In September 1996, the task force published its interim report, which contained a detailed analysis of statistics related to suicide and attempted suicide in Ireland and a preliminary analysis into the factors that could be associated with suicidal behaviour. The final report of the task force was published in January 1998 and marked the completion of a detailed examination of the incidence of suicide and attempted suicide and outlined a comprehensive strategy to reduce their incidence in Ireland. The report outlined 79 areas where interventions should be targeted to reduce suicide levels. This highlights the complexity of the issue of suicide prevention – there are no simple solutions. The report also identified the various authorities with jurisdiction in suicide prevention strategies and their respective responsibilities.

One of the key components of the overall strategy aimed at reducing the number of suicides includes the implementation of measures aimed at high-risk groups, provision of information and training in suicide prevention for relevant professionals and organisations and the improvement of services which would benefit those at risk of suicide and those who attempt suicide. Health boards in particular have a major role to play in co-ordinating efforts to help reduce the level of suicide and attempted suicide. Resource officers have been appointed in all health boards with specific responsibility for implementing the task force's recommendations. Their responsibilities include the recruitment of additional staff, the provision of staff training in risk assessment, production of information literature and events aimed at raising public awareness of suicide and parasuicide.

Within the mental health services provided by the health boards, support on an out-patient and, if appropriate, in-patient basis is provided for patients with suicidal tendencies. The mental health multidisciplinary team in liaison with the person's general practitioner closely monitors those who are chronically suicidal. Active intervention takes place when crises occur.

Preventing suicide means influencing, in a corrective and constructive way, a person's development and his or her own resources at different phases of life. Adolescence is traditionally viewed as a time of profound change when young people make the transition to adulthood. This transition is not easy and for many young people is accompanied by levels of self-doubt, fear and stress. An important aspect of suicide prevention for young people will be the promotion of self-esteem and self-confidence and ensuring they develop personal and social skills. Children and young people often need support in gaining control over their lives and coping with their problems.

An important aspect of suicide prevention has been the establishment by the chief executive officers of the health boards of a national suicide review group, membership of which includes experts in mental health, public health and research. Its main responsibilities are to review ongoing trends in suicide and parasuicide, co-ordinate research into suicide and make appropriate recommendations to the health boards. A researcher has been appointed to the group to collate existing research materials, both national and international, examine the effectiveness of intervention programmes and liaise with local co-ordinators in each of the health boards.

A proposal to develop and implement a national policy framework for suicide prevention has been developed by the national suicide review group and submitted to the health boards executive for review. It is important to stress that this proposed strategy will be action based from the outset as it will build on existing policy vis-à-vis the final report of the national task force on suicide published in 1998. Furthermore, ongoing strategies and prevention programmes across the health boards are continuously reviewed by the national suicide review group and routinely reported in its annual reports. This report meets the requirement of the Health (Miscellaneous Provisions) Act 2001, which provides that the Minister for Health and Children will make a report each year to each House of the Oireachtas on the measures taken by health boards in the preceding year to address the problem of suicide.

The Department also allocates funding, through the national suicide review group, for voluntary and statutory groups engaged in prevention initiatives, many of which are aimed at improving the mental health of the younger age groups. These projects include life skills courses for high-risk youths, school-based personal development modules and mental health promotion campaigns. A number of these projects have been positively evaluated and proven to enhance the coping skills of the participants. It is anticipated that such campaigns will lead to a reduction in youth suicidal behaviour over time.

In order to reduce the number of suicides it is essential that those undergoing life crises should get appropriate support. Expenditure on suicide prevention programmes has increased significantly in recent years. The Department has given special attention to the resourcing of suicide prevention initiatives in recent years and the level of funding being provided by it for suicide prevention is now more than 20 times what it was in 1999. It is important to bear in mind that additional funding allocated to a service in one year becomes part of the baseline funding for the service in subsequent years. Since the publication of the report of the task force on suicide in 1998, a cumulative total of over €13 million has been provided towards suicide prevention and research aimed at improving understanding of the issue.

These figures do not include funding provided by other Departments such as the Departments of Education and Science, the Environment and Local Government and Justice, Equality and Law Reform which were identified in the report of the national task force on suicide as having a role to play in suicide prevention. The health strategy, Quality and Fairness – A Health System for You, includes a commitment to intensify the existing suicide prevention programmes in the coming years. The Government is fully committed to ensuring further investment takes place in this area. Additional funding has been allocated this year to the Irish Association of Suicidology, an organisation concerned with raising public awareness of suicide prevention issues.

Additional funding has also been allocated to the National Suicide Research Foundation, a multidisciplinary research centre which informs health service developments and policy formulation. The late Dr. Michael J. Kelleher founded the foundation in January 1995. It consists of a multidisciplinary research team with contributions from a broad range of disciplines, including psychology, psychiatry and sociology. Its primary aims are to define the true extent of the problem of suicidal behaviour in Ireland; identify and measure the factors that induce and protect against suicidal behaviour; and develop strategies aimed at preventing suicidal behaviour.

The bulk of the foundation's work to date has involved the monitoring of parasuicide. On a yearly basis data relating to every suicide and undetermined death registered in Ireland are sent to the foundation by the Central Statistics Office which are analysed so as to produce up-to-date age-specific and age-standardised rates with respect to demographic variables. These statistics are also provided in response to the numerous requests the foundation receives from professional bodies, students and the public for information relating to suicide.

I am aware that due to the foundation's reputation for high quality research, it has been invited to participate in several important international studies, among them the WHO-Euro multicentre study of parasuicide. International studies have found parasuicide to be one of the most significant risk factors associated with suicide. Those who engage in parasuicide are 20 times more likely to eventually kill themselves. Studies have shown that at least one third of all suicides have a history of parasuicide.

The association has launched the national parasuicide registry. This important project is being undertaken by the foundation with funding from the Department. The national parasuicide registry provides information on the general characteristics of those who attempt suicide. It will provide better knowledge of suicidal behaviour and specify trends in parasuicide over time and in the different regions of the country. The analysis of this general information will be useful in the development of policies and the implementation of measures aimed at preventing suicide. The registry will also be useful in the allocation of resources. It will help identify groups which are particularly vulnerable and assist health boards to evaluate the impact of the preventive and clinical services being provided.

The task force report recommended that steps be taken to make the mental health services more accessible to the public, particularly young people. Concern was also expressed at the risk of suicide in older people. In this regard, significant additional funding has been made available to further develop consultant-led child and adolescent psychiatry and psychiatry of later life services to assist in the early identification of suicidal behaviour and provide the necessary support and treatment for individuals at risk. The level of capital funding made available for the development of community based mental health facilities has increased significantly in recent years and community services such as home nursing, day centres, family support, hostels and day hospitals will continue to be developed in order to make services more accessible to people who may be at risk.

A suicide is a tragic and shattering occurrence that not only brings a life to an untimely end but also has a devastating impact on family and friends. We need to do all we can to make it as easy as possible for those bereaved by suicide to confront and deal with the situation in order that they can learn to get on with their lives. The national suicide bereavement support network, established in 1998, supports those bereaved by suicide by providing them with information on the availability of support groups and counselling services in their local area. This information is essential for those in need of support to enable them to cope with this tragic situation. It will help those finding it difficult to grieve. The people concerned are particularly vulnerable as it is impossible to move on without grieving.

Priority is being given to education awareness and promoting a better understanding among the public towards mental health. We are all aware of the pressures on young people such as bullying, emotional distress, addictions, peer pressure and examination pressure. We tend to think that people are weak if they suffer from anxiety, depression inability to cope or have suicidal tendencies but it is widely acknowledged that one in four women and one in ten men will experience depression during their lifetime. Many are successful people, role models and celebrities.

There is a growing awareness and concern among the community about mental health matters. The national health promotion strategy 2000-05, in conjunction with the new health strategy, Quality and Fairness, sees mental health as being equally as important as physical health in the overall wellbeing of a person. Increasingly, mental health is being recognised as a major challenge facing health services in the 21st century. My Department recognises the need for positive mental health promotion. Mental health promotion is a broad concept as it emphasises the promotion of the psychological health and wellbeing of individuals, families and communities. It is a key task of the health services, not just to treat mental illness but, more importantly and using the principles of health promotion, also to try to improve the mental health of the population.

I emphasise the importance of voluntary organisations in supporting and promoting positive mental health among the population. My Department is fully committed to working with voluntary groups to promote positive mental health among third level students. Close links between the mental health services and voluntary organisations are of the utmost importance and every health board has a development officer who liases between the statutory health services and the local mental health associations to provide an integrated and comprehensive service. Also, the health promotion unit of my Department funds and supports in a variety of ways the efforts of mental health organisations such as Mental Health Ireland, AWARE, Schizophrenia Ireland and GROW. We recently supported the production of "a resource manual for mental health promotion and suicide prevention in third level institutions" jointly produced by Trinity College Dublin and the Northern Area Health Board which will be available to all third level institutions.

There are also numerous regional initiatives being run by the health boards in conjunction with non-statutory organisations which focus on mental health issues such as stress management, depression, stigma reduction and suicide related matters. These are issues of paramount importance which require further attention to ensure positive mental health and the well-being of people is promoted.

The Government shares the public concern about the level of suicide. It is a worrying trend. We are fully committed to the further implementation of suicide prevention initiatives and the further development of mental health services in order to prevent any further premature loss of life.

The number of recorded suicide victims has risen since 1997 and been consistently higher than the number of road accident victims. We know how concerned society is about this and I welcome the efforts to alleviate the crisis which have been of major assistance. The statistics for suicide were 444 in 1997, 504 in 1998, 439 in 1999, 413 in 2000 and an increase to 448 in 2001. In Dublin there were more than 100 suicide victims per year for each of the years from 1997 to 1999.

Reports show that the vulnerable age group is men aged between 20 and 29 years. I am aware that the Minister of State has put suicide prevention strategies in place which represent a balance between general population strategies in the form of education and health promotion and intervention targeting high risk groups. We have seen the various publications, such as Concerned about Suicide, Internet resources, audio-visual training packs, contact details of support groups and funding for areas of mental health promotion, crisis intervention, bereavement support and research.

There is a diocesan family life centre in my town and such a centre in most areas. I welcome the funding the Department of Health and Children has given these groups because they have carried out trojan work. Members of victims' families have come to me seeking my opinion and it is of great relief to me that these professional people are in the vicinity to whom I can refer the families. I know the Minister of State has funded them generously. I ask him to continue.

It is a great advance that many of those who have attempted suicide and their families can talk publicly in groups on radio and television about this tragic issue. Their courage is immense. I hope it will increase the knowledge of researchers and lead to a greater understanding of the motivation behind this drastic action. Research initiatives such as the suicide research group of the health boards are grappling with the issue. The report of the national task force on suicide was published in 1998 and its recommendations have been taken on board. The national suicide review group was established in 1998 to co-ordinate research and make recommendations to the chief executive officers of the health boards. Its reports are of primary importance emphasising the three pronged approach of prevention, intervention and aftercare.

I commend the work of the Irish Association of Suicidology which, since its foundation in 1996, has done much to promote public awareness of suicide and suicidal behaviour, especially through the organisation of conferences and workshops. The promotion of positive mental health as a core issue is important. We are also aware of the important work done by voluntary organisations, to some of which I have referred, their attempts to understand the issues involved in this area and also their great help to the families of victims. Their input is invaluable, not only in providing support for those most vulnerable in society but also in heightening the awareness of the importance of self-help and empowerment of the individual in attaining positive mental health and overcoming many of the crises in life.

We must all cope with various stresses and strains in life but, unfortunately, some are less able than others. Many of the victims of suicide do not have adequate coping skills. Some come from troubled family backgrounds where alcohol is often an issue. The House has frequently discussed the excessive consumption of alcohol. We have become an affluent society but there are also peer and examination pressures and a need to perform outstandingly on all occasions. Modern society places a great deal of stress on the young and it is clear that stability in social relations and healthy cultural attitudes to emotional problems are needed in the fight against suicide. One of the mysteries of this illness is that often the reasons for victims taking this tragic action cannot be seen by those left to pick up the pieces.

There is also a need for young people to be occupied positively. Sport plays a great role in this regard. I pay tribute to those who do untold work in organising sports. I have always believed there should be a closer liaison between the health boards and the Departments of Education and Science and Arts, Sport and Tourism because facilities for young people are an issue where suicide is concerned as much as they are an issue in other respects.

I am involved in politics which is a stressful life, just as everything is stressful nowadays. There is nothing better that I can do than to go for a walk or swim and try to be healthy. It certainly helps me. Basic facilities are not provided in my town nor in many others. If every town had a recreational facility such as a swimming pool or leisure centre or an annual health check, it would undoubtedly go a long way towards alleviating the number of tragic cases of suicide. Will the Minister of State examine the feasibility of spending €1 million or €2 million on providing such leisure centres? They would go a long way to reducing the numbers of suicide cases because, when we exercise, it makes a huge difference.

When in difficulty, a person should feel and know where he or she can find help without being stigmatised. Being stigmatised was once a major problem. I am not convinced that, despite these improvements, those in difficulty can or will access the available resources. That is the reason I welcome the Minister of State's initiative at second and third level. We occasionally see people who appear to us to be vulnerable and wonder what we can do. One does not wish to become involved. Whom would one contact or what would one say?

Statistics show that one in four women and one in ten men experience depression during their lives. That ratio could possibly be higher. Depression affects people from all walks of life, those who are successful and those less so. We must try to improve the quality of life of those with long-term psychological illnesses. Early intervention is vital in this regard.

The challenge of suicide prevention is one of the most urgent issues facing Irish society. I welcome the fact that necessary funding and resources are being provided, but more must be done. I compliment the voluntary organisations that are involved in this area. Suicide is a cause of great grief and suffering and everyone wants to know why people are driven to it. If funding for suicide prevention is increased, I believe fewer relatives will be obliged to ask why their loved ones committed suicide. I thank the Minister of State for coming before the House and I wish him well.

As already pointed out, the overall female suicide rate has not risen significantly. However, there have been signs in recent years that there may be a slight increase in suicides among young females. Ireland still has one of the highest youth suicide gender ratios in the world, which is a matter of grave concern. It is essential that society as a whole realises the seriousness of this issue. It is often difficult for a parent or friend to prevent the suicide of a young person.

Relatives of a person who has committed suicide must be very carefully monitored and should be counselled appropriately. Unfortunately, a suicide can sometimes be followed by the suicide of another family member. In such cases, the second person will often not show any signs of depression. Some of these people will be the life and soul of the party in order to cover up how they really feel and when they take their lives, it comes as a shock to their relatives and friends. In the condition of manic depressive psychosis, during the depressed phase a person normally shows few signs of motivation to commit suicide. However, when the person is coming out of the depressed phase and moving into the manic phase, suicide will often occur.

It is essential that we do something to help these individuals who feel they have no one to whom they can turn. As people get older they have regular physical health checks. These often involve tests on blood pressure, blood count, liver function, thyroid function, urea and electrolyte levels, etc. In addition, the incidence of prostate cancer among men should be considered. However, that is a matter for another debate.

To feel depressed is not a sin and is not something of which people should be ashamed. Psychiatry is a specialised medical discipline, in which many eminent people work. They are there to help and if people are feeling depressed they should consult their psychiatrist or their general practitioner.

I welcome the resources that have been dedicated to this area, but they alone will not result in a decrease in the incidence of suicide. There are many organisations, such as the Mental Health Association – which contains many of my former colleagues who do great work – AWARE, the Samaritans, the Schizophrenic Association and GROW. They all help people with psychiatric illnesses, particularly depression. These organisations are there to be consulted and used in order to prevent people committing suicide.

The Government realises the seriousness of this devastating problem. The Minister of State referred to the additional resources that have been provided. The level of additional funding provided by the Department of Health and Children for suicide prevention increased from €190,000 in 1999 to €3.8 million in 2002.

As already stated, the incidence of suicide has, unfortunately, increased. A multifaceted approach is needed to suicide prevention. Since the publication of the report of the task force on suicide in 1998, more than €8 million in additional funding has been provided towards suicide prevention and invested in research aimed at understanding the issue. Based on figures released last May, suicide is now the biggest killer of Irish people aged 15 to 24. Some 413 people, 83% of them male, took their own lives last year, a drop from the previous year's figure of 439, according to the Central Statistics Office. I hope this trend will continue. People aged between 15 and 34 accounted for almost half of the total deaths. In Ireland, the suicide rate is 10.9 per 100,000 people, compared to 23.8 in Finland and 3.8 in Greece.

Legislation currently going through the Oireachtas will oblige the Minister for Health and Children to provide an annual report on the number of suicides, along with details of contributing factors and preventative measures being taken by regional health boards. I agree with Senator Feighan that an inter-agency, multifaceted approach is required. How often, for example, have we heard about bullying in school and the workplace? This can lead to low self-esteem and in many cases suicide.

Depression takes different forms. One has exogenous depression for which there is no evident explanation, whereas reactive depression occurs, for instance, in response to the failure of a business project, the loss of a relative or similar events.

Life is always worth living. Society must be made aware, it must care. My advice to everyone who is feeling depressed for whatever reason is not to get down, but to get help. Many of the health boards now have a help line. A large number of voluntary organisations work in this area and there is always somebody at the end of the telephone line. I hope the next time we discuss this serious issue, the trend will have continued downwards.

Occasionally thoughts of suicide or self-harm may occur or may increase in the first few weeks of treatment with Cipramil until the anti-depressant effect becomes apparent. Tell your doctor immediately if you have any distressing thoughts or experiences.

None of the research I have read has referred to data on the types of drugs people were taking before they committed suicide. People tell their story to their doctor, who prescribes a medicine with the patient's interests at heart. In the event of the patient in question committing suicide, is research carried out to find out which medicines the victim was taking, whether they were prescribed by a medical practitioner or obtained at a chemist and if they were made aware of the information available on the leaflet accompanying the medicine? The person with whom I spoke on this issue, a medical professional who was being treated with Cipramil, convinced me that if he had not discontinued this treatment the thoughts of self-harm and nightmares he had been having would have had a catastrophic result. I ask that this issue be addressed.

There is a stigma attached to suicide. It does not respect social class or whether a person is working. It takes families years to come to terms with the suicide of a family member. What long-term therapy is available for families in such cases? A family I know needed two or three years to come to terms with a suicide to the extent that they were able to tell their neighbours and friends what had happened. Before seeing a therapist who told them they must deal with the issue, they had been unable to do this. Much more can be done at health board level for families who may spot problems.

The effect of the introduction of penalty points on the number of road traffic deaths, even in a few months, demonstrates that Government intervention can have an impact. With the incidence of suicide now far higher than the number of road deaths – as many suicides go unreported – it is time for the Government to intervene.

In 2001, 448 people died by suicide in Ireland compared to 379 deaths in road accidents last year. This tragic epidemic of death by suicide must be given the same priority as road safety by the Government. While I recognise the efforts the Government has made, we can no longer ignore the fact that deaths by suicide among young people under 25 years have reached the point where Ireland now ranks second in this category in the OECD league. Suicide has become the most common cause of death among 15 to 24 year olds in Ireland, a frightening and startling statistic. As the Minister of State pointed out, the most disturbing fact is that male suicide accounts for almost 80% of this figure.

We must examine the reasons that at a time of unprecedented prosperity so many people feel so despairing that they choose to take their own lives. Changes in society and the expectations of and demands on young people have created enormous stress and strain for them. Males are proving less adaptable to changes in their status. They are more likely to bottle up problems and less likely to discuss them than their female counterparts. It has been a thread through Irish life, which unfortunately persists, that whereas females tend to discuss their problems, we males tend to keep our problems within.

There is no doubt the physical health of young people is better now than in the past. The same cannot be said with regard to the social and psychological pressures to which young people are exposed these days. This also partly due to the increasing instability of family life and the changing sense of personal and family relationships.

The national task force on suicide set up in 1996 by the former Minister for Health, Deputy Noonan, published its recommendations in 1998. The report outlined 79 areas where intervention should be made to reduce suicide levels, which illustrates the complexity of the issue. While there are no simple solutions, there is a need for greater investment in research. The amount spent on suicide prevention research is only 5% of investment in road safety which is not enough.

I compliment the Irish Association of Suicidology, the national suicide review group and many others who are doing tremendous work and playing an important role. They presented consensus statements to the Ministers for Health and Children and Education and Science on suicide prevention and bullying and suicide in schools. These statements should be given the urgent consideration they deserve and the appropriate action taken. I join Senator Glynn in commending the voluntary organisations involved in helping those affected by suicide.

Another study which alarmed me found that of 100 third level students polled, most knew about the issue and 40% had experienced suicidal thoughts. In addition, 13% had attempted suicide but practically none knew how to summon help, although all had achieved high marks in their leaving certificate examinations. That is the key to the issue. The research clearly points to the need for a more acceptable and accessible service for those at risk of suicidal behaviour, particularly in rural areas. This should not be imposed on local communities and will only be successful if the services are developed in co-operation with existing resources such as youth clubs, community groups, sports clubs and other organisations with local knowledge.

I will quote the president of the Irish Association of Suicidology, Deputy Neville, who said we must never forget that suicide was a terrible act against nature, caused desperate trauma to the bereaved families and community and must never be considered as a solution to any problem in any circumstances.

This is not just a matter for statutory health care agencies – we must all change. The study points out that there has been a fourfold increase in the suicide rate in Ireland since 1990 and that psychiatric disorders, usually depression and/or an intoxicant problem such as the abuse of drugs or alcohol, are present in 90% of suicide cases. The organisation suggests a dual approach –interventions focusing on those at high risk and, in conjunction, a long-term strategy aimed at public attitudes to suicide and its causes. This would include schools, the media and all agencies – society as a whole – to enhance coping skills and the approaches people take to the crises of everyday life. The organisation believes a broad involvement of individuals throughout society is required for a long-term strategy.

It is worth noting that there was a marked change in the statistics in the early 1980s, particularly for those under 24 years. Why did that happen? Was it social change or the explosion in the availability of drugs? Were there economic reasons such as the unemployment rate? There should be further research into these issues.

As I said, up to 90% of suicide cases involve diagnosed mental illness of some kind while up to 53% involve the abuse of alcohol or drugs in some way. However, there are other causes also such as eating disorders and poor coping skills, as Senator Feighan pointed out. When one considers that between 10% and 20% of adolescents will have a major bout of depression at some point in their lives, there is an obvious link. This depression could arise because of an interpersonal conflict with a boyfriend or girlfriend, parent or school – one study shows that this is true of 70% of cases.

Senator Cummins pointed out the situation regarding suicide among young men. Studies have shown that Irish men with depression tend not to seek help as they seem to consider that going to talk to someone about a problem would mean being seen as feeling sorry for themselves. One study showed that only 20% of men who had committed suicide had been in touch with any services available in the year before. This means 80% had spoken to no one.

There are warning signs that can be picked up, some of which are fairly simple. They include repeated talk about death, withdrawal, poor coping skills, to which Senator Feighan referred, the abuse of drugs or alcohol and relationship problems. Suicide is very perplexing, however, as we do not know all of the facts relating to it. Even those closest to the person may not know what he or she was thinking or feeling in the hours or minutes leading up to the event. That is particularly true of young men.

The general consensus is that there are three main causes or factors – psychiatric illness, a major loss in life, which could be the loss of a job or the ending of a relationship, and the abuse of alcohol or drugs. There is also the loss of hope, the loss of the ability to visualise the future, a feeling of wishing to be removed from a difficult situation and a sense of hopelessness and isolation. This must be borne in mind by the professionals when dealing with the problem. A recently issued United Nations document states individuals in many roles and at all levels in the community can contribute to prevention, and that equipping individuals, families and communities with the knowledge and skills to foster their general health and well-being is essential.

The Minister of State highlighted a number of initiatives which have been taken. I understand Finland has a state policy in this area. Others measures include tackling the problems of alcohol and drug abuse, especially among the young; the provision of counselling services for families; and outreach services for communities. I also advocate the targeting of the children who fall out of the system as we have a particular problem with early school leaving. There has been a push recently in the United Kingdom against children who engage in truancy, some of those who slip through the net. While there has been much talk about young people in particular, we should also increase awareness of suicide among the elderly. Late life should be promoted as a valuable time in a person's life.

We need a national suicide prevention programme. I understand there is a myriad of both statutory and voluntary associations dealing with this issue. Perhaps they could be brought together in some kind of national programme, possibly under the aegis of the Department of Health and Children. It is essential that all members of society are encouraged to play their part in ensuring it will be successful.

There has been incredible change in our society, both economically and socially in terms of the cultural and sexual norms. I have been a Member of this House for 20 years, which is not a long period, and remember the traumas people went through in the early 1980s about a minuscule change in the law on contraception – I do not intend to go off on a tangent about sexuality. That is an example of the transformation of values in our society. I both welcome and encourage much of this transformation but we must face up to the fact that that type of transformation never comes about without a downside, of which one of the tragic manifestations is the increased incidence of suicide.

It is true that some of the increased incidence of suicide is down to the fact that we now tell the truth. We do not have reliable figures for the incidence of suicide prior to the 1970s because the community consequence of the admission that somebody had his or her own life was so incredible that everybody, church and State to a degree, conspired, perhaps rightly, not to describe it as suicide because of the horrific consequences. In those days church figures felt that if it was made public, they were bound to take a certain course, which was very difficult.

In the past we denied the degree to which elderly persons committed suicide but the new phenomenon of modern Ireland is suicide among young people. I support all the proposals I hear about structures, etc., but all those structures would have to fit into a critical review of our value system. I am not being political; this is just the way we have developed.

When I was 20 years old, I did not drink but when I started drinking in my twenties, I got drunk, although I never set out to drink myself into oblivion. I often did so but it was an accidental consequence. There is no doubt that huge numbers of young people of 15 and 16 years now set out to drink themselves into oblivion. That is terrifying. I say this as a card-carrying hedonist. I believe in all the pleasures of life but what is the point of going out to have a good time if one cannot remember what happened the following day? Young women, allegedly, are turning up at family planning clinics looking for the morning after pill because they might or might not have had sex the night before. What is the point of having sex if they cannot even remember it the following day? I do not mean to be flippant but it is a statement of determination to head for oblivion.

All of our young people do not engage in such behaviour. The young people I teach are well motivated, bright and an inspiration but even they drink far too much. Everyone knows that alcohol is a depressant. Regardless of the short-term buzz, its overnight effect leaves people feeling much worse than when they started. I worry about the huge increase in the consumption of alcohol. I do not minimise the harm caused by other drugs, but the drug that worries me most, that will devastate lives that would otherwise be full of prospects, is alcohol. I do not subscribe to a repressive view in respect of alcohol, but it is our responsibility, as a society, to put together a set of values and taboos that are appropriate to modern society. We must construct a society where it is a taboo for a young person to end up so drunk they cannot remember what they did. The link between youth suicide and alcohol is an area we must examine in depth.

We must also look at the sexualisation of young people, which is taking place at 11, 12 and 13 years of age. The period from 12 to 20 years of age is difficult enough. We all remember it. No one, regardless of the way they dress up or the mask they wear, feels beautiful or comfortable with the opposite sex between 12 and 20. It is an awkward time full of awkward tensions. To insert into that experience a commercially driven sexualisation of a person's self image only makes it much more difficult. The fact that it creates a superficial level of sophistication among teenagers causes an even greater chasm between them and adults – their parents or others – whom they cannot believe have ever had sex. When that sexualisation is increased, the gap also increases.

The macho culture makes men feel that asking for help is a sign of weakness. The degree to which young men are unable to tell anyone they are experiencing difficulties is a problem. We must look beyond psychotherapy and examine the values of society and its priorities. We must look at the language we use. I hate the word "loser", which is now part of common parlance, particularly among young people. It is a dreadful word. It was never heard 20 years ago because people were not categorised as losers. It is meant casually, but it institutionalises the idea that competitive success is vital.

We live in a competitive culture. Competition, by definition, means that there must be winners and losers. If a significant number people identify themselves as losers by using hyped external indices and we mix in the fact that they are in a transitional period in terms of human relationships and add to this an extraordinary over-indulgence in alcohol, we have a society which offers its young people limited values to guide them through a difficult period. We offer them a society which has thrown away most of its taboos but which has not replaced them with culturally appropriate taboos.

It is extraordinary that members of the best educated generation we have ever seen, in the sure and certain knowledge that it is extremely harmful, smoke more than previous generations. This is another indicator of a problem with the belief in the worth of being in alive. It is up to us as leaders in society with some influence on its culture to deal with this problem.

Services and medical care are all also vital. I could make a speech about the quality of our psychiatric services, but this is not the time or place to do so. At the core of this problem lie the values and taboos of society and the way we allow commercial pressures to force our children into adulthood before they are ready.

In 2001, 448 people took their own lives. That is 69 more than were killed on the roads last year. We talk about the need for improved road safety and we have seen the action the Government has taken to implement it. We should now consider suicide. The Minister of State's presence in the House is a sign that the Government takes the issue seriously.

Suicide is often a cry for help. If that is true, our young men are screaming. Suicide is now the most common cause of death among 15 to 24 year olds. Adolescence and its associated pressures are creating many of the problems. A disturbing feature is that 80% of suicides are male, a matter that should be addressed in any studies the Department carries out.

Young men are not the only people at risk of suicide, but the fact that they form the major demographic when the topic is raised tells its own story. Young men are having trouble adapting to life in modern Ireland. There are many reasons for this and Senator Ryan mentioned the culture of alcohol, drugs and sex. We must ask what is it about our society that makes these young men take their own lives. Why is their suffering so great that they feel the need to end it all when their entire lives lie ahead of them? We must try to answer these questions.

The indicators that we can turn this problem around are not encouraging. It is widely believed that unemployment has an effect on the suicide rate. Unemployment has a profound effect on any person, particularly those who are young or middle-aged. Irish society awards a particular status and prestige according to a person's position and contribution to work. Unemployment is associated with the loss of that prestige. People who are unemployed are six times more like to suffer a psychiatric disorder than those in employment. Studies show significantly more unemployment, job instability and occupational problems among suicide victims. Of men who took their own lives, as alluded to in the Kelleher-Daly study in Cork with which Senator Ryan may be familiar, two thirds were out of work at the time of their deaths. With the current economic climate which is discussed regularly in the House – not necessarily with the same consensus as today's topic – we appear to be heading into a period of some job losses and readjustment, with people moving between jobs. It is important to watch this issue in that context.

I wish to refer to the area covered by the Mid-Western Health Board, including counties Clare and Limerick. In 2001 the Mid-Western Health Board area had the second highest rate of suicide, at approximately 14 per 100,000 population. That is particularly high by comparison with some other areas. The national parasuicide register shows there were 966 suicide attempts involving 716 individuals. In County Clare there were 145 suicide attempts involving 127 individuals. That is a particularly chilling statistic for a county with a population of only 100,000 and a matter about which I am quite concerned. Considering that suicide and parasuicide appear more likely to occur in rural, rather than urban areas, we need to examine the causes of this problem. Access to psychiatric and other medical services must help in addressing the problem to a greater degree in urban areas. This would suggest a need for some form of mobile psychiatric unit or better access to psychiatric services in rural areas.

With regard to the approach of the media to the suicide issue, some elements are very responsible in that regard but there are questions to be raised in relation to others. Bodies such as the Irish Association of Suicidology have had some success in getting local and national broadcasters and newspapers to stop reporting incidents of suicide. Such reports may lead to copycat cases, of which there have been very many instances in recent years. It is particularly chilling to realise how many people have taken their own lives at a whim. It may be a snap decision made as the person emerges from a bar late at night while under the influence of drink or drugs, even though all other elements of behaviour in the preceding days may have been perfectly normal. The copycat aspect is of particular concern in that context. Awareness that a friend or colleague has committed suicide may be a strong influence in the circumstances.

In some cases suicide, unfortunately, leaves a degree of stigma on families at a local level. There is still some way to go in educating the media to this problem. I have heard reports on radio stations and read local newspaper reports of deaths which were described as being the result of suicide. Fortunately, such reports are in a minority but they still occur and continue to cause problems. I am also disturbed by media coverage of suicide among people of high profile such as rock stars and film personalities. The media gaze adds an inappropriate sense of glamour to such deaths.

I pay tribute to the work of the Irish Association of Suicidology, the national parasuicide registry and all groups and bodies which have done so much to address this growing problem. I particularly compliment a Member of the other House, Deputy Neville, who has given generously of his time and resources to the ongoing debate on this problem. While the existing level of suicide is a serious worry, the level which might apply were it not for the sterling work of such organisations and individuals does not bear thinking about.

I urge the Minister of State to address this issue to the best of his ability. His contribution to this debate shows that he takes the issue very seriously and is well aware of the statistics. I hope debates such as this and those in other fora will lead to a consensus on a method of dealing with the problem of suicide.

The incidence of suicide in prisons is worrying. Improvements are being made with the establishment of better psychiatric services in prisons but it is regrettable that people with a serious psychiatric illness are still in prison rather than in a psychiatric hospital. I compliment the Minister of State on fulfilling his promise to visit the Central Mental Hospital to see the appalling conditions in that institution. It is quite incredible that the Minister of State, Deputy O'Malley and the Minister for Health and Children, Deputy Martin, were the first Ministers to make such a visit. I have visited the institution from time to time over the past 20 years and it is not something one wants to do too often. One realises that the conditions are not changing and that it is not a place to visit for recreation. I imagine the Minister of State must have found it appalling to see the conditions in which prisoners were held, including sleeping on concrete bunks, having to slop out and so on. This situation simply must be addressed. It is quite wrong that anybody deprived of his or her liberty should be kept in such appalling conditions.

I again thank the Minister of State for making the visit and expect action, not just a task force or commission. There seems to be a notion in this country that we have done something when we set up a task force or issue a report, and it does not mean anything. The walls in my office are covered in reports of task forces and commissions. Some of them are five, six and seven years old and there has been no action taken on them. I do not want to hear a word about a commission.

We can see what needs to be done up there. The plans for the new hospital are ready. All that is needed is for the Minister of Finance, Deputy McCreevy, to put his hand into his long pocket and get out the money so that we can keep people in that institution in some sort of decency rather than in the existing "grim conditions" the Minister described in a newspaper interview.

I want to mention the work the voluntary mental health associations are doing around the country. In my own area there is a very active association which has done great work in taking the taboo away from mental illness. Those organisations should be supported in every way possible.

I fully agree with Senator Ryan about alcohol abuse. The amount of alcohol being consumed by young people today is absolutely frightening. I agree that the Minister, Deputy Michael McDowell, should take every possible step to address this. We debated this matter in the Seanad a short time ago. The Minister and we, as legislators, must do everything possible to stem the abuse of alcohol among young people.

Any improvements that can be made in psychiatric hospitals would be welcomed. I speak for Sligo in this regard. There is an intention to build a new extension to Sligo General Hospital to cater for psychiatric patients. Senators on all sides of the House would agree that psychiatric hospitals were badly financed in the past. While the people working in those facilities did their best, they were very drab buildings and I do not think the conditions did any good for patients. I ask that psychiatric hospitals should be looked at in a more favourable light. They have been the poor relation of the health service over the years.

Every Tuesday evening in my constituency a group of about 30 or 40 men meet. They are very angry, bitter people. The reason they come together is because of their dealings with the courts. Many of them are young men with kids of one or two years of age. They are young fathers aged 18, 19, 20. They cannot get close to their children because they are not married to the mother. They cannot get housing from the local authority because they have no dependants, according to the State. They meet to discuss their situation in the courts. It is a very negative discussion. They believe that the courts are totally structured against them. They believe that the application of the law by the Garda is totally against them and that the experience they have is not being replicated.

I visited this group two Tuesdays ago with a Member of the other House. Within that group I could see one or two guys very close to the edge. We must really associate, and begin to concentrate on, the kind of positive male role models in many working class communities. There are many communities where you do not see a man at all. Some 75% of all teachers in our national schools are women. In many circumstances, because of the high number of one-parent families, fathers are not around the place. There is no positive male role model.

This is a multidisciplinary interdepartmental issue which needs to be assessed. We need more male teachers in our national schools. We need to campaign on men's health issues. The levels of prostate cancer, as the Minister of State will be aware, are significantly higher in this country than in other countries because we have done nothing to advertise and concentrate the minds of people on the issue. When one goes into a GP's surgery, one sees women in the main because of the very poor association between medical health providers and men. Even when I go into a GP's surgery I see all kinds of campaigns rightly focusing on female conditions and female problems, but not the same concentration on men's health issues.

Throughout our society we must address these issues systematically, in terms of education and men's dealings with the courts so that they can stay close to their children. There are far too many families where there is no father close by. Many of the young men I saw at that Tuesday meeting in my constituency cannot get physically close to their children. They have no home to which they can bring their children. They are totally disillusioned by the fact that their children cannot stay close to them and in a sense they are frozen out of their communities, out of the family home.

This is an issue we must continually talk about and highlight. Unfortunately for many working class men within our system there is a view that men are failures. As long as that view permeates society, we will continue to experience high levels of suicide.

I ask the Minister of State to discuss these issues with his colleagues in a range of Departments. Such discussions should take account of the fact that more male teachers are required in national schools. They should also take cognisance of men's health issues – for which the Minister of State has responsibility – and the fact that housing should be provided to men who are on their own in order that they can see their children. Single male applicants are at the bottom of the housing lists in every local authority area and, without accommodation, they cannot see their children. This results in a sense of failure, which can lead to depression and suicide.

The key is to destigmatise suicide so that it is viewed as an illness which has fatal consequences, but which can be prevented. We must realise that our society is going through a very rapid transition. So many of our value systems are being swept away, including many of the pillars that supported people in society. Religious values are gone and we have put nothing in their place. It requires a huge community effort to do that. In the meantime, there should be immediate and available help and counselling for people at risk. There should be encouragement towards self-respect and the creation of an identity and the removal of the appalling sense of worthlessness or inferiority that drives people over the edge. I wish the Minister of State well in his efforts.

There is compelling evidence that adequate prevention and treatment of depression and alcohol and substance abuse can reduce suicide rates. School-based intervention – involving crisis management, self-esteem enhancement and the development of coping skills and healthy decision-making – has been demonstrated to reduce the risk of suicide among the young. The civics, social and political education module in secondary schools could be used to discuss these issues in order to help young people, particularly men, who feel they have nobody with whom to discuss their problems.

Among the young, there is a stereotype of the young man as being macho, good at sports, a big hit with the ladies and a heavy drinker. There appears to be a worrying lack of understanding about the causes of depression, despite the fact that depressive illnesses affect 7% of the population. Depression is also linked to heredity, as are many other illnesses, and people should recognise this.

A recent survey conducted by MRBI for Lundbeck Ireland, specialists in the treatment of diseases of the central nervous system, found that 87% of the Irish public agreed that stressful jobs are more likely to cause depression. A large percentage also agreed that those in management positions, housewives and the self-employed are all prone to depression. I am concerned that, in the section of the survey dealing with attitudes towards treatment of depression, it was found that 41% of people continue to believe that there is no permanent cure for depression and 42% think that only seriously depressed people take anti-depressants. This is not the case, with more than 70% of patients responding to treatment with a single drug. Unfortunately, for some people, life-long treatment may be required to keep them from having relapses of depression.

Given that some 280,000 Irish people currently suffer from depression, it is incredible that the public is so misinformed about this disease and its treatment. Depression is closely associated with suicide, with almost eight in every 100 patients attempting suicide at some point in their lives. Where the patient also suffers from a panic disorder, the figure rises to a remarkable 19.5%. Depression really is a matter of life and death.

The survey revealed that 15% of Irish people believe depression cannot be treated with medication. The 15 to 25 year old age group was the worst informed, with 28% stating that depression cannot be treated with medication. In fact, 80% of people respond to counselling or anti-depressant medication within a matter of weeks.

There have been significant advances in the development of anti-depressant drugs. However, we must also recognise that alcohol is a depressant and surely the abuse of drink is not helping the mental well-being of our young people. According to the survey, 21% of those aged between 15 and 24 years would not visit their GP if they felt depressed. The average was 13%. It is disturbing that one in eight people would not seek medical help if they felt depressed.

It is time to dispel the myth and deal with the reality that people become depressed. It is an illness and it is treatable. We need to break the taboo about depression so that those who need treatment feel able to seek it. I thank Senator Brady for raising this matter in the House.

I know the Minister of State's commitment to his Department and the way he has set about tackling problems. I have every confidence in him and his officials in tackling the problem and turning it around. I hope that, in a year or two, we will have the same falling figures in Ireland that pertain in the US, Australia and New Zealand and it will be a job well done.

The Minister of State said the Health (Miscellaneous Provisions) Act 2001 provides that a Minister from the Department of Health and Children must make a report to each House of the Oireachtas. Various agencies are meeting to discuss the issue and this can only be good as it brings the issue into the open. The opening of the debate brings depression to the attention of a greater number of people, some of whom may seek to contribute to the debate.

As one goes through life one reflects on events that happen and draws conclusions. Those conclusions may not always be correct but they can sometimes be of help. When I taught young women in secondary schools I always watched out for them as they went through school and tried to help them if I could.

I live in Athlone on the banks of the River Shannon. "He went to the river" is a local saying that means he did not come back. It is always a terrible event in an area. The minds of those who attempt suicide are in such turmoil that they see suicide as salvation.

I thank the Minister of State for coming to the House. I also thank those who contributed to this very good debate.

Senator Morrissey referred to the data sheets of the drug Cipramil and I will take up his point. This has been raised on radio shows recently in the aftermath of a suicide and problems with certain drugs. The issue the Senator raised is a huge problem in society and I am well aware of it. The pharmaceutical industry and medical profession used drugs such as diazepam, barbiturates and others and said they were not addictive. While it should not take several years for the truth to come out – unfortunately sufficient people do not stand up and say what they know – there is no doubt that all these drugs are addictive. I am not demeaning the value of these new therapeutic drugs. Many of those who are using them are ambulatory and in the community and but for these drugs would be in institutions. However, their overuse and over-prescribing is an issue.

It is interesting that Mr. Dermot Walsh, the inspector of mental health institutions, has consistently referred in his reports to polypharmacy, the overuse of drugs or the use of several drugs where one or two could be used. Perhaps Members will reflect on this. The more who are aware of it the more we can challenge the medical profession on best practice. I have said many times that the doctor does not always know best. No profession has a monopoly of wisdom, including the pharmaceutical industry. As a pharmacist, I question the role the industry plays in the education of the medical profession. I will speak out on this as time goes by. It is an important aspect of the issue.

Senator Ryan also contributed to the debate. It was fantastic that it was not conducted on political lines. It was excellent. Senator Ryan discussed the value system in society which is hugely important. He and several other Senators mentioned the use of alcohol. I am in no doubt about its influence in many suicides, a large proportion which take place after alcohol has been taken. We have to confront this fact. I am delighted a huge debate is taking place in society about alcohol and its abuse.

Senators Dooley and Moylan referred to inter-county statistics. I urge caution in this regard. The Senators are talking about small numbers which can be dangerous. In my area of Limerick there were one or two suicides but they led to several copycat incidents. When one is dealing with small figures and there are three or four such suicides, it can throw out the statistics.

Senator Henry mentioned the Central Mental Hospital, Dundrum, which the Minister, Deputy Martin, and I visited recently and it was not a pretty sight. I hope we will be able to make progress because it is not a good show for our country. People with psychiatric illnesses who are in jail have the same rights as everybody else. Unfortunately, we have not treated them well. Some Members mentioned the media in which there is a general awareness – certainly the better informed media – about how this issue should be handled.

I thank Members for the debate on this issue, in which all Members of the Oireachtas should take a leadership role. I compliment Deputy Neville on the huge role he has played in leading the debate over several years which I encourage Senators to continue. I was in Limerick about a fortnight ago when I received a telephone call from a good friend who told me her young brother, who was 20 years of age, had committed suicide the night before. One feels so inadequate. For the family left behind it is a shocking experience. It behoves all Members to work together and do all we can to reduce the numbers.