Maria Corrigan (Fianna Fail)

I thank the Minister for coming to the Seanad to facilitate the discussion on this crucial topic. As he said, suicide knows no boundaries or barriers and will affect, in some way, many in our community. Official figures indicate that between 400 and 500 people will die by suicide each year. This is on a parallel with the number of citizens dying as a result of road traffic accidents. Unofficially, many believe the actual incidence of death by suicide is higher.

Of particular concern in the Irish context is the fact that men under 35 years account for approximately 40% of all Irish suicides. Currently, the highest rate of suicide is found among young men in the age group 20-29 years. This contrasts with most other countries where suicide is more frequently observed in older men. Deliberate self-harm is also a significant problem, with more than 11,000 cases presenting to accident and emergency departments each year. As the Minister said, "Preventing suicide and reducing the rate of suicide is an issue that goes right to the heart of our efforts and policies to create a healthy, prosperous and socially inclusive Ireland."

International evidence shows that reducing the suicide rate requires a collective, concerted effort from all groups in society — health and other professionals, social services, communities, community leaders and voluntary and statutory agencies. Reach Out, the national strategy for action on suicide prevention, can provide the strategic framework required for that collective effort. The strategy builds on the work of the national task force on suicide and takes account of the important strategic and operational initiatives developed by the former health boards. A fundamental aim of the strategy is to prevent suicide and deliberate self-harm and reduce levels of suicidal ideation in the general population by addressing the contributory factors. It also aims to ensure those affected by a suicide or deliberate self-harm can receive the most caring and helpful response possible. It recognises the importance of valuing the mental health and well-being of the whole population, ensuring that mental illness is more widely understood and offering effective support to those who are experiencing difficulties. It aims to be evidence based, drawing, where possible, on published scientific research and the experience of those working in suicide prevention.

An excellent initiative to mark the launch of this strategy was the establishment of the National Office for Suicide Prevention. Interim targets for the office include a 10% reduction in suicide and a 5% reduction in repeated self-harm by 2010, with a further 5% reduction in self-harm by 2016. I ask the Minister of State to consider these targets with a view to achieving a larger reduction.

The questions, suggestions and comments I put to the Minister of State concern the four levels of action that were identified by the strategy as the means of achieving its overall aims. Those levels of action have been categorised by the national strategy as a general population approach; a targeted approach; responding to suicide; and information and research. In considering the general population and the targeted approaches, it goes without saying that improving access to quality mental health services is an essential part of any suicide prevention strategy. Considerable improvements have been made in these areas but more remains to be done. It is essential that implementation of A Vision of Change, the national mental health framework, is completed as quickly as possible.

The HSE's recent advertising campaign is to be commended for seeking to promote greater awareness of mental health and more openness in discussing difficulties and seeking help. However, as we cultivate an environment in which people can speak openly of mental health difficulties and decrease the stigma attached to experiencing those difficulties, it is essential that we ensure a

Our schools also have a crucial role to play in promoting from an early age the importance of maintaining good mental health. Modules such as social, personal and health education make a crucial contribution in this regard. Other fora which can contribute significantly to the normalisation of mental health discussions include colleges, businesses, employers and Government sponsored programmes such as Youthreach. An allocation of €1.85 million has been made this year to develop and implement national training programmes and complete the availability of self-harm services through accident and emergency departments. I would appreciate an update from the Minister of State regarding the progress of this training and the people accessing it.

The strategy recognises the necessity for addressing other contributory factors and specifically identifies drugs and alcohol. As previously noted, it is essential that strategies for the prevention and treatment of drug use and alcohol abuse complement each other. We can clearly see in our communities the links between the use of drugs and the abuse of alcohol, particularly among the younger population. Senator Fitzgerald referred to recent research which identified the additional dangers associated with the use of drugs. Similar research has been available for a number of years but perhaps it did not receive the recognition it deserved. It is of concern that several drugs which are considered soft or less dangerous in fact constitute significant risks and, in some situations, can act as environmental triggers for the onset of mental illness. It is important that awareness is raised on this issue in the context of possible campaigns for decriminalising softer drugs.

In seeking to ensure adequate and fast responses to suicide ideation and the development of fast track priority referral systems from primary care to community based mental health services, a number of pilot projects have been funded through the national strategy. One such pilot project is being implemented by Cluan Mhuire services in my own area. This project currently serves a specific catchment area but I ask the Minister of State to consider its expansion and similar projects from a catchment area to a regional basis. Restrictions to catchment areas may result in insufficient demand and, particularly within urban areas, can prevent the promotion of such services if knowledge of their existence is limited to local general practitioners. The Cluan Mhuire pilot project operates until 7 p.m. during working days and is not available during weekends or bank holidays.

Expanding such services regionally may provide the capacity to ensure their availability on a 24-hours a day, seven days a week basis, thereby reflecting a more realistic whole life experience of suicidal ideation. Furthermore, expansion to a regional basis would allow for the open promotion, advertisement and, most importantly, knowledge of such response services to extend beyond GP practices. This is particularly important in the context of research which indicates that a significant number of people who take their own life do not come into regular contact with the health service. A recent study found that the last visit of a patient to a GP prior to committing suicide was either in excess of one year or unknown. This illustrates the importance of ensuring that knowledge of services for people with suicidal ideation is available through a variety of channels.

I welcome the allocation of additional funding specifically for suicide prevention initiatives and the establishment of a suicide review group. I ask the Minister of State to commission research into the reasons for the variance between Irish and international figures regarding men who take their own lives. Internationally, the prevalence is higher among older men but within Ireland the reverse applies. I suggest that monitoring continue of what appears to be an emerging trend of young Irish women taking their own lives. Research should also be conducted into deaths by suicide in the past 24 months in order to establish the extent of contact with the pilot projects in place.

While I welcome the recent innovations on utilising new technology such as text services, I am concerned about the accessibility of sites which provide people with information on taking their lives. I welcome the proposed establishment of an office for Internet safety. I ask the Minister of State to consult his colleagues with a view to determining what international collaboration can be undertaken in regard to Internet safety. It appears that many of these websites operate from other countries and are not Irish.

Deaths by suicide result in considerable distress, grief and loss and the number of such deaths may exceed that pertaining to road traffic accidents. In tackling the carnage on our roads we have harnessed a national determination to reduce such deaths. I ask the Minister of State to note the determination of this Chamber to play its role in reducing the number of deaths through suicide. I urge him to continue with the implementation of the national strategy, take on board the constructive comments in this Chamber and seek to harness a national determination to reduce such tragic instances.