Dáil Éireann díospóireacht -
Wednesday, 1 Mar 2000

Vol. 515 No. 4

Written Answers. - Suicide Incidence.

Bernard Allen

Ceist:

99 Mr. Allen asked the Minister for Health and Children if he will investigate the findings of a new study on psychiatric in-patients' suicide which has revealed that short stay patients are at significantly greater risk, with a suicide rate almost 40 times higher than the general population, and discontinued individual care and poor design of observation units were some of the factors identified. [6326/00]

Minister for Health and Children (Mr. Martin)

The study referred to by the Deputy, Suicide in Psychiatric In-patients in Ireland, by Eleanor Corcoran and Dermot Walsh, was published in the Irish Journal of Psychological Medicine. It noted that major changes have occurred in the delivery of mental health care in Ireland over the last 30 years, with large isolated mental hospitals being replaced by small psychiatric units in general hospitals and a network of community-based services. These general hospital units with open doors have a much higher concentration of potentially suicidal patients than was the case with the large locked institutions of the past, where such patients were often dispersed throughout the hospital. While the study found that short stay psychiatric in-patients were at a particularly high risk of suicide, it also noted that three quarters of those suicides studied, while technically in-patients, were on leave or otherwise absent from the hospital at the time of death. The authors also found that the number of suicides occurring in in-patient settings as a proportion of suicides in the general population is no greater now than at the end of the 19th century. They commented that this finding gave credence to the assumption that the move to community care which psychiatric services have undergone in the last 40 years has not contributed, of itself, to the increase in overall suicide rates.

The study concluded that social factors which contribute to an increase in the suicide rate in the general population, that is, bereavement, physical illness, abuse and unemployment were also relevant to the increase in hospital in-patient suicides and that more effective and comprehensive services to meet the needs of those with severe mental illness, particularly young adults, were required. The results also emphasised the import ance of managing in-patients in a safe, secure environment.

Each person presenting with a mental health problem to the health boards' mental health services is assessed and given a care plan. Support on an in-patient, if appropriate, and out-patient basis is provided to all referrals of patients with suicidal ideation. Those who are chronically suicidal are closely monitored by the mental health multidisciplinary team in liaison with the person's general practitioner. Active intervention takes place when crises occur.

In line with national policy, acute psychiatric units attached to general hospitals continue to be developed to replace large institutional style psychiatric hospitals. The design of these new acute in-patient units is much improved and provides for monitoring of patients in need of close observation. There are now seventeen acute units attached to general hospitals throughout the country and at least a further twelve are planned.

Following the publication of the final report of the National Task Force on Suicide, health boards have been evaluating their services, particularly their prevention and treatment services, with a view to making them more accessible to vulnerable groups such as young males. Additional funding of £1 million has been provided this year by my Department towards the funding of a variety of initiatives by health boards in combating suicide.