two or three doors away from them. That is the result of the society that developed during the Celtic tiger years.

I recognise we need services but listening must start in our own families and communities. We need to be there for one another. Several speakers made an important point about the importance of networks in our communities, whether GAA clubs, the ICA or Muintir na Tíre.

The loss of six good friends to suicide was the spur for me and others in my community to take action. I was very involved in the local GAA club and with the co-operation of the HSE and other suicide experts we developed a ten week course to teach community leaders to identify and assist those at risk. The course helped us to understand that it is not always necessary to seek help from a service or agency when people are in need. All of us would like a 24/7 service but a listening ear is most important when people reach that point of desperation.

I commend Deputy Neville for putting the issue of suicide onto the political agenda. However, few of the recommendations from the 2009 report of the Joint Committee on Health and Children, with which he was closely involved, have been implemented. Our challenge in Government is finding ways of implementing these recommendations in order to assist those who are desperate enough to take their lives. Every politician in communities across the country, whether urban or rural, bears a responsibility for assisting these individuals. I welcome the Minister of State's contribution to the debate and I look forward to supporting her in addressing the challenges.

Photo of Brian WalshBrian Walsh (Galway West, Fine Gael)
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As a fellow county man, this is my first opportunity publicly to congratulate the Leas-Cheann Comhairle on his appointment and I wish him every success. I also congratulate the Minister of State, Deputy Kathleen Lynch, on her appointment and acknowledge the hard work and commitment of her predecessor, John Moloney, who tirelessly championed the issue of suicide and mental health during his time in the House. Deputy Neville's efforts in this area over many years similarly deserve recognition. He was a lone voice when it was not politically correct to speak about the issue.

Our country faces many challenges at present, not least the financial circumstances in which we find ourselves. However, the issue of mental health is one of our greatest challenges. Economic activity operates in cycles and produces periods of boom, bust and renewed growth. I do not doubt we will return to prosperity but when we lose a person who suffers from depression, that life is gone forever. Statistics show that an increasing number of young people are dying in this manner. In 2009, some 529 lives were lost through suicide, an increase of 24% on the previous year, and preliminary statistics for 2010 indicate that the number will increase further. It is worth noting these are only the recorded numbers because there are suggestions that unofficial figures are even higher.

Death by suicide has a devastating effect on the wider community as well as on close family and friends. The tragedy is increased because we know it is preventable. Those who are left behind experience not only the normal emotions one would associate with bereavement but also feelings of confusion and anger, and questions about what they could have done differently.

I welcome the Government's commitment to A Vision for Change, which was published by our predecessor, and the promise of additional resources for the area. We need to change fundamentally our attitude to mental health and suicide. I concur with my colleague, Deputy Coffey, in regard to how society has changed as a result of the Celtic tiger. A fundamental change in attitude is needed. We can start by changing the language we use when dealing with this issue. We say a person commits suicide as if to suggest he or she has committed some sort of a crime. It was a crime in the past but it is no longer one and we should lose that type of language. We also say a person took his or her own life as to suggest he or she had a choice in the matter. Somebody who is profoundly ill and suffering from depression has no choice but simply cannot continue, so we need to lose the term "taking one's own life". If a young person gets into a car, is involved in an accident and unfortunately dies, we do not suggest he or she took his or her own life nor or do we suggest a person who has been a heavy smoker over the years, gets lung cancer and dies took his or her own life. Therefore, why do we use that term when someone dies as a result of depression?

We need to remove the stigma and convey the message that people should not have to hide, or be ashamed of, suffering from depression. It is an illness from which many people suffer. We must encourage people to talk openly about it and to seek help. We should promote initiatives to get people to talk about their difficulties and problems. Perhaps the Minister of State should consider a national day of mental health awareness and invite professionals into schools and colleges to talk to young people and suspend the curriculum for a day or a half day. I know from experience that there would be a very willing audience. During my term as mayor of Galway, I organised a youth conference on a range of issues relating to young people from career prospects to mental health, which was a big issue, to bullying to diet and fitness to other issues of concern. They came in their droves to listen to the speakers on mental health. That is something the Minister should consider.

The banks have been blamed for much of the economic difficulty in which we find ourselves. Some banks are now contributing to mental health awareness. Bank managers became involved in an orgy of credit and were very quick to extend loan facilities to people, possibly without going through due diligence or in a prudent manner. We all remember getting letters or constituents approaching us about letters asking us if we needed a new car or an extension to our homes and telling us to sign a form, send it back and that the cheque would be sent to us within days. That kind of reckless orgy of credit was driven by a bonus culture which existed in some banks.

The people who wrote those letters and extended those loans are now placing huge financial pressure and strain on people. Helicopters were sent to bring large or commercial customers to the races or to play golf. They are now sending the bailiffs in lorries to collect personal assets and so on. I encourage the banks to demonstrate a sense of leniency and fairness when dealing with their customers.

Photo of Anthony LawlorAnthony Lawlor (Kildare North, Fine Gael)
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I congratulate the Leas-Cheann Comhairle on his elevation to his position and the Minister of State, Deputy Kathleen Lynch, on her appointment. She has a daunting task ahead of her. I also wish the Taoiseach and his ministerial colleagues all the best in trying to pull this country out of the mire. As this is my first speech, I thank my wife Margaret for her support during the election campaign as well as my family and friends, Fine Gael members and the people of Kildare North who gave me the responsibility of being their representative in Dáil Éireann. I will raise the issues of concern to them and will ensure that issues, which are important to the country, are brought to the fore in the Dáil.

I thank Deputies McGrath and Neville for raising this topic in the Dáil. One of the issues is that people do not communicate and talk about suicide. When people are in a black hole or see no light at the end of the tunnel, they want to be able to talk to someone about it and yet people shun individuals who may be in this state of depression. It is vitally important we remove the stigma associated with people who take their own lives and give them the dignity and burial they deserve.

On the morning of the election, a young woman came into my office to talk to me. She had lost her brother through suicide approximately a year before. She cried in front of me trying to explain the pain through which she and her family were going. She indicated to me that in the nine months before he took his own life, he was suffering from depression and no matter what people said to him, he could not see any way out of the black hole he was in or any light at the end of the tunnel.

My wife Margaret is a volunteer counsellor with Pieta House. When I visited that organisation several weeks ago, I learned of the serious situation in which it finds itself in regard to funding. It is amazing that the Road Safety Authority is allocated €40 million each year for the prevention of road accidents and yet only €5 million is allocated by the HSE to prevent suicide. Almost two people take their own lives each week. Many car accidents - approximately 38% are single vehicle road fatalities - could also be associated with people taking their own lives.

A number of organisations care for people. Aware makes all of us familiar with what is going on before people commit suicide. Console helps the families of the bereaved. Organisations such as Pieta House help those on the verge of committing suicide. I met the director of Pieta House, Ms Joan Freeman, and when I went into the reception area, I was struck by the fact that most of the signs were about fund-raising. I encourage all Deputies to take what is known as the walk from darkness into light in early May and to raise as much funding as possible for those who listen to people on the verge of committing suicide.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I congratulate Deputies Paudie Coffey, Brian Walsh and Anthony Lawlor on their first addresses in the Chamber.

Photo of Seán CroweSeán Crowe (Dublin South West, Sinn Fein)
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The last time this issue was discussed in the House, I received a telephone call from a friend whose sister-in-law of 20 years of age had taken her own life. As one does, I turned up at the church as did large numbers. I do not know how many funerals I have attended of people who have gone down this road. Everybody was a bit stunned because this girl was full of life. People talked about how lovely the person was and that they did not see the signs or the triggers. Families ask what if they had done something else, what if they had seen the signs and so on. We do not have any answers for them, or certainly I do not.

I am conscious that there are children in the Visitors Gallery. At some stage in their lives, someone belonging to them or close to them will go down this path. The responsibility we have as legislators and public representatives is to come up with solutions. Deputy Mick Wallace referred to the divergence of opinion on how to address this. I remember a former Member of this House who had the attitude that people who commited suicide were "selfish Bs". That is a human reaction, but any of the people I knew who went down that path were not summed up by that description. It did not sum up their lives. While it is a human reaction, the description does not help. It does not help their families and does not turn people away from following that path. That attitude needs to be consigned to the past.

Prevention is the key. People talk about what we can do and there is a great deal we can do. If someone comes to see us, help is available. In many cases, people do not know how to access help from organisations such as Teen-line, of which I am a patron. I knew Darren Bolger who took that path. I know his family well and the great work Maureen Bolger has done as an advocate for change. She works with schools and talks to young people. I refer also to Samaritans, the volunteer services, Pieta House and the national suicide helpline. It is a matter of supporting these services but also of changing attitudes in society. If someone in a family goes down this path, it is not a dirty secret. People need to talk about this. The profile is of young men of a certain age and we must consider what we can do.

I will give a few examples to show how the system fails. Last year a young lad from a neighbouring constituency took part in a play as part of a suicide awareness programme. Having taken part in it, one would have expected him to realise the pain and suffering his family, friends and colleagues would go through, but he ended up taking that path. On his first anniversary another kid from the same school took that path. Support is available in that school. I asked one of his schoolmates how he felt and how he was affected. He told me support was available but that if they wanted counselling, they slipped a note under the door of the school principal. Then they were called out of class. If one is not a hard chaw - many of these kids are not - they will be asked why they were called out and the principal wanted to see them. Young men and boys do not want people to know that they need counselling or help. The system in place in that school does not work.

Friends of mine from a local school came to see me. The mother had been sorting socks and jocks and came across a note written by a young lad of seven years of age. It suggested he was being bullied in school and was thinking of committing suicide. The family had been to the school on three occasions to deal with the matter. They asked me, as a public representative, what I would recommend. I recommended contacting the school board. In the end, they moved the kid out of the school and moved out of the area. Thankfully, he is a survivor and has not gone down that path.

Another case affected me greatly. Before I was elected for the first time, a colleague of mine took the path of suicide. His wife rang me at 7 a.m. to ask me if he had arrived at my house. I told her I would turn on the lights and draw the curtains in order that he might come in. I went over to their house and a young man was lying in the field. I wanted to identify the body because I knew it was him. However, given that he had shot himself, the Garda Síochána was interested in how he had access to a weapon. No one knew. He had previously tried to throw himself under a bus. He had taken alcohol and tablets and locked himself in a toilet in one of the local shops. He had been thrown out and then tried to throw himself under a bus. He ended up in the accident and emergency unit in the local hospital before being released and sent to his GP who gave him a prescription for tablets. Ironically, he was the kind of guy who would not take a tablet if his life depended on it. My point is that the system did not work in this case and many others.

What does a family do when they are concerned about a loved one who may be self-harming or considering self-harm? One cannot section an individual in every case. It is a matter of telling the person concerned that help is available, that he or she is loved and that there is an alternative. I have talked to survivors, people who had decided to go down that path but were saved or changed their mind.

As legislators, there is much we can do and some of it concerns accident and emergency units. One volunteer was involved in counselling and came across a young girl of 15 years who talked about taking her own life. The volunteer talked to her for hours on the telephone and asked her to come into the office. As there was no adult at home, she was brought to the accident and emergency unit. Having built up a relationship with the girl, the volunteer who acted as advocate could not remain with the girl because there was no link. The accident and emergency unit was bedlam at a time, but the girl had been brought in on her own. I raised this point with Mr. Geoff Day. If there was a chill room as part of the hospital system, an advocate could remain with the person concerned. There is a room for bereaved family members, but that is not normally situated beside the accident and emergency unit. If it was located in a secure part of the hospital, it could be used. Most hospitals have such rooms, but there is a need for the system to realise that when people are vulnerable, they need to sit outside the madness of the accident and emergency unit. We all know such stories.

We must set targets. Other speakers referred to the number of deaths on the roads and the amount of money spent in tackling that problem. There is no urgency in tackling this issue. We must set targets to reduce the figures. Opinion-makers in society must speak out and tell people help and support services are available. We must also train people to identify triggers. They need to be trained to identify those people showing signs of going down that road. We must support all the different groups working in this area. I do not believe we need legislative change, rather we need to change attitudes in Irish society, including the attitude that young men should not cry.