Liz O'Donnell
Ceist:3 Ms O'Donnell asked the Minister for Health the plans, if any, he has to deal, as a health issue, with the high incidence of suicide among young men as outlined in a recent report. [12105/95]
Ceisteanna—Questions. Oral Answers. - Male Suicide.
Liz O'Donnell
Ceist:25 Ms O'Donnell asked the Minister for Health the plans, if any, he has to deal as a health issue with the high incidence of suicide among young men as outlined in a recent report; and if he will make a statement on the matter. [12040/95]
(Limerick East): I propose to take Questions Nos. 3 and 25 together.
I understand that the report to which the Deputy refers describes research carried out on deaths attributed to suicide between April 1987 and March 1988 in Finland. It indicated that 59 per cent of male suicide victims between the ages of 20 and 34 years had suffered from depressive syndromes compared to 64 per cent in the 35-39 year age group.
Investigation and detailed research into the causes of suicide has not been easy at national and international level. In the past there has been an understandable reluctance to even discuss the issue and this made the compilation of accurate data on the frequency and pattern of suicide more difficult. It is clear, however, that reliable information on the occurrence of suicidal behaviour is essential if help is to be made available to those considered to be at risk of suicide. While research, such as that described in the Finish study, is of value in increasing our knowledge of the factors which are associated with suicide, we should not too readily transpose data from one cultural context to another.
The health strategy Shaping A Healthier Future expressed concern about the increase in the rate of suicide especially among young people in Ireland. Although not all persons who commit suicide suffer from mental illness, the mental health service has a particular responsibility to prevent suicide. The Department of Health is contributing towards the cost of a pilot project on attempted suicide in Cork, carried out by staff of the Southern Health Board under the direction of Dr. Michael Kelleher, consultant psychiatrist. The aim of this project is to reduce the occurrence of para-suicide, that is attempted suicide, and to develop intervention skills which may be applied in this area. The study is a collaborative partner in the WHO-EURO multi centre study on para-suicide and the MidWestern Health Board has recently become involved with the study.
The Department of Health also provided financial support towards the cost of the Fifth European Symposium on Suicide and Self-poisoning, which took place in University College Cork from 31 August to 3 September 1994. This symposium was attended by researchers from diverse backgrounds from all over Europe. It enabled medical and nursing personnel, social workers, voluntary groups and others to exchange experience leading towards a better understanding of suicide and suicidal behaviour.
With a view to gaining more information on the factors associated with suicide in Ireland, I am examining ways of involving experts in the examination of the annual statistics on suicide and to make recommendations which might help to prevent some suicides.
The World Health Organisation in its Targets for Health for All has recommended action to reverse the rising trend in suicide by the year 2,000. It highlights the importance of early detection and treatment for depression, alcoholism and schizophrenia. These are all being addressed in the context of reorganisation of our mental health services as outlined in the health strategy.
The World Health Organisation also suggests the need for improvements in the underlying societal factors that put a strain on the individual, such as family stress, social isolation and failure at school. It emphasises the need to develop the individual's ability to cope with life events which is a crucial factor in preventing and managing mental illness. The Health Promotion Unit of my Department and the Department of Education are already involved in the delivery of health education programmes for young people both in and out of school settings.
The report to which I referred was on research carried out by Dr. Michael Kelleher, the findings of which were published in the Irish Medical Journal and subsequently in The Irish Times on 20 June. There was a clear finding that 17.5 per cent of young male deaths were caused by suicide. That is a high percentage. Given those figures and the fact that it is Irish research based on empirical studies in Cork, does the Minister agree that this is a major public health issue and the time has come for his Department to put together a multi-disciplinary team composed of professionals involved in the treatment of suicide and members of voluntary agencies, such as the Samaritans, to formulate policy which would respond to the need?
(Limerick East): I thank the Deputy for her clarification. The work carried out will be taken into consideration. The Department of Health is contributing towards the cost of work being carried out by Dr. Kelleher in the Southern Health Board and Mid-Western Health Board areas. It is unfortunately true that the incidence of suicide has increased in Ireland in recent years. In 1970 there was 52 deaths from suicide and in 1990 there were 334. These statistics are sometimes explained away by people claiming that the cause of death was often not stated as suicide but close examination of the figures does not reveal a corresponding fall in other causes of unnatural death — for example, from accidential poisoning, accidental drowning or open verdicts in coroners courts. There is no doubt but that there has been an increase in the number of suicides. I agree that there is a high incidence of premature death among young men which is attributable to suicide.
This is a matter of major concern for society as a whole and I pledge that the health services will play their part in that context. If we were to take the kind of initiative proposed by the Deputy we would need reasonably accurate information on the causes of suicide. The research being carried out at present as a matter of urgency will contribute to this and it will then be a matter for the psychiatric services. The World Health Organisation has recommended that depression, alcoholism and schizophrenia should be targeted and this is being done in the context of reforming the health strategy in respect of mental health, as set out in the health strategy document. I have commenced ordering the work priorities in my Department for the second half of the year and the causes of suicide will be high on the list.
I want to keep the focus on the 15-30 age group where the number of suicides has trebled since 1986 and doubled in the past four years. Will the Minister target this category of suicide victims and consult not only the psychiatric services but also the psychological services which are very involved and have a role to play in this area? Given that the figure for young women is 5.5 per cent, young men between the ages of 15-30 are in a high risk category. Does the Minister agree that this problem does not lend itself to simple solutions and will he ask his officials to ensure a more targeted response to this category?
(Limerick East): I agree in general with the approach outlined by the Deputy but this problem is not as focused as he seems to believe. In 1990, the last year for which statistics are available, there were 95 deaths among men aged 15-34. This represented 28 per cent of total deaths from suicide during that year. Approximately one in four victims is in this category and focusing exclusively on it would not deal with the problem which is wider than that. In the context of the increasing number of suicides there is a sub-group which needs special attention. My approach is to look at the full extent of the problem and if special initiatives are required — other than those already being taken in the areas of depression, schizophrenia and alcoholism — we will take them.
We have accurate statistics of the number of suicides but the problem is that we do not have accurate information on the causes. We cannot solve the problem by borrowing research from abroad and transposing it into our culture. We must, therefore, undertake significant research ourselves. I will not delay the taking of initiatives until a research programme puts results on the table. We can work in parallel with such programmes and respond to data as it comes in.
The Minister said he does not want to wait for research but this is very important in identifying the occupational, environmental and social reasons so many young men take their lives. We need this information to formulate policy. If the Minister does not intend to wait for the research has his Department initiated programmes to deal with this category of suicide victims? It has been established that more young men die from suicide than from cancer or road accidents. The figures are startling and this is why I raised the issue.
(Limerick East): I have no disagreement with the points made by the Deputy but I am dealing with the matter in a different context. I think there would be general agreement among Deputies that the most dramatic changes in practice in the health services in the past ten years have been in the area of mental illness. Everybody is aware of these changes and I do not have to recite them. There is now a totally different attitude to the treatment of mental illness. Not all suicides can be attributed to mental illness — the best figures I have suggest that approximately two-thirds of those who commit suicide were mentally disturbed at the time. It is important to put the problem into context. The World Health Organisation has said that the treatment of depression, schizophrenia and alcoholism reduce the incidence of suicide and the psychiatrists and psychiatric services within the health boards are targeting those areas.
On the question of research, it would be helpful if we had a more accurate or precise idea of the causes of suicide in Ireland and applied this to the subgroups, particularly the one identified by the Deputy. When Ministers say they are setting up a committee or commission to carry out research this is seen by Deputies as an excuse for inactivity. A pilot study is being carried out in Cork and data is being fed into it by the Mid-Western Health Board. We all have access on an ongoing basis to this data. I will not say I will do nothing about suicide until this project is put on a national basis as, beginning later this summer, I will try to collate the information with a view to bringing forward proposals in the second half of the year. The proposals will be based on hard data, anecdotal evidence, hunches within the profession or the experience of groups such as the Samaritans. We know the numbers but we do not know all the causes or how other factors outside the health services affect the situation.
The time available for dealing with priority questions is exhausted but we can dispose of Priority Questions Nos. 4 and 5 in accordance with the new procedures of the House.