Camillus Glynn (Fianna Fail)

We should get real. Community services have a pivotal role to play in suicide prevention. In the mid-1980s the report, The Psychiatric Services — Planning for the Future, was launched. That report needs to be reviewed urgently. Much was made of community services, which are a better service but far more expensive. We should not fool ourselves. Mr. P.J. Fitzpatrick, who was programme manager of community care with the former Midland Health Board at the same time I was a member, made the point exhaustively that we should develop our community services and our hospital services in tandem. We should not neglect hospital services like they did in Britain. Regrettably that has happened to some extent in this country. Thankfully, the intake of students into psychiatric nursing has improved immensely. The Midland Regional School of Nursing, established by the former Minister for Health and Children, Deputy Cowen, is doing great work. Once again psychiatric nurses are being trained in the midlands, which was not the case for over 20 years. How can this House be serious about mental health and suicide statistics when a situation like that obtained for over 20 years?

The ten year strategy developed by the programme management unit of the HSE and the National Suicide Review Group, supported by the Department of Health and Children, set out a range of actions to be taken by various State and non-governmental agencies on four different levels. This has been referred to by the Minister but I repeat, if only to underline it, that regarding suicide the population as a whole is a therapeutic community. It cannot be dealt with by the psychiatric services or the support services on their own — everybody has a role to play. Specific target groups such as young men and prisoners are vulnerable groups. Young men under 35 years of age account for approximately 40% of all suicide deaths, according to the Central Statistics Office. Over 11,000 cases of deliberate self-harm are seen in Irish hospitals every year, according to the National Parasuicide Registry. Some 21% of cases of deliberate self-harm are repeat acts. The highest rates of deliberate self-harm are among females aged 15 to 19 year olds. In a community sample of young men it was reported that 78% knew somebody, 42% knew more than one person and 17% knew a close friend who died by suicide. They are damning statistics.

There are not many families who have not been touched by the icy fingers of suicide, including my own. When it happens it is comparable to throwing a pebble into a pond and seeing a ripple effect. It goes from one side of the pond to the other. The emotions that surface among family and friends when a suicide occurs range from anger, when they ask how somebody could be so selfish to do that without thinking of others, to remorse and self-blame when they ask if they could have done something or recognised something was wrong. People will reflect that they suspected something was wrong but did nothing about it. Then depression ensues for those people, accelerated by self-blame. Thus the ripple effect extends from family to friends to neighbourhoods.

Then there is the "DID" group, the dealers in death or the drug pushers. In my experience they have a pivotal role, as has alcohol. It has been proven by statistics that in a high percentage of suicides alcohol has been taken. I have regrettably come to realise in the past year or so that other substances as well as alcohol are involved in the many unprovoked attacks taking place in our society at the moment, in the depredation, the fights and the brawls we hear of. Yet people advocate the legalisation of a certain drug. We know what happened in Britain. It went down that route but has now retracted. History is a useful subject because if one learns from its mistakes one will not repeat them. Some people in this country want us to repeat the mistake of legalising cannabis. As a legislator that will never get my support.

I agree with Senator Browne that the drinks industry has a case to answer. In many respects the industry glorifes alcohol products, such as alcopops, targeted specifically at young people.

Certain commentators have unfairly vilified publicans. I do not agree with that approach as I know many publicans who are very responsible. Publicans are in the business of selling drink products, but if the drink product is not made it cannot be sold. There is a culture among young people where they wish to become intoxicated as quickly as possible, especially at the weekend. There is also a well-established practice of spiking drinks. I have stated before and I again contend that there should be a mandatory prison sentence for those who spike a drink. Alcohol is a social drug and people do not really worry about its cost. The main worry would be that it might become scarce.

I am pleased to be a member of the sub-committee of the Joint Committee on Health and Children dealing with the high levels of suicide in Ireland, although its operation clashes at times with events in the Seanad. It would be wonderful if we had bi-locational talents and could do several things at once. I am cursed with being human and can only be in one place at a time. As I play a minor role in this House I must attend the Order of Business and, regretfully, I cannot attend all the sessions of the sub-committee I would like.

The sub-committee had an excellent presentation by Professor Eadbhard O'Callaghan of DETECT, and one of his stronger points concerned early intervention. Such intervention saves lives and money while giving young people a chance. This country is playing catch-up to the rest of the world on this issue. There is also strong evidence suggesting that early intervention should be a core part of any effective suicide prevention strategy.

Psychosis and the role psychosis plays in suicide was also referred to. It is a strong role. Professor O'Callaghan also explained the different types of psychosis, such as drug-induced psychosis. It may not be appreciated by many people who take drugs that the end result of such a practice is psychoses like organic psychosis; schizophrenia; bipolar syndrome, which is also known as manic depressive psychosis; or psychotic depression. There are 75,000 people with varying forms of psychosis in Ireland, which is a significant number. Schizophrenics account for 34,000 people in the country. The suicide rate for individuals with psychosis is 20 times the rate in the general population, a large discrepancy. This relates to my point on the importance of having a strong psychiatric service based in both the community and hospitals.

A reduction in mental illness leads to a decrease in the danger of suicide. This can be related to the therapeutic community and the manner in which it can be developed. General practitioners, who currently carry out an excellent service, must be educated. They have a pivotal role in identifying in the first instance psychiatric disorder. They can contact a local psychiatric hospital or a community psychiatric nurse to enable at-risk patients to get help at an early stage. The development of child and adolescent psychiatry is imperative. A good service exists in the midlands, although it is not so good that it cannot be improved.

There is a large problem in the country with regard to suicide. The most important step in a journey of a million miles is the first step. An important step has been taken with the establishment of the National Office for Suicide Prevention, and I wish the office and those working in it well. I will do anything I can for it as a Member of this House and a concerned member of the community.