Camillus Glynn (Fianna Fail)

The total would be 6,570. I cannot vouch for the accuracy of those statistics. The third annual report of the National Parasuicide Registry launched by the Minister of State, Deputy Tim O'Malley, in December 2004 indicates approximately 11,200 presentations to hospital due to deliberate self-harm were recorded for 2003.

I have worked in the psychiatric services and I know there are many reasons people will inflict self-harm. It is true that persons indulging in parasuicide are likely at some stage to take their own lives. Self-harm can also be used as a means of attracting attention. I regard the figure of 444 deaths by suicide as being 444 deaths too many; one death is one too many.

All sections of society are affected by suicide. It is true that young males are particularly vulnerable but this is also the case for schoolchildren. In my own town of Mullingar, three friends committed suicide one after the other. I do not know if this was a case of a suicide pact between them.

A number of factors seem to create suicidal tendencies, such as social exclusion. Many people who commit suicide are found to have alcohol in their system. I do not know how scientifically correct are the suggestions of a strong correlation between the taking of alcohol and suicide. People who have abused drugs and are in debt, forcing them to borrow money from moneylenders to feed their habit, are often not the nicest people in society. When the pressure is too much they take the ultimate step and take their own life.

Another factor to be considered is bullying in school. The mother of a little girl who took her own life has been making inquiries as to what is being done to address the events which led to her daughter taking her own life. Bullying in the workplace and in the home must also be considered as contributory factors in the incidence of suicide. The greatest stress of all for schoolchildren is at examination time. I worked on one occasion in the female admissions unit. One of the patients was a leaving certificate student. Her mother was putting unbelievable pressure on her to do well. She warned her that she had to get a certain number of points in the leaving certificate and that nothing else was acceptable. I find this behaviour absolutely repulsive. These are all situations which contribute to the incidence of suicide.

The person who makes the decision to take his or her own life is normally very secretive about it. People are resourceful in planning the act. In many cases they have never been "psychiatrised". They are people one meets every day of the week. They will go about their daily business, have their lunch, get up from the table and commit the act. It can therefore be very difficult to pinpoint the suicidal intention.

The high incidence of suicide in the population is not exclusive to Ireland, as has been referred to by the Minister of State in his contribution. Senator Browne is correct in his reference to the inordinate level of suicide in Carlow but it is the same in Westmeath. When I was a member of the association of health boards, I remember a councillor from Donegal wondering what was wrong with Donegal because of the high incidence of suicides. In my own parish of Killucan and in Mullingar hardly a week goes by without a suicide. What can we do about it? It is important to realise that everybody in society is part of the therapeutic community. We cannot say it is only a matter for Government or for those excellent voluntary bodies, such as the national task force on suicide and Aware. It is in everybody's best interest to take an interest and give support by keeping an eye on people, especially those living in isolated locations.

The Minister of State made a very important point in referring to the appointment of psychiatric nurses to accident and emergency units, which was one of the most practical steps ever taken. As everybody would know, and nobody would know better than Senator Henry, the statistic was that one in three patients attending a doctor had a psychiatric aspect to their illness. I am not sure what is the present figure; perhaps it is even higher.

The Minister of State said that in its first report, the working group examined the issue of inpatient psychiatric services. I came up through the service and was involved in a health board when the report, The Psychiatric Services — Planning for the Future, was published in the 1980s. I strongly support the concept of acute psychiatric units in general hospitals. Psychiatry is a medical discipline, which should be part of an overall campus. I have said this in the House before and I will say it again. While people did not like it when I said it before, the truth is the truth and sometimes it hurts. The Inspector of Mental Hospitals should be the inspectorate of hospitals with somebody responsible for the psychiatric division.

We should ensure that for those who need psychiatric services the hospital facilities are of the best possible standards. We seem to have let hospital standards slip because the units are built as part of general hospitals. However, for logical and practical reasons many people cannot spend the amount of time they need to spend in psychiatric units. As anybody who knows about the discipline will know, while some patients will do very well in a week, a fortnight or a month, others need much more time. It is not appropriate to have those needing longer-term care in acute units as this will lead to overcrowding. A unit below the acute unit is needed, which makes common sense. Again, I have said this before and perhaps some people did not like it. However, the truth is the truth and I will say it as I see it. Those in hospitals and especially in long-term care institutions should be visited and it should be mandatory for their relatives to visit them. Regrettably, far too often this is not the case.

The Minister of State stated that steady progress has been made in developing a specialised child and adolescent psychiatric service. In the midland region we have been lucky in having such a service and also psychiatry for later life. Addressing these specialised areas in the way the Minister of State has done is very important. The Minister of State referred to 56 consultant posts in child and adolescent psychiatry. How far have we come in recruiting those people? The Minister of State also referred to the number of additional consultant psychiatrists to be appointed, which is also very important.

A most stupid decision in the recruitment of nurses, of all disciplines, was taken in the 1980s. As we had a number of nurses not in the workforce, it was decided that until they were inducted into the workforce we had no need to train any more. A number of smaller training hospitals closed and consequently a number of disciplines, not least the psychiatric nursing profession, the mental handicapped nursing profession and, to some extent, the general nursing profession were unable to fulfil their requirements. We need to take into consideration the length of time it takes to train a nurse. Any intake of students will have some dropouts, some who wish to continue to do postgraduate courses and some who will emigrate, which impact adversely on retaining a core figure from the intake. This again comes back to the number of people we have in those specialised units to cater for people who present with depressive illness.

Reference has been made to the voluntary organisations. We cannot praise them enough as they play a huge role. Mental Health Ireland, GROW, Aware and the Schizophrenia Association of Ireland are all very worthy associations and deserve our commendation. They will bring about in the community the changes for which we all hope. I also mention the National Association of Suicidology. This issue has been abiding interest of Deputy Neville, as it has been of mine and others.

This is a very serious issue and begs the question of what we should do. While we can throw all the money we like at it, every member of society is part of the therapeutic community and has a role to play. It is pointless to point fingers at others; we all have a role. The sporting organisations have a particular role in the matter. We need greater sporting facilities, especially for young people in towns and cities and this matter should be addressed as soon as possible.

Suicide is a very difficult and complex issue. I do not believe anybody has the answer. However, at least we are looking for the answer, which is of help.