Private Members’ Business.

Suicide Levels: Motion (Resumed).

The following motion was moved by Deputy Connolly on Wednesday, 5 May 2005
That Dáil Éireann:
noting,
—the latest statistics reveal that suicide now accounts for 50% more deaths annually than road accidents — 444 last year as against 293;
—suicide is the most common cause of death among 15-24 year-olds in Ireland, and the highest in this age group of all 25 EU states;
—the suicide rate in Ireland is rising faster than in any other EU country, and the rate among young females doubled between 1992 and 2000;
—the highest rate of suicides over the past five years is among young men in the 20-29 age group;
—in 2003, 11,200 parasuicides, or attempted suicides, presented at hospital accident and emergency departments across the country;
—the correlation between suicide and factors such as unemployment, living in poverty, bullying, relationship break-ups, legal and work related problems, alcohol and drug abuse, physical or sexual abuse in childhood and social exclusion;
—student counselling services in third level colleges across Ireland are stretched to capacity, with lengthy waiting lists over the past two years despite having extra staff employed;
—the slashing of the mental health budget to 6.8% of the total health budget from its 1997 level of 11%, despite continuing to claim more lives annually; and
—there are only 20 inpatient beds with specialised services for adolescents with mental health problems, despite a Government-commissioned report recommending in 2000 that at least 120 such beds are needed;
calls on the Government to:
—immediately implement the 86 recommendations of the 1998 report of the national task force on suicide on ways to prevent and reduce the incidence of suicide or parasuicide;
—establish a national suicide prevention agency to coordinate the services provided by various authorities throughout the country;
—provide a comprehensive programme of multi-disciplinary research and investment in suicide prevention strategies;
—improve awareness of suicide by ploughing extra resources into educational programmes and mental health services;
—address the problem in second-level schools by the inclusion of mental health and psychology in the curriculum;
—increase funding for student counselling services at both second and third levels, and diminish the aversion and stigma attached to seeking counselling, particularly among young males; and
—develop an effective strategic action plan for both the prevention and reduction of suicide as an urgent national priority.
Debate resumed on amendment No.1:
To delete all words after "Dáil Éireann" and substitute the following:
"notes the many initiatives undertaken by Government and by health service providers since 1998 aimed at reducing the incidence of suicidal behaviour including, for example:
—the placement of liaison psychiatric nurses in accident and emergency departments of general hospitals;
—the provision of training to relevant health care personnel in matters relating to suicidal behaviour;
—the development, in each health service area, of a directory of services, both statutory and voluntary, which are available to those concerned about or at risk of suicide;
—the introduction of restrictions in the availability of paracetamol, which can be harmful in overdose;
—the establishment of the national suicide review group and the appointment of suicide resource officers in each health service area;
—the provision of additional funding for research into suicidal behaviour and the prevention of deliberate self-harm;
and welcomes the development of a national strategy for action on suicide prevention, which will be published later this year."
(Minister of State at the Department of Health and Children, Mr. T. O'Malley).

I propose to share time with Deputies Grealish, Fiona O'Malley, Tony Dempsey, Glennon and Fox.

Is that agreed? Agreed.

I compliment our colleagues in the Independent group for framing this motion. It gives the House an opportunity to debate an issue that is of great concern throughout the country. I hope there is a measure of agreement across the floor on this issue. My sense is that there is not a family in the State which has not been affected or touched in some way by suicide. I am glad to acknowledge the presence of my colleague, the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, who has shown a particular interest in this subject.

Two weeks ago I attended a meeting in Tallaght, organised in An Cosán, the educational development project. My colleague, Deputy Crowe, was also present. It was a most profound evening in the sense that we had the opportunity to listen to a presentation from people who had been affected by suicide in different forms, over the years. The meeting was organised by the support learning group, Action for Men, and was an amazing experience. The chaplain in Tallaght hospital, Ms Kathleen O'Connor, facilitated the meeting. It brought home to us the difficulties associated with suicide, the effects it has on communities etc. I said at the time that there is a political dimension to these issues and as such political initiatives are required. In that context I am always happy to acknowledge the contribution that is made on a regular basis to this debate by Deputy Neville. We all should applaud the work he does in that regard. I listened carefully to his contribution last night, and it is important that we support the ideals being expressed.

An initiative has emerged in Tallaght following the sad death of teenager Darren Bolger, about three years ago, in Kilnamanagh, which got wide coverage in the national media. Arising from that sad incident, his mother, Maureen, has developed a teenline initiative over the last couple of years. This type of initiative is something we should strongly support. The message came across at that young man's funeral and subsequently, through contacts with his family, that very often teenagers need someone to talk to, particularly at critical times. It is important that we understand the particular needs in that regard.

We all talk about teenage suicides. Coming to the House this morning I heard Pat Kenny doing a trailer for an item he is to do on that subject. I made the point at the Tallaght meeting that I am often fascinated by incidents of suicide involving elderly people. I am, of course, mindful of young people who, as the subject of this motion, are often under enormous pressure. In Arbour Hill, yesterday, the Auxiliary Bishop of Down and Connor made the point that it was even more dangerous, nowadays, to be a young person, bearing in mind the pressures and difficulties they encounter as regards drugs, alcohol abuse and so on. However, I am also emphasising that there is clearly another group that is affected by suicide, namely, the elderly and I hope the Minister of State will continue to examine that.

I picked up a point from Deputy Neville last night as regards the way suicide is accepted nowadays. The traditional view until recently was that if people committed suicide and families were affected, the best course was not to acknowledge it. Coroners' courts frequently put "death by misadventure" on death certificates. It is a healthy sign of the development of the community and the country that there is now an acceptance and acknowledgement that a problem exists. I am often impressed at church services where the reality of what is occurring is accepted. There is no question, however, that families and communities are deeply affected. All of us have had contact with families affected by suicide. We know issues have to be resolved as regards who is to blame, what the conflicts were, what should or could have been done etc. It is a subject that requires great sensitivity, but clearly needs action. I am glad the Minister of State has made the point that efforts are being made at health board level and through the Department of Health and Children to have educational projects targeting this area and more can be done in this regard.

I call on the Department and the Government to continue their work in this regard. Serious consideration should be given to providing an information pack for every home in the country, where people can examine the issues, see what is involved and in particular, learn how responses may be made. There is a job to be done. As legislators, we all have a responsibility to ensure that as much action as possible is taken on this subject. The Government should send information leaflets to every home in the State giving families an idea of how they should respond and providing them with as much information as possible. Such an initiative would not change things overnight as there are many other issues. The families affected by suicide often find it very difficult to access services and to find out what should be done.

Officials from the Department have made the point at the health hearings that they have to deal with a great number of issues. This issue is worthy of our attention.

I am pleased to have an opportunity to speak on the tragic issue of suicide. Everyone has been affected by suicide as we all know someone, or people close to someone who has died by suicide. In my constituency, Galway West, eight people have become so concerned about depression and suicide among young people that they are establishing a support group. Rather than focusing on mental health problems, the group plans to promote positive mental health among children and teenagers. A similar model exists in many American schools. Students are identified who may have worries about bullying and other issues. I wish this initiative well.

This issue is serious. We need to look no further than the statistics to realise that we must do more. There were 444 registered suicides in 2003, which is a harrowing toll for families and society. As Minister for State with responsibility for mental health and disability services, my colleague Deputy Tim O'Malley has made exceptional efforts to tackle the issue of suicide. I commend him for his efforts and welcome his contribution to the debate last night.

Growing suicide rates are an international phenomenon. The question that dominates the entire debate is "why?". Why are more people tragically taking their lives? There are no simple answers and that is what makes this such a complex policy area. People have pointed to the decline in family, community and religious belief as contributing to the problem. At the same time, we have seen the ever increasing pressures of modern life, with an increased abuse of alcohol and drugs. Tackling any one of these issues on its own is a difficult task. Tackling them as a combined contributory factor in suicide rates is an extremely challenging task, but one we must meet head on.

It is crucial that we acknowledge the work of the 1998 national task force in producing its report on suicide, as well as the response of the statutory and voluntary bodies to the recommendations of the report. Discussions in this House might give the impression that the responses by the statutory and voluntary bodies have been less than committed. That is not the case. The recommendations of the task force are an important effort in tackling the complex policy areas to which I referred. In every health board area, responsibility for implementing these recommendations lies with the appointed resource officers and that is to be commended. These officers play an important role in not just implementing the findings of the task force, but also promoting positive mental health and destigmatising the suicide phenomenon. They are a critical element in addressing this tragic issue. The issue of stigma has been central in Ireland for many years.

The Irish Association of Suicidology held its annual conference in Galway last year and the same points were made. For far too long there existed in Ireland a stark silence following a suicide and even sometimes a lack of support for the bereaved. This made the loss of a loved one even more difficult to bear. The silence was often excused as merely being respectful. Even the media engaged in this by reporting suicide as a death in tragic circumstances. The conference in Galway heard that this issue only served to stigmatise and isolate the bereaved families. It also left society paralysed by the fear of suicide. The work of resource officers to destigmatise suicide by breaking the silence must continue. I am encouraged by the progress made on the national strategy on action on suicide prevention. It is critical the strategy is action based from the start and I am pleased that this has been confirmed.

We must make education the centre of wider suicide prevention programmes. Experts have highlighted the need to educate health professionals, the public and patients about the link between psychiatric problems and suicide.

Tá áthas orm labhairt faoin fhadhb seo sa díospóireacht an-thábhacthach seo. I thank the Minister of State, Deputy Tim O'Malley, for his visit to St. Senan's Hospital in Enniscorthy last week, when he met experts in the field of suicide. I also thank him for his positive approach to try to address the causes of suicide. I compliment Deputy Neville on the hard work he has been doing in the same area.

All politicians have to be alarmed at the increasing rise in suicide. In my county of Wexford, I would like to extend my sympathy to those recently bereaved by suicide. We have had more than our share. If rates of suicide rise, they have to have something to do with community. It is time that one of the sociology departments in our universities examined an area like my county and did an in-depth survey of how the community has changed. I am convinced the changes have given rise to increases in suicide. Drug abuse is a new phenomenon. There is a diminished spirituality which once gave hope to people. It has often been replaced by despair. Alcohol abuse is at a new level and the increase in wealth has allowed young people to buy alcohol. The points system in the leaving certificate may well be a contributory factor. One of the highlights of my school career was to play hurling. That has largely disappeared. Many people are afraid to play hurling and rugby with their school because they may not get the points that are part and parcel of the rush to university. When one does not engage in social education in school, be it soccer or debating, it can lead to a kind of isolation. Our system no longer allows for it.

Recently, we had a survey by the planning department of Trinity College on the ideal village in Kilmuckridge, County Wexford. It is high time we asked one of our college departments to analyse community changes. It is almost impossible to look at television without witnessing one form of violence or another. On popular programmes such as "The Late Late Show", people are often interviewed on violent crime, be it recent murders in Northern Ireland or whatever. Violence is part and parcel of everyday life, with 100,000 people dead in Iraq and where we in Ireland can look at that on television. People are no longer afraid of death or of the consequences of it.

A survey might help to identify the causes of loneliness. Task forces set up in 1998 and 2001 identified depression as a contributory factor. The breakdown in marriage may also be a contributory factor. A famous sociologist, Durkheim, identified three different types of suicide. If memory serves correctly, one was altruistic, one anomic and the other egoistic and egoistic suicide was higher among single people than married people. Therefore, relationships may well be a contributory factor. The issue for politicians is not just about spending money, of which a considerable amount has been spent, but more about identifying the changes in community living that are a contributory factor.

I am delighted to have the opportunity to speak on this important but sad topic. Like my colleagues on all sides of the House, I am gravely concerned by the growing rate of suicide here and the statistics are extremely worrying.

Suicide touches the lives of many families and has an intensely devastating effect. Many of us know of a family touched by the tremendous pain of losing a loved one through suicide. I know of many families in my constituency who have had to bear this unenviable and intense loss which is difficult to accept and understand. I have also seen how the resulting pain and anguish, and sometimes anger, affects not only the family but the entire community or town in which the deceased lived. We all agree that suicide and reducing the rate of it are an important public health issue.

I looked for an appropriate definition of suicide when researching my contribution. It was difficult to find one, but I came across some interesting phrases. One in particular stood out in its clarity and simplicity. It was: "Suicide is not chosen. It happens when pain exceeds resources for coping with pain." We must focus on the last part — the resources for coping with pain. This is where we, as legislators, can make a difference. In this regard I commend the Minister of State, Deputy Tim O'Malley, for the personal interest he has taken in this issue, and also, in his absence, Deputy Dan Neville for all the work he has done in this area over the years.

It is accepted that we all experience real pain at some stage in our lives. Dealing with that pain is the secret. The resources available to us to deal with it and how we apply them to the pain are what affect our lives and the lives of those closest to us. Most people do not understand suicide. I do not. We experience a variety of emotions when we hear of the death of someone from suicide. There is no easy explanation.

I was interested to hear it explained in this way. If we put a weight on someone's shoulder and then continually add to that burden, the person will eventually collapse because of the weight. Comparisons to this simplistic description may be drawn with someone who commits or tries to commit suicide. That person has come to the point where the weight is too much. As parliamentarians, we have an obligation to ensure the resources for coping with pain always outweigh the pain.

Recently, the Scottish Executive examined the problem of suicide. Scotland has similar statistics to us in this area. Scotland has launched an impressive and expansive programme, Choose Life, which states that tackling suicide must be a long-term strategy as there are no short-term solutions for a problem of this magnitude. It also states that tackling suicide as a single issue policy will result in failure. Therefore, I suggest that our policy on preventing suicide must be at the heart of all our policies, particularly those associated with social justice, education, health, inequality, community affairs, local government, plans for economic regeneration and right across the board. We have a duty to cater for suicide and to reduce the risk.

The Choose Life programme states that the most effective way to tackle suicide is to provide early support and intervention, thereby developing a wide range of supports and services. The need to provide improved training for our front line workers is imperative so that situations can be identified early and that, where possible, suicide can be prevented. I commend to all the Choose Life report and programme of the Scottish Executive.

I want to draw a link between depression and suicide. The American Institute of Suicidology has issued interesting statistics. It has stated that the risk of suicide in people with major depression is approximately 20 times that of the general population. An alarming statistic is that seven out of every 100 men and one out of every 100 women who have been diagnosed with depression at some stage in their lifetime will go on to complete suicide. This is worrying and alarming. We should keep this in mind at all times when dealing with this tragic issue.

I welcome the opportunity to say a few words on the subject of suicide. Like many others, my community has had the unfortunate experience of losing a number of people through suicide. I thank the Technical Group for raising this matter and highlighting the subject.

One of the first times I spoke in this House was on the subject of suicide. At the time a task force was being set up to examine its high incidence. Since then suicide has overtaken road fatalities as the biggest cause of loss of life among young people. However, while we have many campaigns aimed at reducing the number of road fatalities, there is nothing on a par aimed at those who may be considering suicide.

Thankfully, suicide is no longer the taboo subject it once was. However, in terms of mental health issues, we still have a long way to go before it is a subject that is openly and comfortably discussed in society. Unfortunately, mental health issues such as depression are all too often carried in secret, dismissed or not taken seriously. AWARE tells us that one in three of us will suffer a depressive episode at some time in our lives, yet depression remains under diagnosed and under treated. This rings true when we consider the difficulties with alcohol and drug abuse in society and the ever increasing numbers of those who take their own lives.

The area of mental health services can be a nightmare for many. For many families with a loved one with a mental health problem, it can be impossible to obtain help or services. I am aware of cases where parents have had to go to court and get barring orders against their children, whom they believed were suffering with mental illness, in the desperate hope that a sympathetic judge would force the State to assess them and have them helped. Some families have brought young adults to psychiatric hospitals for help but, shamefully, they were sent home feeling completely alienated. I wish this was an isolated case, but I am aware of a number of such cases.

There are also some families with young adults who are officially diagnosed with a so-called behavioural disorder which does not seem to be severe enough to warrant help. Many of these families tell us that they live in fear of an adult child. They do not want to put them out on the street, yet they do not seem able to get help anywhere for them.

County Wicklow is lucky to have a number of voluntary organisations that provide support and assistance for families of the victims of suicide. Many of the issues they raise with us as public representatives could be addressed on a practical level. Unfortunately, many families have to wait for up to two years for an inquest into the death of their loved one because it was a suicide. When the inquest finally takes place, it is in a courthouse where there are people on all types of business. All the inquests are held together and afterwards bereaved families are just left to grieve in the hallway. This could be easily addressed and the Minister of State should take up the issue.

The provision of counselling services for those considering suicide and families of victims is in short supply. Counselling is mainly left to voluntary organisations to sort out and it is difficult to access the services. The provision of counselling for those considering suicide should be easily obtained and services should be widely publicised and available.

The Department of Education and Science has a vital role to play in highlighting mental health issues in secondary schools because such a large number of young people take their own lives. Special programmes on mental health issues aimed at encouraging young people to seek help if they feel they need it should feature widely in secondary schools so that young people do not feel they are being singled out. A universal programme should be introduced. Young men, in particular, should know a service is available to help them, even if they never need to use it. I welcome the work that is being done on a national strategy and I hope it helps to reverse the trend.

I am grateful to Deputy Grealish for sharing time. I welcome the Minister of State, Deputy Tim O'Malley, and compliment him on the initiative he has shown since taking up office. I am pleased to have an opportunity to contribute to the debate, as I have expertise in this area having worked in the psychiatric service for almost 20 years. I have been chairman of the Roscommon Mental Health Association for the past five years. This is a voluntary organisation, which befriends people who avail of psychiatric services. We have held a number of seminars to which we invited people in public life, particularly from the media and RTE, who have suffered or continue to suffer from depression and other mental illnesses. They have helped to break the stigma and taboo attached to mental illness and suicide.

However, the issue should be examined more deeply. I have put many man hours into the mental health association together with numerous colleagues who work on a voluntary basis. Two issues need to be addressed. I am absolutely convinced that the psychiatric service is the Cinderella of the health services. Its funding comprises 7% of the total health budget. Experts believe the psychiatric budget should be between 10% and 12% of the overall budget. The fundamental issue of resources for the mental health service must be addressed. The reason I have identified it is that approximately 15 years ago, health boards rightly moved to a community-based psychiatric service. While the decision was taken, the necessary resources to implement it have not been put in place.

People suffering from a mental illness who have a brush with the law can wind up in a Garda station or in prison. Generally, the gardaí can only deal with their offences on a public order basis. Many people who engage in unsocial behaviour as a result of a psychiatric problem wind up in the courts and in prison and many suicides result.

The appointment of mental health development officers has been totally inadequate. There is one mental health officer in my area who must cover two counties, Mayo and Roscommon. The health board thought so little of the position that it refused to second a person last year to Mental Health Ireland to carry out the relevant duties. The health board insisted the officer should leave the payroll of the health board and it would make a contribution to Mental Health Ireland for that person's work.

A number of fundamental questions must be dealt with regarding mental health services. Mental health is of vital importance to the country's progress. The lack of a proper mental health service is costing hundreds of millions of euro a year. Sometimes people make the foolish distinction that mental illness can be dealt with elsewhere and they do not recognise the connection between mental health and the ordinary day-to-day lives of people. That is a major mistake.

I compliment voluntary groups such as AWARE and Mental Health Ireland. However, we should examine the issue more deeply.

I wish to share time with Deputies Costello and O'Sullivan.

We spend much time debating issues that have only limited relevance to people's lives in this House. However, in this case, no issue is more relevant to thousands of people and more disturbing to society generally so I warmly welcome the motion. I congratulate the framers of the motion for including all the key aspects that need to be addressed if we are to tackle the reality of suicide.

Directly the impact is obvious — the premature loss of life, often of a young person — but indirectly the impact is extensive. As Deputy Neville has written:

Suicide has a profound effect on the immediate family of the victim, his or her friends and on the immediate community. Bereavement by suicide is different from that resulting from other types of death. The intense reaction to the shock of learning of the tragedy produces a complexity of emotions including feeling angry with the victim, feeling rejected, a feeling of deep despair, being depressed, blaming oneself and a very deep sense of sadness. In many cases years after the event, the bereaved have not begun to deal with the trauma. In all cases the bereaved do not fully come to terms with it.

Recent research carried out in Denmark shows that suicide in one partner is so devastating that it significantly increases the risk of suicide in the other, particularly among men. The increased rate of suicide, therefore, is not of concern because of the victim alone. It matters because of the terrible suffering it causes to families and communities. It was once a hidden tragedy, criminalised and stigmatised but we acknowledge it nowadays, maintain a humane regime to mitigate its impact and ask ourselves why, in a prosperous and more tolerant society, is the rate of suicide rocketing to an unprecedented level.

On a day when he presided over seven inquests, five of which were of people who took their own lives, the County Offaly coroner talked about an epidemic. He is correct but what is highlighted in County Offaly is reflected in other counties to a greater or lesser degree. As the motion rightly points out, people who are poor are at a higher risk of suicide, as are unemployed people, those in prison, and those who are marginalised.

While the number of victims is increasing, the social factors are becoming more stark. Four times the number of people who died by suicide in the 1970s die each year. The extraordinary increase has been experienced in other societies, which have undergone drastic social change. That is one factor but the increase is also clearly linked to a growing inequality within our society. We must rely on British research to give us the hard evidence on this point but over the past 20 years the social difference in the rates of suicide in England and Wales has become significantly more marked. Suicide is on the increase and increasing proportionately among those living in poverty in countries where inequality has deepened over the past 20 years such as Ireland. A fairer society in many ways is a healthier society and that is nowhere more evident than in the area of mental health. The paradox is that clinical resources tend to be concentrated in the least deprived, rather than the most deprived areas.

A remarkable inequity in mental health services is documented in the report, The Stark Facts, prepared by the Irish Psychiatric Association. Not only are mental health services underfunded, the problem is further exacerbated by the way in which these funds are distributed. Funding allocations for different regions are based on historical factors such as the location of mental hospitals and not on current needs of the regions.

This has led to some regions spending five times as much per capita on mental health services as others. The 2003 inspector of mental hospitals report finds a 19-fold disparity in per capita spending. What is worrying about these imbalances is that the worst-off areas tend to spend the least. In other words funding is directed towards the areas that need it least. The most deprived areas have significantly fewer acute beds, larger sector sizes and a greater temporary to permanent consultant psychiatric staffing ratio.

Ireland has the worst suicide rate among young men of any developed country. It is strongly associated with alcohol and other substance abuse. The true extent of the level of suicide is unknown because so many deaths of drug abusers are impossible to determine. Was an overdose a deliberate effort to end an unbearable life or was it simply an accident? We will never know the full extent of the problem but we certainly should know about the young men at risk of suicide. However, only 20% of young males in Ireland who commit suicide were in contact with a health professional in the year prior to their death.

Parasuicide is the strongest identified risk factor for future completed suicide, yet when a person presents at a hospital's accident and emergency department following a suicide attempt he or she may be seen by a liaison mental health nurse or psychiatrist, but too often there are no referral services for this person. There are too few social workers, clinical psychologists and addiction counsellors, and community mental health teams are often only available between 9 a.m. and 5 p.m. The development of primary care teams and primary care networks would provide more accessible health professionals so that GPs and hospitals have support in managing 'at risk' clients. As things stand nearly 50% of the country's medical card holders do not have access to general counselling services. Three of the Health Service Executive areas covering 12 counties do not have any counsellors to deal with routine cases of anxiety and depression.

In our recently published policy document on mental health the Labour Party argues for a comprehensive strategy to tackle suicide, including addressing the epidemic abuse of alcohol in both social and medical areas, targeting of those at high risk such as those who present with parasuicide, addressing shortcomings in our education system on mental health issues, the provision of support services to those suffering from depression and the training of primary care health professionals, especially GPs and accident and emergency services, to enable the early detection of depression and suicidal tendencies.

This kind of strategy requires funding and resources, yet we have seen in recent years under this Government a steady proportionate decline of funding towards mental health services. In 1997, 13% of the total health budget was spent on mental health services. Now the figure is down to 6.9%. We argue strongly that a baseline of 10% should be set to guarantee a certain standard and evenness of care.

It is particularly important that the issue of funding be addressed. We live in a society that is more unequal than ever before, which I regret. It is the direct result of a Government ideology that has failed to resource public services and a quality of life for all our citizens. Inequality leads to greater ill-health and that is nowhere more evident than in the area of mental health and suicide. In a culture where there are only winners and losers, and where the pressures to achieve are so dominant, those who fail whether emotionally or socially often suffer the most terrible anguish.

For some the only way out is an end to life and far too many are taking that route. There is an onus on all of us to question the pressures that prey so heavily on vulnerable people, but there is a particular onus on us as policy makers to address the cause of those pressures where we can. It is clear that despite its unprecedented resources this Government has not seen fit to provide high quality accessible care and supports to people at risk of mental illness. For some that has meant the difference literally between life and death.

I compliment the technical group for putting this motion before us today, and Deputy Dan Neville for ploughing a lonely furrow on this issue for a considerable period. I engaged in a number of debates in the Seanad with Deputy Neville when we were both Senators. He has done good work in this area.

Suicide is the unpredictable killer and tragedy of our time. It contradicts the normal flow of life and death. It takes the young and apparently healthy while older people are left to grieve. It is comparable with road deaths, which also kill the young and healthy. Such unnatural deaths can and must be combatted and prevented. In 2003 there were 444 suicide deaths in this country. The national task force on suicide was established in 1998 and the Minister of State earlier spoke on the €17.5 million that has been spent since that time on suicide prevention. That amounts to €2.5 million per annum, which is not that much to spend on the killer of 444 people per annum, and this number is growing.

Ireland now has the fifth largest suicide figure of the 15 to 24 year old group in the 25 states. Suicide is not just a phenomenon in Ireland it is increasing globally. The difficulty in determining the number of suicides now and in the past is partly due to the incredible stigma and silence that surrounded suicide, which in many ways both church and State conspired to put in place. Suicide was a crime under legislation and the church refused to allow people who committed suicide to be buried in consecrated ground. That double stigma was one of the main causes of those committing suicide being shunned and of people being afraid to come forward. That residue still remains with us and it is still extremely difficult to determine precisely the number of people who have committed suicide.

Nobody knows for certain the reasons for suicide, but the fact is that suicides take place largely among younger age groups and among males. Depression, lack of self-esteem and self-confidence, being emotionally locked in and an inability to communicate are all factors. Suicide is not selfishness, as a certain Deputy previously stated in public. Men have much to learn from women about proper communication, emotional engagement, and avoiding the tension and depression that can be locked up so easily in a young person who finds it difficult to cope. Young people may not have assertiveness, confidence or skills during the traumatic teenage years to cope with the pressures and problems of life.

That being said, there is no doubt that a greater percentage of deaths from suicide take place in disadvantaged and marginalised areas such as prisons and mental hospitals. I have seen prison experiences over the years. A considerable number of people commit suicide or attempt to commit suicide because being locked up for 16 hours a day with nothing to do for most of that time is extraordinarily depressing, and few people have the coping skills required.

Every Deputy believes the greatest cluster of suicides is within his or her constituency, but in Dublin's north inner city, the combination of disadvantage, drug abuse, alcohol abuse and imprisonment has contributed enormously to the huge number of suicides that have occurred. The solution is to have a much fairer and open society with the State providing the intervention mechanisms and the resources when problems arise.

I commend the Technical Group for tabling this motion giving us the opportunity to address the issue of suicide. I join with my colleague in complimenting Deputy Dan Neville on the work he has been doing over a number of years. The Minister of State, Deputy Tim O'Malley, who is in the Chamber, has been involved in the issue also both as Minister of State but also in my local area where we met with a number of groups who are concerned about this issue. In drawing up the national strategy for action it is important that such groups are listened to and that they have a central input into whatever strategy will be put in place because they have done a great deal of work throughout the country. The one I know best is the Rosbrien Suicide Awareness Group in Limerick, with which the Minister is very familiar. It has a great deal of knowledge at this stage, most of which, sadly, is from its members own experience of what needs to be done. These groups should have a major input into whatever decisions are made in terms of implementing the policy.

I spoke to a representative from that group coming into the Dáil this morning and one of the strongest points made is that this issue requires a much broader strategy than mental health alone. It must be dealt with by Government as a broad societal issue. One of the problems of dealing with suicide solely as a mental health issue is that we do not have that necessary broader input. In terms of education in particular, there is a major need for more input than is currently the case.

In the mental health area, the problem is still largely within the realms of psychiatry but I and these groups believe that psychotherapists, psychologists, counsellors and other professionals must be brought to the young person as soon as they need it, for example, if somebody turns up in an accident and emergency unit. I am aware professionals in this area are being put in place in accident and emergency units but the experience is that a person is referred almost immediately to the psychiatric services, are then put on waiting lists and are either admitted to a psychiatric ward or attend day-care units but they are not often in a position to respond in that way. They need immediate support and somebody to talk to. The Minister of State, Deputy Tim O'Malley, has heard the views of the group I referred to but I ask him to take these points into account when drawing up strategies.

On the question of education, I note from the newspapers this morning that Professor Fitzmaurice from UCD will make a speech later today on the narrow focus of the leaving certificate and what students are doing increasingly in schools. Despite programmes such as the social, personal and health education programme, it is not an examination subject that is compulsory at senior cycle level, although it is compulsory at primary and junior cycle level. The focus on the points race and achievement in the school system is having a serious effect on the self-esteem of many young people and does not provide the space to address those type of issues.

The National Council for Curriculum and Assessment has produced a document, from which I will quote, on broadening the leaving certificate, changing the syllabus and introducing what it describes as short courses to which points in the leaving certificate would attach. Among the short courses they suggest is a type of personal self-esteem and health education option. If we include such courses in the central syllabus where they can be awarded points and broaden the leaving certificate generally, it will make a major difference. Currently, those issues do not get the necessary attention in schools because of the drive in the points system. The NCCA stated:

Not changing, leaving things as they are, is not an option. It is a temptation. At a glance it may seem that senior cycle is ‘not broken', and requires no ‘fixing'. A closer look confirms that it is ‘not broken' but that the pressures from a student cohort participating in education for longer with diverse learning needs, together with the dynamics of social, economic and cultural changes are beginning to tell. . . . Senior cycle is too important a stage in the life and education of a young person to attempt to hold the system together with superficial repairs or to await the onset of a crisis.

That advice should be heeded. The Minister is somewhat reluctant to make any changes in the leaving certificate because it is transparent and fair but it is part of the problem because it narrows the focus of young people.

Some programmes in schools appear to be well thought out. One of them is a suicide awareness information programme in the former South Eastern Health Board area. Those type of options must be examined also. I ask the Minister to take on board the points I have made and ensure that suicide is seen as a broader issue than simply one of mental health.

I wish to share time with Deputies Gormley and Boyle.

Molaim na Teachtaí Neamhspleácha as an rún a chur os comhair na Dála. Is práinneach an cheist í seo agus tá dualgas ar gach duine sa saol poiblí díriú uirthi. Tá díoma orm, áfach, le leasú an Rialtais. Ní leor é agus tá súil agam tar éis na díospóireachta seo go mbeidh an Rialtas féin ag díriú i gceart ar cheist an fhéinmharaithe.

I commend the Independent Deputies for using their Private Members' time to address the very serious issue of suicide. It is an urgent issue about which everyone in public life must be concerned. I wish to pay tribute to Deputy Dan Neville for his courageous and consistent address of this issue over the years of my representation in this House.

The motion sets out the stark statistics. By far the most striking is the fact that suicide is the most common cause of death in Ireland for those in the 15 to 24 age group. We all know the reality behind the statistics and I doubt if there is a Teachta Dála who does not know a young person who has taken his or her own life or a family bereaved by such a tragedy. Indeed, I am sure we all know of multiple cases and the terrible tragedy visited on families and whole communities, and the dark clouds that have come over homes and communities throughout the length and breadth of our country that do not dissipate lightly. I am all too familiar with the grief that is visited on individuals, families and communities by the tragedy of suicide and the extended tragedy of recurring, apparently connected suicides.

All of that places a serious obligation on everyone in politics and in public administration to concentrate on this problem and co-operate in its effective address. Government has a special responsibility as it is in the power of Government to take measures that can directly impinge on this serious issue of our time. Those measures are clearly necessary if the problem is to be addressed in a coherent and effective manner. In that regard, I am disappointed with the Government's amendment because it clearly reflects on the very little that is being done.

We have to place the issue of suicide in the overall context of mental health. While not everyone will be comfortable with that, it is very important we recognise it is the context in which it needs to be addressed though not by any means exclusively. It is in the framework of mental health services that the State needs to address the issue of suicide.

There is an immediate problem in that mental health is by far the most neglected sector in our health services. Despite the fact that one in four people will suffer from some form of mental illness at some point in their lives, the budget for mental health as a proportion of the overall health budget has consistently fallen through the years. The standard explanation is that over the past 40 years we have moved from a model of institutional care, which confined large numbers of people with mental illness and which took a large slice of the health budget to maintain. There has been a very welcome move away from what was, in effect, the imprisonment of the mentally ill. The new care in the community approach spearheaded by those at the coalface of psychiatric services in my constituency of Cavan-Monaghan must be commended as essential and welcome.

The people continuing to develop the service deserve our praise and support. The problem is that a sufficient proportion of funding was not maintained to support alternative mental health services. The fact that there are not comparable numbers in institutional care now should not have meant a decreased budget. We need to maintain services and continue to invest more to mirror and aid the success we have seen. The main concentration must be on the areas of education, prevention and counselling.

Despite advances in treatment and attitudes, there is still a significant social stigma associated with mental illness. People are reluctant to acknowledge to others that they have mental health problems such as depression. There are very few of us who could not put our hand up at some point in our lives and say that to some degree we feel low. We must remove the stigma and provide courage and support to people. The first step to be taken is to be prepared to speak about depression. This is most especially true of young people, especially boys and young men, for whom it is the most challenging step of all.

AWARE addressed the issue in its report on suicide published in 1998. Other Deputies may already have quoted from it, but I am especially taken by it. It is very important to record aspects of the report.

The attitudinal shift that AWARE believes society needs to go through, if it is to effectively address suicide prevention, is only likely to come about by addressing the issue in or before the early teenage years. Development of positive attitudes to mental health coupled with acquiring skills in problem solving and building self-esteem are likely, over the medium term, to result in significant change in help-seeking behaviour by those with psychological distress, and to provide a more positive approach to these problems by people beginning careers in the caring professions.

The key phrase is "significant change in help-seeking behaviour". I have no doubt that many lives will be saved if that is achieved. We hear it said often that many people in our society are voiceless. The tragedy of suicide is often that those who take their own lives feel they are without a voice to speak or a friend to listen to them in their trouble. We must get the message to young people in distress that there is a way forward and provide essential resources for accessible education, advice, counselling and treatment.

AWARE's 1998 report summarises very well the complex, causal factors that contribute to suicide. Psychiatric disorders, usually depression or an intoxicant problem, are present in 90% of people who take their own lives. Not everyone who suffers depression, however, goes through the act of suicide or even attempts it. AWARE speaks of a domino effect with the three components depression and related disorders, dramatic losses in life and, finally, the added depressing effect of alcohol or illicit drug use. AWARE's recommendations, of which I will cite three, are reflected in the number of recommendations of the 1998 task force on suicide.

First, AWARE recommends a dual approach to suicide prevention, an immediate range of interventions focusing on those considered to have a high suicidal risk, a longer term strategy directed at public attitudes to suicide and its causative factors and the development of programmes within schools. Second, AWARE recommends the development of a health partnership whereby the health services, voluntary bodies, the workplace and schools review, monitor and implement preventative strategies in the area of public health, including suicide prevention. Third, AWARE recommends a significant emphasis on addressing public attitudes to mental illness, enhancing awareness of depression and its improved treatment in general practice, reducing the impact of life crises such as employment loss and personal relationship breakdown, including media reporting of suicide events and increasing efforts to address suicide among young men and the elderly.

The national task force on suicide reported in 1998 and made a very wide and comprehensive series of recommendations. That very few have been implemented is very clear from the inadequate Government amendment to the motion. Even in the key area of research on suicide in Ireland, not enough is being done. I commend the issue for address by the widest body of public debate possible. It is an issue that requires open and accessible discussion. Many organisations could consider hosting or sponsoring events that focus greater attention on suicide. I encourage strongly local organisations to give time to this subject.

I congratulate Independent Members for putting this motion to the House and join other speakers in commending Deputy Neville on his work on suicide. The problem of suicide has reached crisis proportions in Ireland. I remember as a child hearing that Sweden had the highest rates of suicide internationally, but perhaps that was apocryphal. While we hear now that Hungary and other eastern European countries have very high rates of suicide, Ireland has phenomenal levels. There is not a family or neighbourhood that has not been touched in some way by this growing trend.

As Deputies, Members are very aware of the impact suicide can have on a community. While the death of a family member is always a source of grief, suicide leaves mental and emotional scars that are very difficult to heal. Suicide is quite simply devastating for families who feel anger and guilt in equal measure while the questions of "why" and "what if" remain. There are no easy answers, which makes suicide a very difficult and sensitive political issue. Members on this side are reluctant to make suicide a political issue as we do not wish to create a political football from a matter that is very sensitive for the families involved. Nevertheless, there are questions to be asked, which is why the motion has been moved.

Suicide is largely a white male phenomenon, though statistics from the United States of America suggest this is changing. The AWARE report, which like most Deputies I have read in preparation for the debate, demonstrates that there are three essential components of suicide, the most important of which is depression followed by traumatic loss and alcohol and illicit drug abuse.

Some 90% of those who attempt to commit or commit suicide suffer from some form of depression, which is a telling statistic. We do not really deal properly with the issue of mental health, which has been largely ignored. The problem is that once depression sets in a person's thinking becomes restricted to the extent that there appears to be only one logical outcome — perhaps one could call it a twisted logic — which is to end one's life.

Research shows that, unfortunately, telephone help-lines, such as that of the Samaritans, do not seem to work. Last weekend, I visited a beauty spot in England which features a series of cliffs. People have taken their own lives at that location and right beside the cliffs there was a telephone number for the Samaritans. I thought it was a futile gesture to provide the number, however, because anyone contemplating suicide is hardly going to use their mobile phone at the last minute to ring the Samaritans. We need to understand, therefore, what works in preventing suicide and what does not. According to the AWARE report, the Samaritans' service does not work and, likewise, school information programmes on suicide appear to have little impact. Those of us who qualify as lay people in this area may not have been fully aware of these facts but now we know that certain things do not work. We also know that where methods of suicide are made easier, more people will obviously avail of them. This is an important factor in the United States where 60% of suicides result from firearms. It is different here because guns are not widely available.

Alcohol abuse is not being addressed properly, as I have said repeatedly. We are talking about the implementation of a task force report on suicide, but we should also examine the question of implementing the report of the task force on alcohol abuse. Why have those recommendations not been implemented? There is a cultural aspect in that, in many ways, we have glamorised the consumption of alcohol. Many years ago, I recall that the current Minister for Health and Children, Deputy Harney, appeared on RTE's "Late Late Show". Another guest on the show advocated the use of cannabis, but Deputy Harney condemned him out of hand. When she was asked about alcohol, however, she said there was nothing wrong with it. I put it to the Minister of State that the real drug problem in this country is not heroin, crack cocaine or cannabis, but alcohol. We are ignoring it at our peril. Alcohol affects one's mood and leads to depression. The question is whether that in itself leads to depression and, in turn, to suicide or whether there is a direct correlation between excessive alcohol consumption and suicide. In any event, we have not implemented those recommendations and continue to permit the advertisement of alcohol at sporting events, which are sponsored by drinks firms. This is completely unacceptable. Yesterday, during a break in a television news bulletin, I saw an advertisement for Coors Lite which glamorised the consumption of alcohol. More young people are drinking at an increasingly early age and that is leading to increased suicides.

The AWARE report goes into many details about why things have changed, but what has changed? The House may take the statistics as it wishes, but the report states that three studies have compared trends and demographic features in Europe. They found that the increasing suicide rate in people aged 15 to 24 is associated with a higher divorce rate, high unemployment, and a reduction in the population under the age of 15. Ireland has experienced huge social change and AWARE makes it clear that in other countries such change has had negative results. I am not saying the Government can do much about some of the aspects involved in social change, but we need to examine closely why people are engaging in anti-social behaviour.

Another problem is the decline in church attendance and the fact that people do not have a strong belief system to counteract the trend towards suicide. I agree with speakers who said that one cannot always be sure that past suicide figures were compiled accurately. For example, there were 71 suicides in 1947, although the real figure may have been higher. I can see that the Minister of State is sceptical and perhaps he is right. The figure may have been a lot higher in those days when people were afraid to admit it. Even if they were disguising the level of suicide, however, it is a fact that it has increased enormously.

As regards suicide prevention programmes, the AWARE report makes it clear that there are tell-tale signs concerning potential suicides. We need to examine that matter. Primary care can play an essential role in detecting those with suicidal tendencies. The Minister must implement the primary care strategy which can deal with 90% of illnesses, including depression.

I welcome the opportunity to speak on the important issues of suicide and suicide prevention. I congratulate the Independents and the Technical Group for tabling this motion. Naturally, as a Minister of State, I might not agree with every sentence in the motion but it has formed the basis for a valuable discussion. While the quality of the debate has been high, it has also demonstrated that no side of the House has a monopoly on compassion. Suicide is a subject that touches the lives of every Deputy nowadays. I have listened carefully to the contributions and I was stuck by their high standard, both yesterday and today.

The motion refers to statistics and it is not a bad point of departure to examine the statistical position. Deputy Gormely summarised it fairly in concluding that the statistics were remarkably low decades ago, even allowing for the fact that there may have been, and probably was, an element of under reporting. There has been a noticeable shift in recent times. There is no doubt that, in particular, the number of young males committing suicide has increased significantly in the last decade, with 305 such deaths in 1994, rising to 358 in 2003.

It is important to point out, contrary to what is suggested in the motion, that youth suicide in Ireland is not the highest in the European Union. The most recent analysis, however, does suggest that it is the fifth highest, which is a very high ranking in European terms. As regards the overall suicide rate, Ireland ranks 17th in the European Union. It is obvious from this statistic that while our general rate of suicide is not especially high compared to other EU member states, our rate of youth suicide is very high. That is quite a remarkable disparity. Recent figures suggest that the rates have stopped rising. Perhaps we have come to the end of that period of rapid social change, to which Deputy Gormley referred. We may not have come to the end of it, but it is correct to say that we experienced the fastest rising rate in Europe in the 1980s and 1990s, albeit from a low base rate that may have included an element of statistical inaccuracy. These are, therefore, worrying trends which require further research to back up our strategies.

We can touch on the causes of this difficult problem, a number of which were pinpointed by Deputy Gormley. He referred, for example, to the culture of alcohol abuse. While it is a clinical fact that the consumption of alcohol causes depression, this is not well known, particularly among young people. We must continue to point out this fact because it often helps those who realise they are depressed to overcome the problem. Although the period of depression for many abusers of drink is short term in character, persons, particularly younger persons, who abuse alcohol are in a vulnerable position during this short period.

Deputy Gormley also referred to the decline in traditional religious belief systems. There is no doubt this has also played a part in recent rapid social change. This creates a challenge in the educational context to ensure schools not only impart information but also assume a role in forming character. All the different patrons in primary schools are concerned about this issue and are promoting definite ethical curricula, irrespective of the ethos from which they come.

As Deputies are aware, there was a marked reluctance to discuss the issue of suicide in the past. Since the 1998 task force report we have had available to us a template for analysing our efforts in this area. Many contributions focused on the recommendations of the task force report. We have made significant progress in implementing the report. For example, a suicide resource officer has been appointed in each Health Service Executive area. In addition, the national suicide review group, National Suicide Research Foundation and national parasuicide registry have been established and liaison psychiatric nurses appointed to accident and emergency departments in general hospitals. Provision has also been made for training relevant health care personnel in regard to suicidal behaviour and such training is ongoing in all Health Service Executive regions.

Furthermore, legislation has been enacted restricting the availability of medication which can be used to overdose. A social and personal health education programme has been developed and is now compulsory for all junior cycle students in secondary schools. A directory of services has been published in each Health Service Executive area for those who may be at risk of suicidal behaviour. A new Form 104, the form on which the Central Statistics Office figures are based, has been developed and a Garda inspector has been nominated in each division to oversee its use and completion.

These are just some examples of progress made to date. Much greater detail about various initiatives under way around the country can be found in the annual report of the national suicide review group which is laid before the House each year. As Deputies will be aware, many of the recommendations of the task force require continuous development, particularly in the areas of training and the enhancement of mental health services. I would like to address the development of mental health services for adolescents in greater detail but, unfortunately, insufficient time is available to do so. The Minister of State with responsibility for mental health services, Deputy Tim O'Malley, is committed to making progress in this area.

It is a dreadful fact that suicide is the most common cause of death among young people in Ireland aged 15 to 24 years. It is not surprising, therefore, that every one of us will have a friend, neighbour or relative who has been directly affected by such tragedy.

The questions before us are how effective are our health agencies in responding to this major national issue and have even the most basic measures been introduced to assist those who might seek help. Yesterday, I put these questions to the test when my office telephoned a number of health agencies to ask a basic question, namely, whether we could be put through to a suicide helpline or an emergency telephone contact number for suicide. We started with the main telephone number for the Department of Health and Children and were put through to the mental health services. I was hopeful at this point but after a period on hold we were informed that no helpline or contact number was available and were advised to try the Samaritans. The attitude to our request was one of surprise.

We then tried the main telephone number of the Eastern Regional Health Authority, now known as the eastern region of the Health Service Executive. We were put through to an information line which gave us a suicide bereavement helpline number. When we called this number we were informed it was not in service. Having double checked the number with the same negative result, we called the Health Service Executive information line again and were given a second number. On telephoning this number we were greeted with a voice message that we had reached the AWARE helpline. This message was repeated six times before we were cut off.

We then tried the main telephone number for the former Northern Area Health Board and were immediately given the name of a counsellor designated as a suicide officer and a direct telephone number. When we rang, we were greeted by another voice message informing us that we had reached the Health Service Executive, offices hours were from 9 a.m. to 1 p.m. and 2.14 p.m. to 5 p.m. and we should leave a message after the tone. The call was made at 4.30 p.m. on Wednesday. If this is the best our health service has to offer on a mid-week working day, what would have been the response to a crisis call late on a Friday or Saturday evening? We all know the answer.

Where does our experience of the system leave the statements in the Government amendment, which notes, for example, the "many initiatives undertaken by Government" since 1998, including "the development, in each health service area, of a directory of statutory services" and "the appointment of suicide resource officers in each health service area". The amendment is shamefully bogus and I call on the Minister to withdraw it in light of what I have said. Suicide continues to be largely ignored, a fact the Minister of State should admit, and urgent basic action is required immediately.

I thank the many voluntary organisation involved in this area, including GROW, AWARE, Schizophrenia Ireland, Mental Health Ireland and the Samaritans, all of which are involved in raising public awareness, addressing local needs and dealing with individuals and families who have been traumatised and devastated by suicide in their family circle or community. I have personal experience of suicide in my extended family. I thank Deputy Neville who regularly raises the issue of suicide and Deputies from all sides who spoke on the issue last night and this morning in a concerned, compassionate and genuine manner.

Suicide must be addressed in a sympathetic and sensitive manner using effective, urgent and committed means. Unfortunately, none of these terms applies to the Government amendment and I join my colleague, Deputy Gregory, in asking the Minister to withdraw it, even at this late stage, and allow the motion to be passed unanimously. The amendment borders on the dishonest and is clearly disingenuous. It refers, for example, to Government initiatives which have resulted in the "placement of liaison psychiatric nurses in accident and emergency departments of general hospitals". Deputies are given to believe that a liaison nurse is available in every accident and emergency department on a 24-hour basis. As the Minister of State, Deputy Tim O'Malley, is aware, this is untrue, as is clear from his decision last night to amend his speech by inserting the word "many" before accident and emergency departments. It is disingenuous of the Government to make this claim given that a liaison psychiatric nurse is not available in every accident and emergency department and, even where one is available, it is not on a 24-hour basis. What happens after 5 p.m. or at weekends? As Deputy Gregory who tested the system told us, nothing happens.

The amendment also refers to "the provision of training to relevant health care personnel". The relevant personnel are solely professionals, that is, nurses and doctors. What is the position regarding non-nursing personnel such as cleaning, catering and porter staff who have a track record in developing contacts with vulnerable patients? They, too, should be trained in matters relating to suicidal behaviour. We have heard about directories of services but many of them are gathering dust on shelves. I call on the Minister of State at this late stage to withdraw the amendment and allow the motion to pass unanimously.

Each day it is estimated that in excess of 2,000 people commit suicide around the world. The available figures greatly underestimate the true suicide rate. In the field of mental health, the discrepancy between what we suspect and what we can prove to be true is nowhere greater than in the case of suicidal behaviour.

I call on the Government, and on the Minister for Education and Science in particular, to undertake a review of our educational priorities and ensure appropriate account is taken of the needs of our young people as part of a balanced education. There have been knee-jerk reactions to the problems of drug abuse, crime prevention and anti-social behaviour faced by our young people. They have come too late from a Government that only reacts because the problems are costing us money and upsetting the middle class voters and business people who have a vested interest in making our society appear safe so they can earn their money in comfort. It is time to examine the real issues affecting Irish life, to instigate adequate educational programmes and to equip young people with the tools they need to deal with the issues they will face during their lives.

It is time to end the stigmatisation of mental health issues. This can be done by introducing mental health to the school curriculum at an early stage. Our young people can learn that it is acceptable to seek help for problems and that mental health issues can be dealt with in society in a way similar to physical health. It is time we promoted a positive attitude to mental health, encouraging the young to seek help in times of crisis. The Government should plough some of the money we have gained from our economic success into our communities and education system to fund life skills education for young people and to provide adequate care resources for those seeking help.

We should examine the prevalence of suicide in rural areas and the possible implications of rural isolation. It is vital that the Government does not abandon rural areas. Services must be available to everyone and not concentrated in areas of high population density. Resources must be available to examine the effects of unemployment, social exclusion, lack of educational opportunities and rural isolation as factors in the increased numbers of people attempting to or taking their own lives. Following such research, a commitment must be given to act on the results and to provide for proper responses to such needs as are identified.

I call on the Government to put people first and provide increased funding as requested to deal with the current sad situation. I call on the Minister of State to withdraw the disgraceful amendment to this motion and face the true facts outlined by Deputy Gregory. The Government should put people first instead of making cheap political points to cling to power. The Minister of State should act as a man of his word and withdraw this shameful amendment. Government Deputies should have the courage of their convictions and vote with the Independent Deputies in this matter. I commend Deputy Connolly for tabling this motion.

I welcome the opportunity to speak on this motion tabled by the Independent Deputies. It calls on the Government to develop an effective, strategic action plan for the prevention and reduction of suicide and to implement it as a national priority.

I listened to many speakers on this motion and the subject has been treated sensitively. We are talking about people's pain, the devastation of families and the shock and incomprehension of communities. We tread lightly because we do not want to add to that pain. The discussion is not political in the sense of scoring points. It is, however, political in that a meaningful political response is urgently needed. So far the response has been woefully inadequate.

I call on the Minister of State to withdraw the amendment, particularly in light of the statement made by Deputy Gregory today. Most of the amendment is meaningless. The basic facilities to assist those who need our help are not in place. The answering machines at the end of helplines that give opening hours of 9 a.m. until 12.30 p.m. confirm that the response of the Government to the suicide issue is totally inadequate. The Minister of State should do the decent thing and withdraw this empty amendment.

I attended a seminar on suicide recently in Dromahair in County Leitrim organised by recently bereaved families. I commend those who organised it for making the effort to raise awareness, to inform the public and to destigmatise suicide. Similar seminars have been held throughout the State; I know of two recently in County Monaghan. Meetings have been crowded with people who are genuinely concerned. There is a desire on the part of the public for information and help.

This Government is failing to give the help that is so badly needed. Many speakers referred to the cut in the mental health budget. Last week I went to see the new Clarion Hotel in Sligo which was formerly the old mental hospital, St. Columba's. When St. Columba's was closed a number of years ago people were glad but the money was not re-invested in community services and it is not being invested in support services for those concerned about and those at risk of suicide.

Politicians cannot solve all of society's problems and this issue is wider than resources and services. The responsibility of the Government, however, is to implement immediately the 86 recommendations of the 1998 report of the National Task Force on Suicide, as we have asked in the motion.

This is a difficult issue and there are no easy answers, quick fix solutions or guarantees we will get things right but the research has been done here and in other countries. The reports have been written and there is no excuse for inaction. A document was published in the last few days entitled "The Health of Irish Students". When will its recommendations be put in place or will it simply be put on the shelf on top of the pile that is there already?

We have all the information we need, we now need action. We need suicide prevention programmes in schools, colleges, health centres and community centres and we need suicide awareness programmes. Most people are aware of the symptoms and signs of meningitis due to an excellent information campaign. We need the same level of awareness about suicide. Early detection and treatment lead to better outcomes.

My colleagues have quoted the different models across the world, with Deputy Connolly mentioning the German model that showed a reduction of 26% in self-harm incidence, and the Australian and Canadian models, with reductions of up to a third in self harm. Experience in other countries has shown action can work and we need as a matter of urgency to put such projects in place on a nationwide basis and not just as pilot programmes to protect all citizens who are at risk. We must increase the mental health budget and adequately resource the primary care system so it can respond to those who need help.

If the Minister of State will not accept the motion today, we ask him to implement the recommendations in it. The Minister of State, Deputy Brian Lenihan, listed actions being taken by the Government to address the suicide issue but they are not working, they are wholly inadequate and we ask the Government to develop an effective strategic action plan for the prevention and reduction of suicide and to implement it as a national priority.

Amendment put.
The Dáil divided: Tá, 59; Níl, 52.

  • Ahern, Dermot.
  • Ahern, Michael.
  • Ahern, Noel.
  • Brady, Martin.
  • Browne, John.
  • Callanan, Joe.
  • Callely, Ivor.
  • Carey, Pat.
  • Carty, John.
  • Cassidy, Donie.
  • Cooper-Flynn, Beverley.
  • Coughlan, Mary.
  • Cregan, John.
  • Cullen, Martin.
  • Curran, John.
  • Davern, Noel.
  • Dempsey, Tony.
  • Dennehy, John.
  • Devins, Jimmy.
  • Ellis, John.
  • Fahey, Frank.
  • Finneran, Michael.
  • Fitzpatrick, Dermot.
  • Fleming, Seán.
  • Fox, Mildred.
  • Gallagher, Pat The Cope.
  • Glennon, Jim.
  • Grealish, Noel.
  • Harney, Mary.
  • Haughey, Seán.
  • Hoctor, Máire.
  • Jacob, Joe.
  • Kelleher, Billy.
  • Kirk, Seamus.
  • Kitt, Tom.
  • Lenihan, Brian.
  • McEllistrim, Thomas.
  • McGuinness, John.
  • Moloney, John.
  • Moynihan, Michael.
  • Mulcahy, Michael.
  • Nolan, M. J.
  • Ó Cuív, Éamon.
  • Ó Fearghaíl, Seán.
  • O’Connor, Charlie.
  • O’Dea, Willie.
  • O’Donnell, Liz.
  • O’Donoghue, John.
  • O’Keeffe, Batt.
  • O’Malley, Fiona.
  • O’Malley, Tim.
  • Parlon, Tom.
  • Power, Peter.
  • Power, Seán.
  • Sexton, Mae.
  • Smith, Brendan.
  • Wilkinson, Ollie.
  • Woods, Michael.
  • Wright, G. V.

Níl

  • Breen, James.
  • Breen, Pat.
  • Broughan, Thomas P.
  • Bruton, Richard.
  • Burton, Joan.
  • Connolly, Paudge.
  • Costello, Joe.
  • Cowley, Jerry.
  • Crawford, Seymour.
  • Crowe, Seán.
  • Cuffe, Ciarán.
  • Deasy, John.
  • Deenihan, Jimmy.
  • Durkan, Bernard J.
  • English, Damien.
  • Ferris, Martin.
  • Gilmore, Eamon.
  • Gormley, John.
  • Gregory, Tony.
  • Harkin, Marian.
  • Hayes, Tom.
  • Healy, Seamus.
  • Howlin, Brendan.
  • Kehoe, Paul.
  • Lynch, Kathleen.
  • McCormack, Padraic.
  • McGrath, Finian.
  • McGrath, Paul.
  • McManus, Liz.
  • Mitchell, Gay.
  • Mitchell, Olivia.
  • Murphy, Gerard.
  • Naughten, Denis.
  • Neville, Dan.
  • Ó Caoláin, Caoimhghín.
  • Ó Snodaigh, Aengus.
  • O’Dowd, Fergus.
  • O’Keeffe, Jim.
  • O’Shea, Brian.
  • O’Sullivan, Jan.
  • Penrose, Willie.
  • Quinn, Ruairí.
  • Rabbitte, Pat.
  • Ryan, Seán.
  • Sargent, Trevor.
  • Sherlock, Joe.
  • Shortall, Róisín.
  • Stagg, Emmet.
  • Stanton, David.
  • Timmins, Billy.
  • Twomey, Liam.
  • Upton, Mary.
Tellers: Tá, Deputies Kitt and Kelleher; Níl, Deputies Gregory and Connolly.
Amendment declared carried.
Motion, as amended, put and declared carried.