Dáil Éireann díospóireacht -
Thursday, 12 Feb 1998

Vol. 487 No. 2

Other Questions. - Suicide Incidence.

Richard Bruton

Ceist:

5 Mr. R. Bruton asked the Minister for Education and Science the extent of the rise in the number of suicides among persons of school going age in the past ten years; the number of second level schools without guidance counsellors; the average waiting time for a student at second level to receive an assessment by the psychological services; and the plans, if any, he has to make improvements in these two areas in view of the recent report by the national task force on suicide. [3715/98]

Mr. Martin

The incidence of suicide in Ireland is recorded by the Central Statistics Office and is classified according to age groups. My Department does not keep separate statistics for young people of school going age. However, it is clear from the recently published report of the national task force on suicide from the Department of Health and Children that there has been a disquieting increase in the numbers of suicides reported among young males between the ages of 15 and 24 years.

The psychological assessment and counselling of young people who have attempted suicide or who are considered to be at serious risk is properly dealt with by the specialised clinical psychological and psychiatric services of the regional health boards. The main role of the Department of Education and Science is to assist teachers and parents to identify young people at risk, to promote a climate of good mental health in schools and to support staff and pupils if, tragically, a suicide occurs.

A guidance counselling service in second level schools is funded by the Department of Education and Science. Each school is given a guidance allocation which varies according to its size. There are currently 567 wholetime teacher equivalents allocated to guidance in the system. A dedicated agency, the National Centre for Guidance in Education, has been established to provide professional support for guidance counsellors. It also provides a forum to review guidance provision and advances proposals for its enhancement. In addition, financial support for the professional development of guidance counsellors is provided by the in-career development unit of my Department. This support provides for seminars which deal specifically with suicide, depression and bereavement.

Where a risk of suicide is suspected, the guidance counsellor will support and counsel the young person concerned. The advice of the Department's local psychologist will usually be sought and this is given promptly. The psychologists give absolute priority to pupils experiencing difficulties of this kind and do not operate a formal waiting list. Where necessary, the school psychologists refer pupils to the appropriate specialist agencies of the health authorities for further assessment and treatment.

Last year I announced my intention to develop, in liaison with the health authorities, a national educational psychological service. This will be available to all primary and second level schools as well as to young people of school-going age who are outside the formal education system. Planning for this service is well advanced. A planning group, representative of the partners in education, will report to me before the end of April of this year. The report of the planning group will be critical in putting the psychological service on a firm footing for the future.

I am aware of the need for schools to promote mental health in all young people. I am grateful to the health promotion unit of the Department of Health and Children for its co-operation and support for health promotion in schools.

As part of the revision of the primary curriculum, a new subject of social, personal and health education is being introduced. The syllabus has been developed by the National Council for Curriculum and Assessment. Issues of self esteem and the need to express feelings are addressed in this programme. A syllabus for post-primary schools is currently being developed.

A "whole school" approach to health promotion is being developed by the Irish Network of Health Promoting Schools. This pilot project involves families and community as well as teaching staff. Forty schools, both primary and post-primary, belong to the network. The project will shortly enter the dissemination phase.

In-career programmes for teachers are essential if health promotion in schools is to be effective. These are funded by the in-career development unit. In 1997, approximately £200,000 was allocated for this purpose. In addition, grants were made to schools and education centres in respect of specific seminars dealing with stress and depression in young people. All such applications were granted.

Mr. R. Bruton

Does the Minister agree with the figure released by the USI at a recent seminar that the suicide rate among 15 to 19 year old males has increased by 400 per cent between 1990 and 1996? Does that coincide with the information he is receiving?

How does the Minister intend to respond to the specific recommendation made by the task force on suicide to his Department that guidance counsellors should be available in all schools? Could he indicate the number of second level schools that do not have such a guidance counsellor? Has the task force on suicide had a chance to look at the social, personal and health education programme being drawn together at secondary and primary level, in view of the fact that they have made specific recommendations about that programme in the course of their recommendations? Are those recommendations being taken on board or is the original programme going ahead as it was developed?

Will the Minister provide national guidelines along the lines of the ASTI guidelines which found that 30 per cent of their schools had experienced suicide in the past two years? Will he also provide directories of services to individual schools so that they can respond in a timely way?

Mr. Martin

This is a very important and grave issue. The recommendations and conclusions of the report will be taken on board in terms of the social, personal and health programme at primary level and second level. The report is significant because it does not just deal with schools but with the broader community. There is considerable empirical evidence that further contributory factors to the incidence of suicide in particular, are high rates of unemployment, increased stress in living, drugs and their abuse, particularly alcohol, and the length of adolescent dependency in today's world. The report identified that the provision of good educational services at as early a stage as possible is extremely important to prevent the conditions which lead to suicide.

In terms of the Deputy's question in relation to the USI figure, I would tend to go along with Dr. Michael Kelleher's assessment because he is one of the foremost experts and has put a lot of work into this in terms of the range of the problem. It is now the second most common cause of death after road traffic accidents among 15 to 24 year olds. Dr. Kelleher also came to the conclusion that 80 per cent of young males who take their own lives have not received counselling or medical care.

In terms of guidance counselling generally, every school has some access to a level of guidance counselling, depending on the number of pupils. Schools with more than 500 pupils have a full-time guidance counsellor. At second level there are about 278 schools with fewer than 500 pupils which therefore do not have a full-time guidance counsellor. There are 58 schools with more than 800 pupils; 75 schools with between 500 and 799 pupils; 278 schools with between 250 to 499 pupils; 41 schools with between 200 to 249; 43 schools with between 150 and 199 pupils; 27 schools with between 100 and 149 pupils; and 28 schools with fewer than 100 pupils. We have to improve in terms of provision of guidance counselling. We are looking at the recommendations of the National Centre for Guidance Counsellors, particularly in terms of increasing the minimum number of hours of guidance counselling available to schools to eight hours. We are working with them in terms of the implementation of that recommendation.

Mr. Gormley

Is the Minister aware that at a recent meeting of the Joint Committee on Health and Children where we discussed the task force on suicide and para-suicide, Dr. Kelleher, who headed the task force, said categorically that there was no correlation between the points race and para-suicide and suicide? Does the Minister accept that finding?

I welcome the fact that the Minister will promote mental health in schools, but how does he intend to go about it? How can baseline studies be established? For example, in regard to physical health one can assess an individual to establish how healthy he or she is. How can that be done in the area of mental health? That is very important. The Conference of Religious in Ireland have always promoted the idea of a social health index that measures the quality of life, mental health and contentment of individuals, as opposed to having very crude indicators, such as economic growth. In this instance how will the mental well being of students be assessed?

Mr. Martin

The social, personal and health programme is not just about assessing the mental health of students. One of the problems in Ireland is that as a society we have not developed a positive attitude towards mental health. There was a taboo surrounding mental ill health, a stigma attached to it. We intend to work with the associations involved in mental health, the Mental Health Association in particular. I have had meetings already with the Cork association who have developed their own resource pack for schools. One of the key issues they have consistently identified is that we must develop a positive attitude to mental health, and there must be a "whole school" approach to that. It is not a question of focusing on suicide, going one dimensional in terms of the approach to mental health. Mental health is as important as physical health, and we need to have the same degree of emphasis on that as we do on other areas. We need to be much more open about the issue than we have been historically as a nation. We need to work closely with the people who know most about this.

Mr. Gormley

How will we establish a baseline study, starting in primary schools or wherever, to establish how mentally healthy people are to begin with, because it is only by doing that that a comparative study can be made ten years down the road? How are we going to do that?

Mr. Martin

We need to talk to our colleagues in the Department of Health and Children to develop a baseline study of that sort. I would be interested in the Deputy's views on that.

Mr. Naughten

Does the Minister agree that the sex education and drugs education programmes are an integral part of tackling the suicide problem? However, some schools have complained they do not have room in their timetables to teach these subjects. Does he also agree that the industrial action threatened in his Department's Athlone office will not help young people sitting examinations this June and will increase the stress on them?

Mr. Martin

We need to be clear on this. Deputy Gormley asked whether I accepted the conclusion of Dr. Michael Kelleher's report that there is no correlation between the points system, examination-related stress and suicide. That conclusion was cogent and strongly argued and I accept it. We should be careful of using an industrial relations problem to score a political point about its impact on children. I regret any additional stress on young people as a result of industrial relations difficulties, which is why we are working to resolve them and are treating the matter seriously.

It is intended to incorporate the programmes on substance abuse and on relationships and sexuality within the overall social, personal and health programme, along with the Stay Safe programme, so that we have a comprehensive and solidly based programme which can be fitted into the curriculum. I accept it would be difficult to do it in a piecemeal way.

Mr. Stanton

Does the Minister accept it is important to have small numbers in the classroom when the social, personal and health education programme is being taught? If teachers are forced to work with more than 24 pupils the programme will not work. It might even be detrimental to its overall objectives.

Mr. Martin

While we seek improvements to the second level pupil-teacher ratio the average is usually better than 24 to one — some classes are higher than that average but others are much less. The more we continue to reduce the ratio the better for all programmes, not just the social, personal and health programme. In addition, where the school has a full-time guidance counsellor, he or she tends to take smaller groups for their programmes and to deal differently with students. As a general principle there are benefits to be derived from continuing to reduce the ratio but there are other issues. One could argue we did not make sufficient provision for guidance counsellors over the last four to five years but economic circumstances may have played a part in that. We must increase the provision for guidance counsellors at second level.

We await the outcome of the primary curriculum review, which will consider the social, personal and health programme. Considerable inservice training will be made available to primary school teachers in that regard, including training related to the programme. I think it will be successfully introduced to our schools.

Mr. Gilmore

Does the Minister agree that one problem in this area is the lack of co-ordination between different services as they apply to children at risk? Whereas a teacher may quickly identify a minority of children who are at risk, in terms of their health or behaviour, there is little co-ordination between the school, the psychological service, the gardaí and the health board social services, all of whom may be dealing with the same family or the same child. Would he consider formally putting in place a strategy or system of co-ordination which would address the problems of children at risk? While I accept that professionals in the area, including teachers, contact each other on an informal basis there does not appear to be a structured or co-ordinated approach towards bringing together all the services or professionals dealing with the problems of children at risk.

Mr. Martin

I accept the Deputy's basic point. That is why, when I established the planning group towards setting up an educational psychological service, I ensured it included both educational interests and the health authorities, because whatever educational psychological service is put in place on a national basis must involve both sectors with their particular expertise.

My colleague, the Minister of State, Deputy Flood, who has responsibility for the drugs task force areas, is doing exactly what the Deputy suggests on a pilot basis. He has identified four areas where he will put in place models of best practice for integration and co-ordination between the statutory and voluntary agencies in a given area where there are significant difficulties. That is the way forward and when those pilot projects are completed, we hope to have models of best practice for integration and co-ordination which we can replicate throughout the country, particularly in the drugs task force areas which have been identified and which require special attention.

The area partnerships are also beginning to show greater co-ordination between the agencies. I have met some of them but the difficulty is that practices vary from area to area. In the psychological sector I have been heartened by what I have seen in some areas, where genuine intervention is taking place in terms of case studies on students and young children in difficulty, as well as helping teaching counsellors, etc. I accept the basic principle outlined by the Deputy and that is the road we must follow.