Dáil Éireann debate -
Wednesday, 13 Dec 1995

Vol. 459 No. 7

Adjournment Debate. - Suicide Incidence.

Ms M. Fox

Thank you for allowing me to raise this matter. Suicide is a major public health issue in Ireland. Official figures show that over 1,000 people committed suicide in the past three years. Several thousand people have attempted suicide during that period but were saved from death by family intervention, medical assistance and, in some instances, by good luck. The official figures are very depressing, but the real story is much worse. Experts estimate that the number of suicides in Ireland could be three or four times greater than the official figures suggest.

As a young person I am greatly concerned at the increase of suicide, which is particularly marked among young people. Some of these people were friends of mine and while the loss of a friend at any time is a terrible and devastating blow, to lose a friend through suicide is much worse. So many unanswered questions remain. Should we not have noticed the suicidal intent? Could it have been prevented? The bereaved, in trying to come to terms with the situation experience mixed emotions. They can vary between bitterness, sadness, loss and blame. In every case of suicide there are a number of people left behind who are in great need of counselling. They must learn and understand the whole grieving process, and they must be helped to come to terms with this tragedy.

The Minister for Health, Deputy Noonan, recently established a national task force on suicide. I very much welcome this move. It is intended that by July 1996 the task force will have completed a detailed analysis of all existing data relating to suicide, attempted suicide and associated factors. The remainder of the year will be devoted to a major consultation exercise involving all interested parties leading to the formulation of a national suicide prevention strategy.

I wish members of the task force the best of luck. If it succeeds in preventing the loss of one life it will have achieved much although I expect it will be more successful than that. Suicide and attempted suicide were decriminalised in Ireland in 1993. However, despite the change in legislation there is still a social stigma attached to such acts. The lid of silence has yet to be lifted and until such time as we acknowledge a major problem exists progress will be slow.

Suicide has been a taboo subject for far too long and it is vital that we have a national debate on it. Each year in December the gardaí launch a campaign to prevent death on the roads yet more people die as a result of suicide than are killed on the roads. Action is needed. It is vital that the true picture be established. We must learn the real extent of the problem and put measures in place to reduce it.

Society must take a more compassionate view of suicide. It is vital that suicide prevention programmes are available throughout the country. Help and support for the bereaved is also essential. I hope the task force carries out its work openly and that it helps to change the public's perception of suicide, the victims and their families.

Over three times as many men as women kill themselves in Ireland. While spring and summer are the most common times for people to commit suicide, many seriously consider taking their lives around Christmas time and the New Year. For the majority of people, Christmas is a time of celebration but for others unfortunately it is a time when they feel most alone. It is important that people are mindful of this fact.

There is no doubt that people will continue to commit suicide. More support is needed for those at risk and for those affected by suicide. I pay tribute to the Samaritans for the wonderful work they do in this area. They provide an ear to those who hit rock bottom and their work cannot be fully evaluated. We owe a huge debt to them.

A large number of Irish people are affected by suicide. It is not good enough that the required support is provided solely by the professonal services and the Samaritans. We all have a part to play. Society must have a more compassionate attitude towards those who commit this final act — as Fergal Bowers stated "Let God be the judge of their actions, not us".

Mr. Noonan

(Limerick East): I thank Deputy Fox for raising this issue and dealing with it in such a sensitive and compassionate way. In the past, the numbers of deaths from suicide in Ireland were low but numbers have increased in the last 20 years. In 1970, there were 52 suicides reported. In 1993 this figure had risen to 360. These increases have not been accompanied by a fall in other causes of unnatural death such as accidental poisoning, accidental drowning and open verdicts in coroners' courts. For this reason, it must be accepted that there has been a genuine rise in the incidence of suicide.

It is more pertinent, however, to examine the rate of suicide, that is, the number of suicides as a proportion of population, and this has also increased significantly over the years. Between 1970 and 1993 the suicide rate ranged between 0 and 4 per 100,000 of the female population while the rate among males showed an increase from 3 to 17 per 100,000. A classification of suicide rates by age indicates that adolescent males in the 25-34 year age group have the highest rate of suicide.

The Criminal Law (Suicide) Act, 1993 abolished the offence of suicide but it continues to be an offence to be an accomplice to suicide.

It is important to distinguish between suicide and para-suicide. Para-suicide may be defined as an act with a nonfatal outcome in which an individual uses non-habitual behaviour which, without intervention, will lead to self-harm. It is aimed at bringing about a change in circumstances or as a "cry for help". It would be wrong to assume that all suicide victims are determined to take their own lives. Many are ambivalent. The outcome is determined by the degree to which the method used is lethal or otherwise. However, it is estimated that approximately 1 per cent of those who deliberately self-harm will take their own life in the following year and that over their lifetime, 15 per cent will have taken their own life.

Few acts have such deep roots in social and human conditions or as far reaching consequences. The factors which give rise to suicide have been the subject of debate for many years. Changing structures in society, increased pressures of daily living, depression and social isolation could all be seen as contributory factors.

Along with research into the factors that influence an individual's decision to undertake a suicidal or para-suicidal act, it is also necessary to look at services already in place and to examine ways in which these could be improved and made more accessible to those in need. The development of the psychiatric services in line with the aims of Planning for the Future, a service which is comprehensive, community-oriented, sector-based and integrated with other health services, has led in a short time span to a greater level of public awareness and understanding of psychiatric illness.

Both the Green Paper and the White Paper on Mental Health discuss the need for the promotion of positive mental health and the prevention of suicide. Mental health personnel have an important role to play in the prevention of suicides and voluntary bodies such as the Samaritans also make a valuable contribution. I welcome Deputy Fox's endorsement of the Samaritans.

The World Health Organisation in its Targets for Health for All has recommended action to reverse the rising trend in suicide by the year 2000. It highlights the importance of early detection and treatment for depression, alcoholism and schizophrenia. All these factors are currently being addressed in the context of the reorganisation of our mental health services.

In recognition of the need for detailed analysis of existing data on the factors which lead people to take their own lives and the most effective way of intervening to prevent premature loss of life, a task force on suicide has been established to address these issues in detail. It will be serviced from within the mental health services division of my Department. The first meeting took place today. It has the following terms of reference: (i) to define numerically and qualitatively the nature of the suicide problem in Ireland; (ii) to define and to quantify the problems of attempted suicide and para-suicide in Ireland, including the associated costs involved; (iii) to make recommendations on how service providers can most cost-effectively address the problems of attempted suicide and para-suicide; (iv) to identify the various authorities with jurisdiction in suicide prevention strategies and their respective responsibilities; and (v) to formulate, following consultation with all interested parties, a national suicide prevention strategy.

It is anticipated that by July 1996 the task force will be in a position to submit an interim report containing detailed analysis of all existing data relating to suicide, attempted suicide and associated factors. The rest of 1996 will be devoted to a major consultative exercise involving all interested parties leading to the formulation of a national suicide prevention strategy by the end of 1996. I am confident that research and consultation on this issue will significantly help to prevent this tragic loss of life.

Prior to the establishment of the task force there were a number of studies on suicide taking place. The Department is providing financial support to a study on para-suicide in the Southern and Mid-Western Health Board areas. The aim of the study is to reduce the incidence of para-suicide and to develop intervention skills which may be applied to this area. The study is a collaborative partner in the WHO-EURO Multi Centre Study on Para-Suicide.

A further study on the incidence and associated risk factors in relation to suicide is being piloted in the NorthEastern Health Board by the recently appointed directors of public health.

The task force on suicide will draw on the research findings of each of these studies and following the consultation process it will develop a national suicide prevention strategy.