Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Last year, I stood here to appeal for help from the then Minister of State with responsibility for mental health and for an immediate reply in the wake of a series of harrowing suicides which shook the community of Ballyfermot to its core. Since 2015, Ballyfermot had already experienced over three times the average national suicide rate, but in the summer of last year there was a surge of deaths of a number of young women in very tragic circumstances. It demanded action and I appealed then for an all-hands-on-deck approach. The report the HSE has released confirmed what many of us then suspected, which is that many of the suicides in the area and in neighbouring areas such as Clondalkin and Tallaght were related to deprivation, domestic abuse, substance misuse, alcohol, social media, low school completion rates and fear that their children would be put into care by Tusla.

The report, Rapid Assessment and Community Response to suicide and suspected suicide in Dublin South, contains a number of recommendations and the challenge now is implementation. I was calling for a co-ordinated response, the beginning of which I believe we are starting to see. Ballyfermot Star is leading the suicide prevention and community engagement group in Ballyfermot and Cherry Orchard. Its job is to identify clusters of suicide, identify the underlying issues, to start to tackle it and to act. In some ways, the easier part is done. We have done the talking, now there must be action. We have seen many reports and we have definitely seen too many tragic deaths. It is time to act, to maintain the momentum and to deliver on this report. I ask the Minister of State to tell us how the report will be implemented in order that the situation in Ballyfermot last year will not be repeated.

Mark Ward (Dublin Mid West, Sinn Fein)
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I thank the Minister of State for taking the time to respond today on the very serious issue of clusters of suicides among young women in Ballyfermot, Clondalkin and Tallaght last year. The fact that the HSE investigation has linked these deaths to the housing crisis, domestic violence, poverty and recreational drug use is a clear message that the Government must act. Parts of Ballyfermot, Clondalkin and Tallaght are traditionally disadvantaged areas with high levels of poverty. Poverty underpins all the issues I just raised. As somebody who talks each day to people affected by the housing crisis, I am not surprised to see that this is one of the leading issues in the tragic deaths of these young women.

Government policies over the years have had detrimental impacts on people's well-being. Having a safe and secure place to call home is one of the basic needs of human beings. The HSE produced the report, Rapid Assessment and Community Response to suicide and suspected suicide in Dublin South. Since 2015, the female suicide rate in these areas is three times the national average, but it took the deaths of eight young women in their 20s and early 30s in a ten-week period to prompt this report. The Government must have a proactive response to the report and put in place supports, services and policies that will stop clusters of suicides occurring.

My constituency of Dublin Mid-West has experienced spates of suicides over the years. In fact, as I mentioned on previous occasions, it was the first area to have a Pieta House and it is the area where Jigsaw started. That was directly to meet the demand in the area. However, the Minister of State should be mindful that while both organisations provide very good services, they have gone from being community services to being national services. They are not the same services that the people went out onto the streets to demand. The Minister of State should bear that in mind. As Deputy Ó Snodaigh said, the report contains a number of recommendations. How and when will they be implemented?

Mary Butler (Waterford, Fianna Fail)
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I thank both Deputies for raising this important issue. Any loss to suicide is a tragedy and I send my deepest condolences to the families, friends and communities affected. Each suicide affects the entire community and it is important that strong supports are in place to help the families, friends and the community. Last year, there were 421 deaths by suicide in Ireland; 317 were male and 104 were female.

The devastation that causes to each and every family cannot be even put into words. Tackling suicide is a Government priority.

Connecting for Life, CfL, the national strategy to reduce suicide, takes a whole-of-government approach. A cross-sectoral steering group, comprising Departments, agencies and NGOs, supports the HSE National Office for Suicide Prevention, NOSP, in implementing the strategy. Work is under way to extend the strategy for a further four years, from 2020 to 2024. A memo will go to the Government in the next week in that regard.

NOSP co-ordinates suicide prevention efforts throughout the country and implements Connecting for Life. NOSP funding has increased from €3.7 million in 2010 to the current €13 million. This funds activities including suicide prevention resource officers, local response plans, Connecting for Life actions, suicide prevention training and counselling provided through the HSE and partner agencies.

Under Connecting for Life, 17 local CfL plans have been launched, including the Connecting for Life Dublin South Suicide Prevention Action Plan 2018-2020. Community healthcare organisation, CHO, Dublin south, Kildare and west Wicklow works with local communities to respond to suspected suicides. Responses include supports to families in the aftermath of suicide and needs at community level. Throughout Dublin south, services promote positive mental health and address people's mental health needs. These include adult, child and adolescent specialist mental health services, suicide prevention supports and primary care services, including counselling in primary care.

In addition, the HSE funds Dublin south partner agencies to provide support and build resilience. These include: Candle Community Trust, Aware, Belong To, Mental Health Ireland, Pieta, the Samaritans, and Suicide or Survive. The three local resource officers for suicide prevention in Dublin south, Kildare and west Wicklow are involved with local mental health promotion and training. In 2018 to 2019, nearly 4,000 people in the Dublin south area were trained to enhance the community's capacity to respond to suicide and self-harm.

In February 2020, NOSP commissioned a rapid assessment of suicides among young women in south and west Dublin in 2019. Both Deputies referred to it. The report noted many contributory factors to suicide, including low income, unemployment, housing, domestic violence, social media, substance misuse and underlying trauma. In response to this report, an interagency group has been formed to develop a work plan to carry out its recommendations.

I was really shocked when I learned recently that two thirds of the 421 people who died due to suicide last year were not availing of any mental health supports. For some reason those people felt they could not reach out for the supports, the supports may not have been made available to them, or they might have fallen between the cracks. That is something that I am very conscious of.

In direct response to the question, €15,000 has been given by HSE mental health for a training programme to support young women's resilience and mental health. This will be tendered and run as an initial pilot in 2021. In addition, a community leadership programme in Ballyfermot will train local residents to recognise and support community members who may be experiencing suicidal ideation. This approach has proved successful in Jobstown, with a significant reduction in suicide. I again thank the Deputies for giving me the opportunity to speak on this issue. I will respond further to their questions.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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I acknowledge that work is being done and the small amount of €15,000 that has been given for the training programme. Anything is welcome. It is a pilot programme and I wish it every success. Some of the recommendations cannot be addressed by the suicide prevention and community engagement team, SPACE, programme in Ballyfermot, which was set up specifically to address this report because some of the underlying issues are bigger and deeper and, as the Minister of State outlined, some people did not reach out to the mental health services. In other cases they did, and the problems persisted. Housing is one of the key issues. I am a Deputy for 18 years and in recent years I have seen more adult women and men break down in front of me in floods of tears because of the housing crisis in their lives. Unless that is addressed we will struggle to address the problem of suicide. I hope we will never see what I saw last year, which was the fear and anxiety in a community that had seen a number of women die in very harrowing and public circumstances. That affected entire communities.

Mark Ward (Dublin Mid West, Sinn Fein)
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There is one long-term recommendation in the report. The report states that there is a higher risk of suicide and suicidal behaviour in areas of high socioeconomic deprivation such as Clondalkin, Ballyfermot and Tallaght. It also states that there are higher than average rates of self-harm with myriad challenges faced by young women in particular, in addition to the lack of adult mental health staff in the area. The recommendation is that the HSE and the National Office of Suicide Protection should take steps to ensure the participation of both St. James's Hospital and Tallaght Hospital in the national clinical programme. I urge that this not be a long-term goal. It is something that should be implemented very quickly. These areas are crying out for 24-7 access to emergency mental health supports. These women would like to have help when and where they need it. I know I keep saying that. The Minister of State mentioned figures about people who were not linked into mental health agencies, but many of those people would have turned up to an accident and emergency department and not had their needs met. They were turned away. The statistics do not always capture everything.

I join the Minister of State in extending my heartfelt condolences to all the families of these women who have passed away by suicide and to anybody who has been affected by suicide as well.

Mary Butler (Waterford, Fianna Fail)
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This is a very emotive issues. There is no doubt that we need to continue to build resilience and strengthen all communities to reduce the incidence of suicide. It is also important to ensure that, where such a tragedy occurs, we have sufficient supports in place to help those who need it. The Deputies are right to say that we need to have the supports in place before a tragedy occurs.

Deputy Ó Snodaigh referred to SPACE in Ballyfermot. It includes representatives from the HSE resource office, HSE adult mental health services and HSE addiction services. The rest of the members are drawn from Tusla, the local authority and local area partnership and community services in Ballyfermot, so we do have the whole community coming together.

The Deputy touched on the point that the purpose of the new Sharing the Vision policy is that it is cross-departmental. Mental health does not stop with the Department of Health. A person's mental health can be affected if he or she has issues with housing, employment or earnings and whether that person has enough money to pay the mortgage. For that reason, it is so important that Sharing the Vision is cross departmental. I recently asked Mr. John Saunders of the Mental Health Commission to chair the national implementation and monitoring committee. I am delighted to say that all the various Departments with responsibility for housing, transport and social protection will be members of the committee. It is very important that we do have a cross-departmental approach.

I referred to the €15,000 that has been given by HSE mental health to develop a training programme to support young women's resilience and mental health. It will be tendered and run as an initial pilot in 2021. A significant recommendation in the research is to communicate the work of SPACE to Ballyfermot residents and to develop a community leadership programme within the Ballyfermot area. I know the community has been devastated by the suicides and I am happy to work with both Deputies on the issue.