Pat Buckley (Cork East, Sinn Fein)
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This is in response to one of many parliamentary questions I submitted in the last month. The question was to ask the Taoiseach and Minister for Defence:

the number of suicides recorded among members of the Defence Forces in the past three years, respectively; if no number is recorded, his plans to compile such information on members' health; and if he will make a statement on the matter.

The reply I got was surprising and not surprising at the same time. It reads:

I am advised by the military authorities that the Defence Forces are not in a position to provide the information requested in relation to death by suicide. All sudden deaths must be reported to the relevant Coroner's Office. It is a matter for the Coroner to decide whether a post mortem should be conducted and to determine the cause of death.

Before we go any further, I have asked members of the Defence Forces the same question and the answer seemed to be very different. For example, the answer to the above question is "Yes, they are." The Defence Forces clearly know how many people have killed themselves, especially when done in Defence Forces barracks. For example, if a soldier shoots himself or herself in a guard or duty room, this is clearly a suicide, but the Defence Forces would record the death as an "ND", which is a negligent discharge. There is some kind of cover-up here. The information I received states that there have been four suicides in the Defence Forces recently. I have also been informed in a parliamentary question that an independent strictly confidential 24-hour careline manned by trained counsellors is available to all. My witnesses said they have never heard of it.

It has been well highlighted in the last year that members of our Defence Forces have and are still being treated very badly. Wages are very poor, with some serving members actually relying on the family income supplement. Others are sleeping in cars because they cannot afford fuel for transport to get home. The Air Corps is another major issue. Its members are overworked and it is understaffed. It is also known that certain chemicals that the members have to work with are leading to major health problems. There is a higher than average number of suicides in this section. We have followed up on information received on Lariam and I have raised it with two separate Ministers here. This problem has not gone away. I have been informed that members of the Defence Forces are still receiving this. One of the first things I want is confirmation about whether this is entirely true or entirely untrue.

Damien English (Meath West, Fine Gael)
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I am here to answer Deputy Buckley's questions on behalf of the Minister of State, Deputy Kehoe. I am conscious that he has asked a few more questions that were not flagged and I am afraid I will not have details of them. I will do my best to answer the questions he previously flagged would be asked.

We are not in a position to comment on the number of deaths as a result of suicide within the Defence Forces as this information is not recorded by the military authorities. All sudden deaths must be reported to the relevant coroner's office. It is then a matter for the coroner to decide whether a post mortem should be conducted and to determine the cause of death. However, I can assure the Deputy that the health and welfare of the men and women of the Defence Forces is a high priority of the Minister of State, Deputy Kehoe, who has responsibility for defence and his Department. Mental health supports are part of a range of medical and non-medical services provided to ensure that Defence Forces personnel are medically fit to undertake the duties assigned to them.

Medical mental health services available to personnel include access to clinical psychology and psychiatry services. The psychology service assesses, diagnoses, treats and advises on strategies to prevent mental health disorders. Psychiatry services specialise in the assessment, diagnosis and treatment of mental illness. There are currently two clinical psychologists employed by the Defence Forces. Psychiatry services were until recently provided in-house by a military psychiatrist. This position is currently vacant, with interim services being provided through a combination of external public and private services. However, efforts are continuing to recruit a full-time psychiatrist to provide an in-house service. This is proving to be challenging in the context of a nationwide and indeed worldwide shortage of trained psychiatrists. It must be stressed that there is no delay in referring patients requiring immediate psychiatric care or assessment.

In addition to these clinical supports, non-medical mental health services are provided by the Defence Forces personnel support service. The Defence Forces personnel support service provides a welfare, information, psychosocial support and referral service to serving members of the Defence Forces and their families. The service is delivered through a network of military barrack personnel support service officers and civilian occupational social workers. This network of professionals is prepared to provide immediate help to service personnel and their families in a routine environment or at a time of crisis. This assistance can range from the simple provision of information to counselling or, if required, signposting and referral to specialist help and assistance. Furthermore, the assistance may include psychosocial support, including counselling, information and assistance services on a variety of issues such as relationships, general finances, addiction, retirement including pensions and gratuities, housing, taxation and PRSI and much more.

The Department of Defence funds a confidential counselling, referral and support service for serving members of the Defence Forces, civilian employees and Civil Defence volunteers. The service provides confidential counselling on a wide range of personal and work-related issues, including but not limited to health, relationships, addiction, financial, bereavement, stress, conflict, critical incident and trauma. In the case of relationship counselling, the spouse or partner may also attend the counselling sessions. A freephone confidential helpline is available 24-7, 365 days a year. The helpline is staffed by fully-trained and experienced counsellors. The helpline provides for referral to appointment-based telephone or face-to-face counselling. Deputy Pat Buckley said that number is not available. I doubt that is the case and will put this on the Dáil record. If it needs to be promoted more or advertised more, we can look at that, but I am confident, if it is written here, to say on behalf of the Minister of State, Deputy Kehoe, that it is true.

Deputy Buckley said that he has confidential information. Maybe he might share that with the Minister of State at an appropriate time. I am sure he would be open to that. The Deputy raised a number of issues that he says have been brought to his attention but I get the impression that they have not been brought to the Minister of State's attention. If the Deputy has information of a very serious nature, there are appropriate channels to deal with it and I recommend that he brings it forward. From what I know, the Minister of State, Deputy Kehoe, is always open to hear all these stories and would be concerned on behalf of his forces and would act on that.

The Defence Forces are fully alert in relation to suicide awareness and prevention, issues of depression and other mental health issues among its personnel.

This is particularly important given the nature of their role and potential access to firearms and weapons. As outlined previously, the Defence Forces, through its personnel support services, PSS, and working closely with the HSE, engages in extensive suicide awareness and mental health education programmes for all members of the Defence Forces. While the Minister is satisfied that the available services offer comprehensive supports to Defence Forces members, I can assure the Deputy that they are kept under constant review.

Pat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State, Deputy English, for the reply. As I said, the purpose of this Topical Issue matter is to flag what is not happening but should be happening. I will give the perfect example. A document I have to hand states that the Defence Forces, through the PSS, engage in extensive suicide awareness and education programmes for all members of the Defence Forces and that these programmes include an information guide on mental health and well-being in the Defence Forces. The response to that is posters are stuck up around the barracks but are never permanent. The programmes also include issuing Defence Forces guidelines on suicide. The response to that is that it is done rarely during initial training and members must attend but thereafter, it is not a requirement due to the stigma of mental health. As for running courses on suicide and self-harm, the response is the same as above. In respect of providing a mental health fitness programme within the Defence Forces, members are allowed to participate in training because they must train if they want to pass their mandatory annual test. On the provision of wellness recovery action plan, WRAP, training, members say they have never heard of it. As for the programmes in which skills training on risk management, STORM, and risk assessment and suicidal self-harm mitigation training for overseas units are conducted, they have been classed as a box-ticking exercise undertaken by an officer. On the provision of applied suicide intervention skills training, ASIST, in conjunction with the HSE, the response was they have never heard of it nor have they heard of the HSE coming to any barracks. The perception in this regard is that this training may be for senior rank staff only. As for conducting safeTALK training, the response from members was that this is done on recruitment and in initial training. In respect of the provision of critical incident stress management training and the issuing of a booklet entitled Defence Forces Suicide and Self-Harm Prevention, it is acknowledged that this is correct but that it is being handed out like a menu. These are the programmes the Defence Forces state they provide. I reiterate this is not an attack on the Minister of State, Deputy Kehoe, because a lot of people are not being informed.

I hope that I have painted a clear picture of the grave situation within our Defence Forces. Despite the claim that the Defence Forces are doing everything right, the witnesses' testimonies I have outlined make clear that they are at a disadvantage because members of the Defence Forces are afraid to use many of these services. This is because they fear they will be downgraded straight away, will never get an opportunity for promotion or participation on courses or overseas duties and may face being forced out and left feeling hopeless. This is the general feeling among many serving and former members. I tabled this matter because I believe the members of our Defence Forces should be respected for the job they do. I believe they are being victimised when it comes to speaking out and admitting they are severely stressed at times. This issue needs to be re-examined.

Damien English (Meath West, Fine Gael)
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I again thank the Deputy for raising this issue. I regret he does not paint a clear picture. The Deputy referenced responses but I do not know who gave them. If the Deputy has information, I urge him to engage with the Minister of State, Deputy Kehoe, and to share it with him in order that his concerns can be addressed through the appropriate channels. As I said, I am not sure if the Deputy is referencing responses from one person or a number of people. I accept he is raising serious issues but I urge him to seek to have them addressed through the appropriate channels. The Minister of State, Deputy Kehoe, is an open Minister who is concerned for Defence Forces personnel.

Pat Buckley (Cork East, Sinn Fein)
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I accept that.

Damien English (Meath West, Fine Gael)
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I am glad to hear that. I again urge the Deputy to engage with the Minister of State, Deputy Kehoe, on the issue.

As outlined previously, the Defence Forces are fully alert in respect of suicide awareness and prevention, issues of depression and other mental health issues among their personnel. As already mentioned, I am not in a position to comment on the number of deaths as a result of suicide within the Defence Forces, as this information is not recorded by the military authorities. All sudden deaths must be reported to the relevant coroner’s office. It is then a matter for the coroner to decide whether a post mortem should be conducted and to determine the cause of death.

I reiterate that a range of mental health supports is available to personnel. The Department of Defence is continuing in its efforts to secure a dedicated Defence Forces psychiatrist and has implemented a number of interim measures until such time as this process has been concluded, including authorisation for the referral of cases to local external private psychiatrists or outpatient treatment where deemed appropriate. However, it should be noted that there is a nationwide shortage of trained psychiatrists as evidenced by the number of HSE vacancies. I am informed that the NHS in Britain has similar difficulties and it has been suggested that there is a worldwide shortage of consultant psychiatrists. The difficulty with recruitment is, therefore, not unique to the Defence Forces, but it is an issue they take seriously.

While the Minister is satisfied that the range of mental health services provided to the Defence Forces, including access to psychiatry, psychology and counselling services, is comprehensive, I assure the Deputy that they are kept under constant review. I hope that in this day and age, people feel it is open to them to avail of these services and that they do not feel they cannot be seen to avail of them. I think we have moved on in that regard and thankfully we have a much more open conversation in this space, and rightly so. If there are any doubts in that regard, the Deputy should discuss it with the Minister of State, Deputy Kehoe, because he would not be happy if that were the case.

Pat Buckley (Cork East, Sinn Fein)
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I will certainly take up the matter with the Minister of State, Deputy Kehoe.