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Dáil Éireann debate -
Thursday, 5 May 2011

Vol. 731 No. 3

Suicide Prevention: Statements (Resumed)

Suicide is a silent killer. In particular, it strikes many young men, so often without warning. Twice as many people die from suicide as in road deaths here. Combined, they are the two highest killers of young people. It is a hugely important issue. Road deaths have received enormous attention and were the subject of debate in the Chamber and in other fora. Scarcely a year has gone by without another Bill passing through the House to improve road safety and reduce road traffic deaths. I refer to permitted blood alcohol levels, speed cameras, road improvements and drug issues. Young people are those most at risk on the roads.

One could ask how often we have had a debate in the Chamber or in the public arena on deaths by suicide. I recall the previous debate we had lasting approximately two hours, which was hardly adequate to address the issue although it results in double the number of road deaths here annually.

I hope the debate that has been taking place for the past four weeks will change the situation and stimulate more activity in terms of the manner in which we approach the issue. More intervention and preventative measures are required. I hope also that we will bring to the attention of people the length and breadth of the country that there are voluntary and State facilities in terms of assistance and intervention.

I received a letter only yesterday from 1life suicide helpline which referred to the effects of the debate. It offered an update on the calls received over the Easter break in the light of the recent and forthcoming statements on suicide in the Dáil. Some 705 callers rang the 1life suicide helpline over Easter week alone and some 56% of those callers presented with serious suicidal ideation. Five calls were classed as ‘suicide in progress'. Some 59% of the callers were female and 40% were male. The number of male callers was much higher than the average for male callers, which is 20%. Young men do not come out into the open on this issue and do not use the helplines in the same way as young women. The number of female callers is quite high, at 59%, but young men are generally only one-third of that number. That we are having a debate on this issue and that the issue is being raised in the public arena through the media will have a desirable and beneficial effect in the broader community where some young people are subject to depression, have suicidal tendencies or suffer some form of mental illness that drives them to take extreme measures. While Dáil Deputies were enjoying the Easter break, calls to the helpline numbered more than 1,000.

I hope this debate on the issue of suicide will bring ongoing benefits. The debate reflects the fact that many new Members, particularly younger Members, have a great awareness of the issue and we have had no shortage of Members wishing to speak on it. It is a growing concern that the largest increase in the number of suicides currently is among middle-aged men. This is unexpected as suicide was mainly a youth issue. There has been a sharp increase in the number of men in their 40s or 50s who die by suicide. Anecdotal and other evidence suggest that this is related to the prolonged recession we have had here over the past three years. Men who have been holding down stable, safe jobs and who have had a good career, now find themselves with mortgage difficulties and find it difficult to put bread on the table, educate their families and hold on to their jobs. They see little prospect of improvement. The result is enormous stress and trauma for people who did not have any problem with earning a living, rearing a family and buying a home. Now all of these issues are causing problems which are often overwhelming. Depression, stress, trauma and inability to cope are the result and these have given rise to the sharp increase in suicide in the middle-aged group.

In my constituency, Dublin Central, we have seen a new phenomenon of grandparents burying grandchildren. This has been going on for some time and is related to the scourge of drug addiction which has blighted so many young lives in the constituency and elsewhere. It is also related to the hopelessness and lack of purpose in these young lives, the shortcomings and frustrations of their environment, the emasculation of young men by a society which provides few job opportunities, the inadequate education services, the lack of facilities and the lack of a meaningful role in an environment which is often ghettoised. This environment undermines young people's self belief and many of them turn to drugs and drink. This is the pattern in the deprived areas of the inner city of Dublin, other suburbs and other parts of the country. It has been a particular feature of my constituency in the north inner city. The fact that grandchildren are being buried by their grandparents is unnatural. This should not happen in any civilised society. It happens due to the stresses and trauma, particularly for young men, in an environment where they face hopelessness and lack purpose in their lives. This is an issue we must address. Suicide in this instance is a malaise of our lopsided and unequal society. It results from the degree of poverty and ghettoisation in certain sectors.

A long-term solution to the problem will only be found in redressing these inequalities and in providing hope, self respect and equality of opportunity for all. The Minister of State mentioned some good intervention and prevention policies in her address. She mentioned what she intends to do and what the previous Minister of State, Mr. John Moloney, put in place. The policies are there and much good work is being done by voluntary and State agencies throughout the country. There has been a stigma attached to the issue of suicide at individual, family and neighbourhood level. It is important the issue is more transparent and discussed more openly. That is the reason for this debate.

Some €8.7 million is to be spent on suicide prevention this year. This compares poorly with the amount of money being spent on road safety. It is most unlikely the amount will be increased significantly because it would be difficult to put policies in place that would be able to avail of an amount anywhere close to what is being spent on road safety in a short space of time. However, there should be a gradual increase in the amount allocated annually and that should be part and parcel of the policy to be adopted by the Minister of State for the duration of this Administration. Policies must be researched and put in place over the next years and the increased funding should only be put in place when those policies and the necessary legislation are implemented.

I compliment the Minister of State on the priority she has given to this issue and on the commitment she has given to dealing with it. I acknowledge that it is a priority issue for society, although it has been neglected for a variety of reasons, not all of which relate to the authorities. It is time we came to grips with the issue. I wish the Minister of State the best in the work she proposes to do to deal with the issue. I suggest that she should institute a debate on the issue in the House each year during which she can report on progress in dealing with this awful scandal of suicide in society.

I welcome the opportunity to contribute to this important debate. It is encouraging that a debate on suicide prevention is getting priority in the 31st Dáil, with contributions from so many Members in recent weeks. I offer my congratulations to the new Minister of State with special responsibility for mental health, Deputy Kathleen Lynch and wish her well in her new role. I also acknowledge the years of work my colleague, Deputy Dan Neville, has put into the subject of suicide.

The tragic growth in the number of people taking their own lives is disturbing. The 2009 statistics show that 527 people died by suicide, but experts believe the numbers were much higher. There is little doubt there is a direct correlation between the increased number of people taking their own lives and the economic situation the country is facing. The modern day pressures created by an economic situation with job opportunities hard to come by and increasing personal debt, in particular credit card debt and mortgage debt, are placing an enormous strain on people and, tragically, in some instances people are taking their own lives. There is now a well documented crisis in the number of suicides in Ireland each year. In reality the rate of suicide has been rising for many years prior to the economic downturn but the added pressures placed on individuals in recent years does not help.

People presenting with depression and anxiety must be seen in a prompt and timely manner with proper access to relevant medical and psychological treatments where required. There is not a town or village that has not been impacted by suicide. It is a classless and seemingly non-age specific affliction that leaves more questions than it gives answers. In some cases we do not know why people decide to take their own lives. The most striking figure is the shocking number of young men who take their own lives. Why is this the case and what strategy can be introduced to address this growing problem?

It is clear that when it comes to suicide, young males are the most vulnerable section of society and policy on suicide prevention must reflect this fact. In the second quarter of 2010, there were 127 recorded deaths by suicide in Ireland. Of these 102 were male, which reflected a slight increase on the same period in the previous year. In 2009, some 527 people took their own lives, which is significantly higher then the number of people killed on our roads in the same period. We must divert the same level of resources and political action to the issue of suicide as is currently given to tackling road deaths. We also need to try to understand why so many Irish people, particularly males, take their own lives.

I commend a recent RTE television programme on the issue and I also commend Carl O'Brien of The Irish Times who wrote a series of articles on suicide. He dealt with it very sensitively and candidly, and did a good job in raising awareness of suicide. Creating awareness and highlighting the terrible emotional legacy it leaves are important for society. We know that links between alcohol and drug abuse and suicide is quite high, and further studies of the area are needed to get a more comprehensive picture. For too long issues such as suicide in Ireland have been taboo, to be contained within private grief and not for national discourse. We need to change that in a sensitive way.

I compliment the work of organisations such as the Samaritans and Living Links, which do tremendous work. Support groups also play a very important role in offering vital counselling services to those who have been bereaved by suicide. One such group, Solas, is based in Ennis in my constituency. This group was established in 2005 and does very valuable work.

If we are to make a dramatic reduction in the number of people we lose through suicide each year, the solution must lie in a community-led approach. Local community groups, youth clubs, the GAA, soccer clubs and other organisations can play a key role. Some of these clubs and organisations are already doing this in that they are rolling out different programmes. There are outstanding people who are active members of these clubs and want to play a part in preventing suicide. These clubs need resources and supports.

The issue of suicide awareness and prevention is a complex and difficult one. If a community-led approach to suicide prevention is to work, clubs will need help and encouragement to establish suicide awareness and prevention programmes that can be delivered through their clubs. Funding for mental health issues needs to be protected and channelled through primary mental health care and communities. Understanding suicidal behaviour is not enough if we as a society do not change and look at the issues behind suicide and in doing so develop the skills needed to deal with them.

I wish the Minister of State, Deputy Kathleen Lynch, well in her new role and I hope she takes on board some of the positive proposals made my Members on all sides of the House during this very worthwhile debate. I concur with Deputy Costello who proposed that we should have a debate on the issue every year and get an update from the Minister of State as to progress on the measures she hopes to introduce to reduce the number of people who die through suicide.

Cosúil le daoine eile, déanaim comhghairdeas leis an Aire Stáit, an Teachta Kathleen Lynch, as ucht an post nua atá faighte aici. Ní bhfuair mé seans é sin a rá go dtí seo. Tá a fhios agam, ón obair a rinne sí roimhe seo, gur duine maith í. Tá súil agam go mbeidh sí in ann obair de réir a briathar nuair a bhí sí ar an taobh seo den Teach.

Baineann an díospóireacht seo le ceist ríthábhachtach don tsochaí. Níl an ghné seo gafa le polaitíocht páirtí, ach leis an bpolaitíocht agus leis an sochaí. Ní chóir go mbeimid in adharca a chéile faoi. Sa deireadh thiar thall, tá an díospóireacht seo níos tábhachtaí ná aon rud eile a tharlaíonn anseo. Baineann an t-ábhar seo le beatha na ndaoine. Mar a dúirt an dá Theachta a labhair romhaim, más féidir linn díriú isteach ar an ní seo uair sa bhliain, b'fhéidir go gcuideodh sé le duine éigin a shábháil ó fhéinmharú. Measaim gur fiú é sin. É sin ráite, caithfimid díriú isteach ar cén fáth ar tharla méadú chomh mór ar ráta féinmharaithe na tíre seo le blianta beaga anuas. Ní leor a rá go bhfuil níos mó taifid á dhéanamh ar seo.

It is not just that there is now greater recording of suicides than there was in the past. That accounts for some of the increase in recent years, but it does not explain why our society is suffering the current level of suicide. The previous speaker said that 527 suicides were recorded in 2009, which was a substantial increase on the previous year — that is not even the full figure.

That gives a sense of the scale of the problem we have. It is not a party political issue but is a political issue because we as a society must ensure that the appropriate resources are dedicated to addressing this issue. The services and supports need to be in place, whether it is at a local community level or at a national level. The HSE should give a greater priority to dealing with mental health issues than it has given in the past. In our schools and clubs those who are mentors, leaders and teachers need to understand how to identify the signs. Not everybody who has committed or attempted suicide projects the signs but quite a number of people do so. I am no expert in this field but realise there are signs that need to be spotted and that people need to be listened to. The problems need to be addressed in as comradely and helpful a fashion as possible. It is partly a question of resources. The various groups that help those who are suffering from distress or depression, or who are contemplating suicide, have set out in some detail the steps one can take. We need to consider these.

A harrowing statistic I read in recent months is that over 74% of citizens know somebody who has died by suicide. This shows the scale of the problem. It is only one step removed from us. How many Members have attended funerals of suicide victims and noted the absolute grief of their bereaved families? We have noted the harrowing scenes and distress.

Families of suicide victims often feel guilty. They ask whether the suicide would have happened had they taken a certain course of action. They sometimes blame themselves not realising that the suicide might have happened in any case. In many cases, families do not know the reason for the suicide, even years later. "Why" is the big question for families. Families and associates of victims often need help.

Not so long ago I attended a funeral of a young man who had committed suicide. I met his parents again last week and discovered they still ask why it happened. There were no signals. Perhaps the family will never know why it happened. At the man's wake, there was considerable anger among his friends. I could not figure out whom they were angry with. Was it with themselves, society or the young victim? I talked to some of the men and met some of them since in various locations, including the local club and pub, and noted the conversation always returns to the question of why the suicide occurred. The anger of some of the men was associated with their belief that there is nothing for them and no hope. Some asked why the victim had not talked to them. I have had similar conversations at one or two other funerals I attended.

Suicide does not affect just one group of people. While it is most prevalent among young men, which in itself is scary, it is a problem right across society. Quite successful people have committed or contemplated suicide because of a collapse of their business or relationship, for example. Some have attempted suicide and have not been successful. The problem arises right across society. It is partly a question of education. That we in the House are willing to talk about suicide is very important. Twenty years ago, the Dáil would not have discussed suicide to the extent we have discussed it. It was a taboo subject and people did not mention it, pretending it was not really happening. We now have a more enlightened society and this alone will help dissuade some people from committing suicide and bereaving their families.

The main step we need to take as a society is to listen a little more. In the past ten or 15 years, we have become inward-looking. We are too busy rushing here, there and everywhere and sometimes do not take the time to stop and listen to friends and those around us. If this message, which is the same as that of some of the groups that offer tremendous support to the distressed, can be sent out, it will be of benefit. I refer to suicide support groups such as Samaritans, Teen-Line and 1life.

A group I met recently is involved in online counselling. Not everybody wants to discuss problems over the telephone or on a face-to-face basis; some want to put their thoughts on paper. We should support every organisation that can help people. I congratulate all those who are involved in offering support. In many ways, theirs is a thankless task. Sometimes they come home distressed after having spent a few hours manning a telephone line. Every Member of the House ought to praise those who give up their time voluntarily to help people they have never met, and we ought to praise everybody else involved also.

There is a range of steps that the Government should take urgently. There should be a properly resourced suicide prevention strategy, which strategy might involve determining whether the time of all the relevant organisations has been put to the most effective use. There is a wide range of groups. They should be properly resourced and should have the skills and staff required to deliver the services they are advertising, such that the services of Teen-Line and Samaritans, for example, would be available morning, noon and night. Every group is struggling to raise money and to operate with existing resources.

The modernisation of the mental health legislation in line with the new convention on the rights of persons with disabilities is required. I hope the Minister of State, Deputy Kathleen Lynch, will be able to introduce legislation in this regard in the near future. I am not expecting it to be introduced in her first couple of days in office. We need to promote a cross-departmental action group to combat social exclusion, prejudice and discrimination against people with mental health problems. We should ring-fence a certain proportion of the budget of the Department of Health and Children for mental health services in line with the recommendations of the World Health Organisation. The required child and adolescent community-based mental health service must be provided. The placement of children in adult inpatient facilities must cease, which means facilities must be created that are more appropriate to children than the facilities that were made available heretofore. It is disgraceful that some young people to whom I have spoken have ended up in inappropriate wards in hospitals and did not receive proper care because of a disconnect in the HSE over the years. There has been a failure to address the issue of suicide attempts, particularly among young people with suicidal tendencies. Many organisations are doing great work in the field of suicide prevention and counselling and they must be resourced properly.

The week before Easter, a group contacted me with a view to abolishing the stigma that surrounds mental illness. This is a useful goal. The organisation outlined certain stigmatising words that should not be used and which can lead to isolation among those who are trying to deal with mental illness. As a society, we are all responsible for the prevailing culture and need, as individuals, to make a conscious decision not to use certain words, such as "mad", "crazy", "bonkers", "psycho" and "schizo". There is a range of such words. I have heard my children and other children using them, albeit not understanding the consequences for those with mental health issues or those who may be struggling in life.

First and foremost, we must save lives. It is that simple. We must seek to prevent suicide in whatever steps we take. We do not wish to be attending funerals and consoling friends and families who have lost a loved one due to this society not being caring. For many years Ireland was known as Ireland of the welcomes. That welcome should not just extend to people from abroad but to everybody, including those with mental health problems. That means taking the time and making the space in our lives to address it.

I am a member of the Ballyfermot drugs task force and one of its initiatives is to train local people to spot the signs of possible suicide. It is a cost-effective programme and now 200 people have the training to watch out for signs that people, particularly young people, are contemplating or actively planning suicide and to know what steps to take. It is not that they interfere but they know where to direct the people concerned. Many of the problems in our society are due to the huge change whereby alcohol and drugs have taken a greater role in people's lives, particularly in the case of young people. That feeds into the national drugs strategy which will take on the alcohol issue when it is fully implemented and resourced.

It is useful and correct to address this issue in the House. As we give more attention to it hopefully the numbers will stabilise and start to reduce as quickly as possible. Ultimately, we must have a society in which people who feel under pressure, particularly young people, know they can talk to somebody, be it a relative, friend or somebody anonymous through a helpline or website. We should do whatever we can in this House.

I wish to share time with Deputy Kenny. I congratulate Deputy Kathleen Lynch on her appointment. She is a very down-to-earth woman and I hope she has much success in her office. I believe she will be on top of the issues with which she must deal.

I am conscious of the huge sadness and trauma surrounding suicide and the terrible impact it has on the friends and families of the individuals concerned. I wish to record my appreciation of the work done by many organisations and individuals who tackle the issue of suicide and the heroic efforts of priests and clergy who are in the difficult position of conducting the funerals of suicide victims. I witnessed one priest manage to maintain the very fine balance between honouring the person who had taken their own life and ensuring that suicide was not painted in any type of glamorous way. That was particularly difficult and the more people who can do it, the better when it comes to tackling this issue.

I will focus on the links between alcohol and suicide. The data from the World Health Organisation regarding suicide are striking. The 2009 figures show Ireland in a reasonably good light with 9.2 deaths per 100,000 people. That puts Ireland close to the bottom of the table, in contrast with countries such as Estonia and Lithuania where the incidence is up to over 30 per 100,000. However, when one examines the suicide figures for the 15 to 24 year old category, the situation is considerably different. In that context Ireland's figure is 14.4 per 100,000 people, which puts it fourth from the top. This contrasts with the rate for countries such as Portugal, with 3.7 per 100,000, and Greece, with 1.9 per 100,000. This is a considerable contrast to the overall figure in Ireland. While we must focus on the general issue of suicide, we must also examine why there is a higher incidence at that stage in life. That incidence is not necessarily reflected in other countries.

I strongly believe that alcohol plays a considerable role in many suicides, most especially in those that occur in the 15 to 24 year old age group. Although pure alcohol consumption reduced from a peak of 14.2 litres in 2002 to 12.4 litres in 2008, Ireland still has the third highest rate of alcohol consumption in Europe after Estonia and Austria according to European figures. The starkness of these figures is worsened by the fact that the European Union survey indicates that one quarter of Irish people had not drunk alcohol in the previous year. This means that those who are drinking are consuming considerable amounts.

I recently asked the Oireachtas Library and Research Service to look into the research on this matter. The evidence on the connection between alcohol and suicide is quite frightening. A 2006 study of the emergency department at Cork University Hospital looked at patients who attended the emergency department during three periods between December 2002 and January 2004. The study reported that 50% of people attending the emergency department with acute intoxication had also consumed large amounts of prescription medication and-or had over-medicated in an attempt to harm themselves. Almost all the participants were young, male and from lower socioeconomic backgrounds. The authors state that "the results of this study suggest that excessive alcohol consumption is closely related with suicide and deliberate self-harm".

Another study, conducted by Bedford et al in 2006, reviewed coroners’ reports in Cavan, Monaghan and Louth in 2001 and 2002. The study was undertaken to identify the blood alcohol concentrations, BACs, in persons who died as a result of accidental death or suicide. All cases where the person died as a result of injury or suicide in 2001 and 2002 were included. There were 129 deaths eligible for inclusion, of which the majority were male, at just over three quarters, and 113 were adults aged 18 years and over. Blood alcohol concentration levels were tested for the majority, 105 or 81%, and 55% tested positive for alcohol. The key findings were that 31 or 24% of the deaths were suicides, of which 90% were male. Blood alcohol concentrations were recorded for 29 of these suicides and, of these, 16 or 56% had alcohol detected in their blood.

Persons aged less than 30 years of age were significantly more likely to have alcohol in their blood. Over half of those aged less than 30 years had blood alcohol concentrations in excess of 160 mg per 100 ml, twice the legal drinking limit. The blood alcohol concentration findings in the study, particularly for the under 30s, are among the highest reported in the international literature. From these findings the authors conclude that the high blood alcohol concentrations in those who died as a result of suicide or injury reflect the high level of alcohol consumption and binge drinking in Ireland. Another study, which I will not have time to deal with in detail is the national report, "Suicide in Ireland: A National Study", in 2001. It had somewhat similar findings.

The World Health Organisation has estimated that the risk of suicide where a person is currently abusing alcohol is eight times greater than if he or she was not abusing alcohol.

A report from the UK Mental Health Foundation also states that as many as 65% of suicides were related to excessive drinking and identifies alcohol problems as one of the highest risk factors for suicide. This report also identifies a strong link between alcohol use and thoughts of suicide, suicide attempts and completed suicides among young people under the age of 24.

These studies clearly outline a connection between alcohol and suicide. It seems obvious that high alcohol consumption can induce depression, which might cause suicide or which might lead to someone with a suicidal intent drinking in order to gain the courage to commit suicide. Groups such as Alcohol Action Ireland believe that the connection between alcohol and suicide is strong and argue that alcohol use can act as a factor in suicide. This view is also supported by Ann Hope who, in a research report compiled for the HSE in 2008, argued that alcohol is an important contributory factor in suicide and concluded that "Alcohol can facilitate suicide by increasing impulsivity, changing mood and deepening depression".

A problem which has also been highlighted is that there is insufficient evidence to examine whether a link exists between single vehicle road accidents and suicide. Professor Denis Cusack made a call in respect of this matter and I wonder whether there have been any developments in this regard. It would be useful if material relating to whether their is a link between such accidents and suicide could be made available because it would be of assistance in examining the overall position.

I ask the Government to seriously consider banning advertising which relates to alcohol. Such advertising always glamorises alcohol and usually links it with something such as sport. While alcohol does have a positive function, if not used properly it can have hugely negative effects. It would certainly be worthwhile for the Government actively to consider banning the type of advertising to which I refer. I accept that such a move would probably lead to quite an aggressive debate. However, I am of the view that it would ultimately be of major benefit, particularly in the context of allowing us to confront the issue of alcohol consumption.

I appreciate that this debate primarily relates to suicide. If, however, the advertising of alcohol was banned, this would have a positive impact not only in respect of alcohol consumption, but also in the context of suicide. A ban on advertising might give rise to a situation where younger people might tend not to start drinking until they reach a more mature age. This would certainly be beneficial in the context of the issue of suicide.

I congratulate the Minister of State, Deputy Kathleen Lynch, on her appointment. I wish her every success in her new position.

Suicide is a global issue. The WHO has indicated that it is a significant public health problem worldwide and that each year more people die as a result of suicide than die in armed conflict. That fact places the matter in perspective. It is possible for everyone, whether inside the House or outside it, to be in a position to take steps to prevent suicide and to inform others of those steps. The key to preventing suicide is to take it seriously. I wish to outline some of the steps to which I refer in the hope that the information I will provide will be of use.

Suicidal behaviour is a cry for help. Most people have suicidal thoughts or feelings at some point in their lives. Almost all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery programme. There are modest steps we can take to improve our response to those who are suicidal and to make it easier for them to seek help. It is a myth to state that people who talk about committing suicide do not do it. However, studies have found that more than 75% of all those who commit suicide did things in the weeks or months prior to their deaths to indicate to others that they were in deep despair and in need of help. Anyone who expresses suicidal feelings requires immediate attention.

It is also a myth that individuals who attempt suicide are insane. It has been stated only 10% of all suicidal people are psychotic or have delusional beliefs about reality. Most suicidal people suffer from the recognised mental illness of depression but many depressed people adequately manage their daily affairs. The absence of insanity does not mean the absence of suicide risk.

On average, a single suicide intimately affects at least six people. Sometimes people who know someone who ended their own life can say that the problems that person was experiencing were not enough to prompt him or her to commit suicide. It is a mistake for people to assume that because they may feel something is not worth feeling suicidal about that others feel the same way. It is not a matter of how bad is the problem, rather it is how badly it is hurting the person who is experiencing it.

Another myth is the suggestion that nothing can stop a person from committing suicide once he or she has made a decision to do so. An individual who is suicidal can be ambivalent. In other words, there is a partial desire to live. The other part of the person does not want death — it wants the pain to end but not necessarily to die. It is the part of the individual that wishes to live which seeks to say to another person "I feel suicidal". If a suicidal person turns to us it is likely that he or she believes that we are more caring or more informed in respect of coping with misfortune and are more willing to protect his or her confidentiality. No matter how negative the manner and content of what such a person says, he or she is doing an extremely positive thing. We should all be willing to give or receive help. In addition, we should be prepared to do so sooner rather than later.

The prevention of suicide is not something to be undertaken as a last minute activity. Text books on depression indicate that it should be reached as soon as possible. Unfortunately, individuals with suicidal tendencies can fear attempting to get help. They are concerned that help may bring them more pain and result in their being informed that they are stupid, foolish, or manipulative. These individuals may fear rejection, punishment, suspension from school or work or written records of their condition or their involuntary commitment to a psychiatric hospital being recorded.

We must do everything in our power to reduce the pain experienced by a person who is feeling suicidal, rather than increasing or prolonging it. We should give that person every opportunity to unburden himself or herself of his or her troubles and to ventilate his or her feelings. Not much needs to be said and there are no magic solutions. We should not judge people. In addition, we should avoid arguments.

Yet another myth is the idea that discussing suicide may give someone the idea of committing it. Individuals at risk of suicide are already aware of the idea, particularly in light of the wide coverage relating to it in the media. People already have the idea because suicide is constantly in the news. Asking a person whether they feel suicidal is a good thing — we are showing that we care about him or her, that we take him or her seriously and that we are willing to share his or her pain and be of assistance. Persistence and patience are needed in order to seek and pursue as many options as possible to ensure that a suicidal person is able to obtain the help he or she needs.

I previously served as a member of the HSE Dublin north-east regional health forum and last year I was in attendance when Mr. Geoff Day, director of the National Office for Suicide Prevention, made a presentation to it. Mr. Day identified solutions that work in the area of suicide prevention. These include GP education, skills and problem-solving programmes, education of community gatekeepers, restriction on access to the means of suicide, treatment of mental illness, follow up after self-harm and responsible media reporting.

There is a need for better and more rigorous controls in respect of the sale of non-prescription drugs. Paracetamol is just one example of a non-prescription drug. Such controls would provide a way to restricting access to the means of committing suicide. Non-prescription drugs are freely available in shops and supermarkets and if they are mixed with alcohol they can cause accidental death, which can often be categorised as suicide. It is possible to purchase these and other life-threatening drugs on the Internet, over which it is extremely difficult to exert control in the context of the sale of products.

I will conclude by quoting comments by President McAleese at the world congress on suicide prevention in Killarney in 2007:

Reducing suicide rates requires a collective, concerted effort from all groups in society: health, social services, other professionals, communities and community leaders, voluntary and statutory agencies and organisations, parents, friends, neighbours and individuals. It also requires the careful nurturing of a culture in which people in psychological distress don't hesitate to seek help.

I would like to express my gratitude to all the groups and organisations who help people to deal with suicide and its after effects.

I welcome the opportunity to speak on this debate today. I wish the new Minister of State the best of luck in her role. I know that she will do an excellent job because she has a great interest in this area. I specifically want to acknowledge the tremendous work that has been done by my colleague, Deputy Neville, over a long number of years in both Houses. We would not be debating this issue today but for the Trojan work he has done over a long period of time.

The first thing we must acknowledge is the scale of suicide. People do not talk about it. They are afraid to talk about it and it has not received the same level of debate as issues such as road traffic accidents and road safety. Deputy Neville's own organisation, the Irish Association of Suicidology, carried out a study which indicated that three out of four respondents in a survey knew somebody who had died by suicide. Every one of us has personal experience of this. I am aware of family members, friends and neighbours who have all died by suicide. It is important that we talk about the issue, but it is also important that we deal with some of the myths on suicide and mental health.

Huge stigma is associated with mental health in Ireland. Addressing the perception of mental health will go a long way towards ensuring that people who have a risk of committing suicide get the help they need. Between 80% and 90% of those who take their own lives are suffering from some type of psychiatric condition. For those who are young people, it has often been unidentified depression. We need to look at the stigma associated with mental health in this country. It has been ingrained into us as a society. Everybody will talk about someone who is diagnosed with cancer. Somebody with cancer has no difficulty talking about their diagnosis and their treatment, be it in the pub, outside the church or in the local community. However, if it is mental illness and somebody is on medication for it, that person closes down, the family closes down, and they try to ensure that nobody finds out about it. That typifies the public perception and the attitude in society to mental health issues. If we look at the number of people who have a diagnosed mental health issue and the number of people with an undiagnosed mental health issue, then a significant proportion of the population will be affected. It will cross every single home in this country at some stage in everybody's life. The concealment of depression and other mental health problems is a serious concern and is a significant part of the problem of addressing suicide in society.

One in three people have experienced depression either personally or among family members. In the vast majority of cases, that particular experience is concealed from immediate family members and from friends. It is interesting to note that around 400,000 people suffer from depression, yet do not feel comfortable talking about it. It was interesting to listen to Mary McEvoy on the television recently telling her own story about depression. She finished up by saying that she had not beaten depression, but she was able to function in society, still suffering from depression and still on medication for the condition. We need more people like that who are prepared to come out and talk about their own personal experiences of depression.

We need more debates like this. When I was doing research on this issue, I found out that 60,000 people attempt to take their own life every year. I did not believe the figure and I had to double check it. One person attempts to take his or her own life or do some form of self-harm every nine minutes in this country. It is far greater than the statistics on road traffic accidents, yet it is being brushed under the carpet every day.

Everything these days is about economics and mathematics. We have to listen to the expert economists who tell us how to run our economy and what we should and should not do. However, if we look at the economics of two mental health issues, about €3 billion per annum is being lost to Irish business due to bullying. Another €1 billion per annum is lost due to suicide. These two issues cost about €4 billion per annum, not to mind the impact on people who try to commit suicide or self-harm. This is roughly the amount of money that the Government will have to save for the budget in 2012. From a purely economic perspective, it makes sense to put further resources into mental health issues, as well as bringing in a change of attitude.

We need to be able to talk openly about mental health. There is much sympathy for people diagnosed with cancer. The community rallies behind them and their families, yet people tend to steer clear of those diagnosed with something as common as depression.

I want to raise the issue of school and work place bullying. Anyone who saw the headlines in the newspapers today on Phoebe Prince would have to acknowledge that it is a massive issue both in the workplace and in schools. No doubt it is a significant contributing factor in suicide rates. As I pointed out purely from an economic point of view, €3 billion per annum is being lost to Irish business solely in the associated costs of workplace bullying. We need to take it back a step and deal with this issue at school level.

I am also conscious that we tend to try to dump everything on schools and on teachers and get them to solve everything. It is important that we deal with this issue in terms of not only the victims of bullying, but the bullies themselves, both at primary school and at secondary school, and to eradicate the problem before it goes into wider society. In many cases, the bullies themselves have other issues, including family issues, that need to be dealt with. It is indicative of some other problem. It is crucial that there are anti-bullying strategies within the school environment because they have been proven to work successfully.

A proper co-ordinated national structure on the issue of anti-bullying strategies in the school system is needed because each of us has come across stories of parents who have encountered significant difficulties getting a bullying issue addressed in their local schools, either at primary or post-primary level. There needs to be a far greater awareness of it within communities and the school setting so that it is nipped in the bud when it arises in the first place. School-yard bullying cannot be tolerated in any circumstance. If one can deal with the issue in the school setting, there will be not only the immediate impact, but also a longer term positive impact in cutting down workplace bullying and anti-social behaviour.

Bullying has profoundly negative consequences, both short term and longer term, for the children concerned. They become isolated and withdrawn and they suffer from anxiety and low self-esteem. It has an impact on their school performance and, sadly, there are tragic incidents where it also leads to suicide. The Phoebe Prince story highlights that. It is happening in schools and communities and it is an issue we cannot continue to ignore.

The final point I want to make relates to the economy. When one turns on radio or television, news of the economy is all doom and gloom. It is all negative. Economic strain and personal financial crises for families precipitate events that can lead to deaths by suicide and problems with mental health, and we must look seriously at this issue. It is worth noting that despite all the doom and gloom due to the problems of the banking crisis and the way the bankers have got away with blue murder, which is sickening and forms part of the problem of public perception, we have not ended up in difficulties such as those experienced by the Japanese due to the earthquake and the subsequent nuclear disaster in that we have not had any physical disaster in this country. People do not have money and are in serious financial difficulty, but it is important that we put it in some sort of perspective.

It also is important that we start talking ourselves up because we, as a race, are good at knocking people and looking for the negative in everything. It is about time we started looking at the positive. Listening to the radio last week, I heard two good stories on "Morning Ireland" about communities that are starting to turn around the economy. In a community in south Galway, the parishes are coming together to develop tourism by bringing second, third and fourth generation Americans back to Ireland to visit their ancestral roots. This stimulates the local economy as a result. In Longford, the business community has come together and put a fund of €1 million in place to invest in small businesses to get them off the ground. There is much good news out there but the sad part is that it does not travel. We, as public representatives, need to start selling the good news stories. Leaving aside the political debate that we can have here on whether the Government is taking the right decisions, there is an onus on each of the 166 Members of this House and the 60 Members of the Upper House to start talking about some of the positive stories and to see how we can support those businesses. It may not be a matter of providing funding but of providing advice or encouragement to individuals who do not believe that they have anything to look forward to.

The Deputy has one minute left.

The position is not as bad as it is being spun at present. We will get out of this recession. In the past, we as a society have got out of difficulties far greater than the one we are in. If we start picking ourselves up, dusting ourselves off, and looking to the positive and what we can do well in this country, then we can drive the economy forward and deal with some of the negative impacts of the recession. One step that can be taken quickly, and which will not cost one cent, is to deal with that issue of perception of mental health and to start openly talking about it. If we could even take that one small step forward as a society, it would have a significant impact on the rates of suicide and those seeking the professional help. People do not have to suffer in silence.

Since this is my first opportunity to speak in this Chamber, I thank the people of Carlow-Kilkenny, particularly the people of Carlow, for entrusting their confidence in me to represent them in the 31st Dáil. I thank my family, my party and my party workers for their help and support during the recent election campaign.

Like every other speaker, I am delighted to get the opportunity to make a few brief points in this important debate. Suicide affects every town and village in this country. Ironically, since this debate started three to four weeks ago, in my county four young people under the age of 25 have taken their own life. Like previous speakers, I have found going to those funerals very difficult. Suicide is an area that we need to tackle immediately.

A number of years ago, road safety was a big issue. I do not mean to downgrade that important issue, but it was a national emergency over the past five or ten years and we tackled it strongly. We need to go down the same road now to tackle this important issue.

There are three main categories of which we all know. There are young males, males in the 30 to 45 age bracket and then there are females, who are more affected than anybody else. Two main areas should be looked at and bearing in mind the old adage that prevention is better than cure, education is the first step we should take. Young males in the 15 to 20 age bracket are vulnerable. Once somebody in that particular age bracket takes his or her own life, friends in the same age group might think they may be better off going down the same road. We need to tackle this and ensure they are more aware of the better services that are available and that better options exist than taking one's life. We need to have a structure in place at secondary school level, perhaps during transition year, to ensure they are more knowledgeable and not as vulnerable.

Media campaigns are very important and have been very effective in road safety. We spent a great deal of money on media campaigns in recent years and it was money well spent. We need to go down this road with regard to suicide prevention to ensure we are successful. While suicide will never become a thing of the past, the current figures are frightening. We need to bring on board people who are looked up to by young people, such as sporting heroes and TV personalities, to make young people aware of the options that exist and the fact that taking one's life is not the way to go.

Funding is also very important and we need to ring-fence a certain amount of money every year to try to reduce the figures. In the past, we set targets for road safety and we should go down the same road for this.

I thank my colleague, Deputy Neville, for his work over the years, for ensuring we have had this debate, and for ensuring this issue has come to the forefront rather than being kept in the dark as it was in the past. As we know, suicide was something about which people did not want to speak but because of Deputy Neville's work, we are having a national debate on it. It is something about which we should speak more openly. I wish the Minister of State, Deputy Kathleen Lynch, well in her new role. I know she takes it very seriously and I wish her every success.

I thank Deputy Deering and I congratulate him on his first speech in the Dáil. As Acting Chairman, I wish to be associated with the remarks of commendation for Deputy Dan Neville on the heroic work he has done on this matter for many years. I warmly commend him.

I also wish to be associated with the remarks made about Deputy Dan Neville. My first experience of Deputy Neville with regard to this issue was many years ago when someone who was unsuccessful in a suicide attempt came to Cork. Deputy Neville contacted me and between the two of us we befriended the person and did a little socialisation. Dan's record is not only with regard to prevention or public information, but it also stands with regards to people who are not successful in their attempt as he has talked many of them and their families through very difficult situations. It is for this that we should be most grateful.

It is also appropriate that I recognise the contribution made by my predecessor, John Moloney. He was also very dedicated and put in place many of the initiatives on which we are now following through. If we constantly state that if more women were involved in decision-making in society that things would be different, then it is incumbent on us as women to act differently when we get there, and acknowledging what others have done is very important.

I thank all of the Deputies who contributed in a very sincere manner. Clearly, they know the subject, and I suppose this is on the basis of personal experience, which is a sad way to find out about something such as suicide. It strikes me that according to the most recent statistics, the number of people who have taken their own lives would fill this Chamber more than three times over. We need to keep this in mind always.

We may attend an individual funeral or we hear about a cluster of three, four or five suicides in an area but it is very difficult to envisage the total of more than 500 people. If one closes one's eyes, it is virtually a small village. If that number of deaths happened as a single tragedy any year, our response would be far more immediate and urgent. This is what we need to do; we need to keep in mind the number of people we are speaking about and the devastation each death leaves after it not only for the family, but for friends and the community, and also the terror it sends through each house in the immediate area. What this is really about is this sense of terror, which perhaps makes us not want to speak about it because if we do not speak about it then somehow it will not happen again. We know this is not true because it has gone on for so long.

It was interesting to hear almost every speaker compare funding for suicide prevention with funding for the Road Safety Authority. A comparison can be made on funding, but I am not certain a comparison can be made on the manner in which people die. I must admit I am not into this; I can understand it is an easy argument to make but I do not think it is a comparison of like with like. Every evening, on the six o'clock news one can see the carnage of road accidents but we do not see this with regard to suicide and I am not certain we want to do so.

People who decide to take their life by suicide do not make an immediate decision to do so; it is something they have thought about. What is important is to say to those people who are listening and who are contemplating suicide that they should speak to someone. The old adage that talk is good is vital. If they cannot speak to someone nearby they should pick up the telephone. They should speak to the various helplines or their GP. They should speak to their sisters or brothers or someone, because it is important that we recognise that people who have taken this course of action need someone to talk to. They need help and that help is there. When that help is given, it can divert people away from this path and this is very important. We are not speaking about strangers on the street; we are speaking about fathers, mothers, sisters, brothers and a beloved son.

In the argument about where we are going with regard to mental health, the stigma attaching to mental health is probably the greatest preventer of people seeking help in the first instance. Why is this stigma attached to mental health? Surely it is no different from having cancer. I remember a number of years ago one did not say the word "cancer" in public. One would say "the big C" or "she has been diagnosed with the other thing". We have got past this because we recognise that it is a disease, and one which not alone is preventable but curable and treatable. So is mental illness and we need to get our heads around this. We need to start saying it out loud and exploding the picture.

Last night, I attended the launch of Make a Ripple, which is an excellent new Internet campaign for people feeling down and unwell with regard to their mental health. They can go online and share their stories and read other people's stories. Amazingly, one of the people headlining the Make a Ripple campaign is Alastair Campbell, someone with whom all of us here would have an affinity. He is hugely successful in politics, writing and his contribution to society, and he suffers from depression. He speaks about it. Some days he feels very good, some days it is a little bit mild and other days he stares into the abyss. He talks about it and we need to start doing the same. We need people to come out and to start talking about the very bad days they have had but which they have left in the past. I worry that we are not allowing young men and not so young men the opportunity to speak and the opportunity to tell us that they are feeling vulnerable. I am a great believer in balance. I have spent my life trying to achieve the type of balance necessary in society so that women can be treated equally. Sometimes by creating balance in one area, something else is put out of kilter. We need to start telling men, both young and middle aged, that they are not just valued as being providers but that they are valued as fathers, as brothers and as contributors to society. They need to know we value them. I can understand the type of humiliation men feel when they lose their jobs or businesses because they can no longer provide what they provided in the past. I say to them that is not what we value in you but we value your contribution to your family, to society; we value you. We need to get that message out there.

Deputy Naughten told the House about the cost to the economy of the effects of depression and of suicide. How do we judge whether a person has been successful in life? I hope that not everything is judged in economic terms based on the size of a person's car or house. We need to reconstruct how we regard people, how we value success and how we monitor that success.

It is good that people will praise a man who is a good father and regard this as a very honourable role. We need to start thinking outside the box about how we view people who take their own lives and people who suffer from depression. We need to start speaking out about stigma and we need to tell people that it is not the shameful thing they think it is. Around 75% of mental illness emerges during childhood and adolescence and early intervention is essential so that such illness does not bring with it a lifetime of pain and misery. I refer to projects which provide such intervention and the very successful work of voluntary agencies such as Jigsaw and Headstrong. Such projects must be rolled out in all parts of the country so people can access the assistance of individual people as well as agencies.

Deputy Dowds suggested a ban on alcohol advertising. In my view, the day is fast approaching when alcohol needs to be included in the bundle of what we consider to be harmful drugs. This needs to happen. It is known that alcohol has the same destructive effect on health as do cigarettes, yet we still maintain that it is permissible to advertise alcohol. However, any ban on advertising must be a European-wide ban. It would be pointless for RTE to ban the advertising of alcohol if it is advertised on UTV and other stations. We must put across the message that success in life is not automatically regarded in terms of economic success as success must be measured in how a person contributes to society.

Children in primary school should be included in programmes which encourage them to talk about their feelings rather than about their mental health. Very young children can very quickly identify and name a bully but as they get older they will not do so because it is considered less manly to do so at second and third level. Just as in industry there is a Safe Pass system and legislation provides for health and safety instruction, we need a similar system for dealing with mental health and it should be provided for in legislation. We need to start walking the walk and to start breaking the silence. Safe Talk and Assist need to be part and parcel of induction courses in all employment. It is only by adopting such a holistic approach to mental health and only when we all start to talk about it that people will feel safe and secure in approaching others.

Neither the previous Government, this Government nor the next Government can do this work on its own. It is a societal issue and society has to take ownership of it. The Government must put the structures in place so people can approach a service and receive assistance. We must all recognise the signs so that when someone feels threatened we can ask them how they are doing today. We may be a friend, a neighbour or a family member but we can then help them. If it is the case that according to the latest statistics this Chamber could be filled three times over with the number of people who have taken their own lives, then we need to deal with it.

That concludes statements on suicide.

Sitting suspended at 2.45 p.m. and resumed at 3.30 p.m.
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