Written answers

Wednesday, 27 January 2016

Department of Health

Self-Harm Incidence

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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131. To ask the Minister for Health if he has major concerns regarding increased incidences of self-harming among young boys; and if he will make a statement on the matter. [3365/16]

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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In 2014, the National Registry for Deliberate Self-Harm recorded 11,126 presentations to hospital due to self-harm nationally, involving 8,708 individuals. The self-harm rate, 200 per 100,000 of the population, was essentially unchanged from 2013. This levelling off follows three successive decreases in the rate of persons presenting to hospital following self-harm from 2011 – 2013. The only significant change in the rate of hospital-treated self-harm by age was among boys aged 10-14 years, where the self-harm rate increased by 44% from 34 to 49 per 100,000. Since 2007, the male rate has increased significantly, by 14%, whereas the female rate is less than 1% higher than in 2007.

The HSE Mental Health Division has a multifaceted response to people at risk of self-harm or who have had a self-harm episode including referral by GP to Community Mental Health Teams for the appropriate service; liaison psychiatry services onsite in Model 3 and 4 and acute hospitals; a comprehensive mental health on-call service in Emergency Departments in the acute hospitals for people presenting in crisis during the on-call period; self-harm clinical specialist nurses in a number of Emergency Departments; the Suicide Crisis Assessment Nurse (SCAN) Initiative by which GPs can refer directly to SCAN Nurses for assessment and advice on management of their patients who attend their surgeries with suicidal ideation. In each of these settings, a comprehensive biopsychosocial assessment is carried out together with an assessment of mental state and a risk assessment for suicide. On the basis of this, a care plan is drawn up and the next steps depend on the psychosocial stresses identified together with the presence or absence of a mental illness such as depression.

Community Child & Adolescent Mental Health teams are the first line of specialist mental health services for children and young people. There are currently 67 Child and Adolescent Community Mental Health Teams and 3 liaison services nationally. The multidisciplinary team, under the clinical direction of a Consultant Child & Adolescent psychiatrist, includes junior medical staff, psychologists, social workers, nurses, speech & language therapist, occupational therapist and child care workers. The assessment and intervention provided by such teams is determined by the severity and complexity of the presenting problem(s). This range of disciplines and skills offer a care and treatment package geared to individual needs.

The upward trend in self-harm among young boys is concerning and highlights the on-going need for prevention and intervention programmes to be implemented at national level.In this regard, the HSE in its National Service Plan for 2016 commits to “Develop early intervention and prevention services, in collaboration with primary care and NGO providers, to ensure that children and young people can access assessments and interventions, including access to counselling and psychology, at the appropriate stage to prevent and reduce escalation to secondary care mental health service and as recommended in Healthy Irelandand Connecting for Life." Funding is also being provided this year for the provision of three new Jigsaw youth mental health services in Cork, Dublin and Limerick.

The HSE’s National Office for Suicide Prevention (NOSP) helps to support a wide array of work in communities, in partnership with the voluntary sector, across the country that focus on promoting positive mental health and reducing suicide and self-harm by providing significant grant funding each year, as well as by assisting in coordinating and giving strategic direction to the work undertaken in this area. NOSP supports a range of services for teenagers and young people including Pieta House, SpunOut.ie ReachOut.com/Inspire Ireland, BeLongTo. The 24 hour call services provided by the Samaritans and Childline are available to any young person in distress and are also funded by the NOSP. In addition, the NOSP also worked closely with the Department of Education and Skills in the development of Guidelines for Mental Health Promotion and Well-Being in Primary and Post Primary Schools.

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