Ruairi Ó Murchú (Louth, Sinn Fein)
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I wish to deal with the issue of mental health services, particularly in County Louth. I am looking to draw attention to two particular cases. There has long been a belief among the population of Dundalk and County Louth that we do not have a mental health service that is fit for purpose.

Ian Browne was 25 years old when he died by suicide on Thursday, 14 March 2019. On Tuesday, 12 March, Ian spoke to his counsellor, who referred him to Our Lady of Lourdes Hospital's emergency department so he could get the equivalent of a doctor's note and be brought into the psychiatric service in Crosslanes. He presented himself to the service in Crosslanes and was assessed. I am told a document of between 12 and 14 pages was written up. He was told he would not be seen; he told them he was suicidal. He said he had taken sleeping tablets. He got a dual diagnosis, which was a problem. He came back up the next day with a doctor's note and again was told to go away. It was three weeks before he was dealt with. The end result was that he was sent away with leaflets for another place where he could go for treatment that was not a State service. He just felt like there was no one there for him.

On Saturday, we had an event organised on the basis of a similar issue we had with Harry Taaffe. Harry presented himself to the service in Crosslanes, told them he was suicidal and was sent home with medication. I accept that hospitalisation is not always what is necessary, but he was told community care would not be available to him for four to six weeks. The following Sunday, Harry killed himself.

We have had a number of these issues. We need to check what the protocols are and whatever other resources are required so the people of Dundalk have a better service than we have at the moment.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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3 o’clock

It is with a heavy heart I stand before the Minister of State to speak about the issue of mental health. As I speak, another family in my constituency is trying to come to terms with the untimely death of their 16-year-old daughter. There is another community gripped by grief and it just is not right. It is every parent's worst nightmare to see their own flesh and blood feel so lost and down and to see no way out.

Unfortunately, I have seen a significant rise in the numbers in recent months, particularly since Covid took a grip of this country, and age and gender are no barriers. Within my constituency, the numbers are high and the age profile is young. Today I talk about a 16-year-old girl. Last week it was an 18-year-old young man. A number of weeks before that it was another 18-year-old man and before that, one family in Cavan town lost two members of their family, a brother and sister, to suicide a week apart.

There are wonderful people on the ground who are exemplary in terms of their volunteerism and while there is help from the HSE and Pieta House, it is still not enough. I feel passionately that as a county and constituency, we need statutory help. We need the help of an organisation like Jigsaw. I have mentioned this to the Minister of State, Deputy Butler, before. We are all new to this position of being in government but while on the Opposition benches, I also made this point. We also need the help of a suicide crisis assessment nurse, known as a SCAN nurse. Such a nurse would provide assistance and support immediately so that when people go to their general practitioner, they are given a contact person immediately and are not sent to an accident and emergency unit or put on a waiting list but can be attended to immediately.

I ask for three things today, namely, further help in primary care psychologist support; a SCAN nurse to be allocated to Cavan-Monaghan; and for the Minister of State to look seriously at the potential of putting Jigsaw into Cavan-Monaghan.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Deputies Ó Murchú and Smyth for raising this issue. Any loss of life through suicide is a tragedy and I do not want to class the people the Deputies have brought to the floor of the Dáil as being merely "any life". It is their life and it is their families who have been affected. Deputy Ó Murchú spoke about two individuals, from the Taaffe and Browne families, and Deputy Niamh Smyth did not mention names but referred to the age profile and gender of the individuals from her constituency. There is not a constituency in the country that has not been hit by suicide or that does not contain family members who are grieving the loss of a loved one at this moment. Deputy Smyth talked about multiple suicides in families and that is not an unusual case either, unfortunately. That grief really knocks the community so much in such a short space of time.

I have a script to hand and the Minister of State, Deputy Butler, sends her apologies. She would like to have been here to answer the Deputies. I know she has spoken to Deputy Smyth in respect of Jigsaw and she told me to assure the Deputies that she is taking both requests in relation to Jigsaw on board. On the SCAN nurse and the primary care psychology support, I will also relay those issues back to Deputy Butler. I will read the script that was presented to me but I will take on board that Deputy Ó Murchú would like to know about the protocols, because that is important. It is important the protocols are not just read out here but that a meeting be convened with Deputy Butler, in conjunction with the HSE and the local community healthcare organisation, CHO, on the ground in order that there is a clear understanding around protocols and deliverable, tangible actions.

Each suicide affects not just family and friends, but the community itself. It is important to ensure that strong supports are in place to help family, friends and the community to deal with a tragedy. Protection of the vulnerable continues to be a Government priority, especially in challenging times, and those with mental health issues are often among the most vulnerable in society. Tackling suicide is an important element of this. Connecting for Life is Ireland's national strategy to reduce suicide. Although it is due to end this year, the Minister of State, Deputy Butler, intends to bring a memo to Cabinet in the next couple of weeks, recommending the extension of the strategy to 2024. Implementation of Connecting for Life has involved a cross-departmental, cross-sectoral approach, overseen by the Department of Health. The HSE National Office for Suicide Prevention, NOSP, was specifically established to co-ordinate suicide prevention efforts around the country and to implement the Connecting for Life strategy. NOSP funding has increased from €3.7 million in 2010 to the current level of €13 million and an extra €2.75 million was provided in 2015 for additional resource officers for suicide prevention and for priority actions under Connecting for Life, including in Louth, Cavan and Monaghan.

I cannot comment on individual cases other than to express my deepest sympathies to every one of them and to others listening in who have lost family members through suicide. Whether today or in the past, the grief never leaves them and I acknowledge that. In Ireland, a coroner decides whether someone has died by suicide. This is a legal decision, not a medical determination made by doctors or the HSE. The Central Statistics Office publishes national data on deaths by suicide based on coroners' findings.

A key part of Connecting for Life, CFL, is development of local CFL plans. All 17 plans have now been launched, including the Cavan and Monaghan Suicide Prevention Action Plan 2017-2020 and similar plans for Laois and Offaly; Longford and Westmeath; and Louth and Meath. The local plans were developed in collaboration with the whole community.

I am happy to bring any situations of the type raised by the Deputies to the attention of the Minister of State, Deputy Butler.

Ruairi Ó Murchú (Louth, Sinn Fein)
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I appreciate what the Minister of State, Deputy Rabbitte, says. The reason I referred to those two families was that they did what we tell people to do. If one has problems, one is told to present to the correct services and they will deal with it. It seems that this did not happen in these cases. I welcome what the Minister of State said regarding a possible follow-up meeting with the Minister of State, Deputy Butler, involving the head of the local CHO and whoever else needs to be there. We need a facility for answers for families but also in respect of these protocols because it is about the service we have at present. We have the wider issue in relation to resources, allocation and the number of acute beds but that is for another day. At this point, it is about people presenting and it is about ensuring they are given a service, that we do not let them down and we have their back.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I reiterate the requests I have for the Minister of State, Deputy Butler, which I know Deputy Rabbitte will relay back to her. I ask that she come to Cavan to meet people on the front line dealing with these situations. Prevention is what we all want. I request we have more resources put in psychologist support in primary care, that we get a SCAN nurse provided for Cavan-Monaghan and that we get Jigsaw. These are the things we need, from talking to professionals on the ground who are providing youth intervention mental health services. It is critically important, as the Minister of State can see from the numbers I have read out.

I acknowledge the work of Emer Mulligan, resource officer and suicide prevention officer for the HSE and is doing amazing work on the ground with families and communities; of Gerry Soden, health and well-being officer with the GAA, providing immense support for communities and clubs around the country; and of Kathryn McAree, who works with Pieta House providing bereavement services for families afterwards.

I ask the Minister of State, Deputy Rabbitte, to relay those points to the Minister of State, Deputy Butler.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputies for the constructive way we have addressed this Topical Issue matter. They have come with solutions and suggestions and I take on board everything Deputy Smyth has said and I think the convening of a meeting will ensure the protocols are reiterated and there is a clear understanding. CFL is about connecting the community. Deputy Smyth has mentioned the involvement of the local HSE, the GAA and Pieta House and that is what CFL is about.

It is important that we also continue to build resilience in all communities to reduce the incidence of suicide. It is also important to ensure, where such a tragedy occurs, that we have sufficient supports in place to help those who need them. The HSE National Office for Suicide Prevention works closely with the CHOs, local agencies and communities to deliver strategies and services in the most appropriate manner, in line with available resources and evolving services. Deputies can rest assured that I will relay their concerns and requests regarding this matter to the Minister of State, Deputy Butler, and I am sure she will be more than happy to facilitate a meeting.