I wish to share time with Deputy Neville.
Adjournment Debate. - Suicide Incidence.
Is that agreed? Agreed.
I acknowledge the work done in this area by our colleague, Deputy Neville, who has a deep knowledge and understanding of the issue and in many ways has been one of those most responsible for the progress made so far.
Each week, in various parts of the country, more families must face up to the pain of the loss by suicide of one of their loved ones. I have gained some sense of the devastating effect on family, friends and the community of sudden death by suicide. Recently, I spoke to members of the Rosbrien suicide awareness group in Limerick – a support group established as a result of a number of suicides in a particular part of Limerick. Its campaign arose from its members' collective experience and a determination to ensure preventive caring and supportive measures are a reality rather than an aspiration.
The recommendations of the national task force on suicide are excellent and while progress has been made, many measures have still not been implemented. I want to focus on what needs to be done, while acknowledging the work that has been done, particularly by the regional inter-agency groups and suicide strategy co-ordinators.
As most of those who take their own lives are young, school awareness programmes are crucial. From talking to the Rosbrien suicide awareness group, I understand the social and personal health education programme in secondary schools does not deal with depression and suicide. Young people, particularly young men, need to be given the skills to understand and cope with latent negative feelings that may eventually lead to them to consider taking their own lives. School-based programmes have a major role to play in this regard. General practitioners, out-patients' staff, psychiatrists and other medical and paramedical staff need updated training. Protocols have to be rigorously established whereby no distressed or parasuicidal young person is allowed to walk away because of a lack of awareness of front-line health staff. Appropriate follow-up through community based services is also crucial. I have been told that the onus to return to the services is frequently left with the young person whose state of mind may make him or her walk away and try to deal with his or her problem in isolation. This issue needs to be addressed.
The geographical basis of psychiatric community services is too rigid as is its hierarchical system. A psychologist or counsellor may be the most helpful professional for such a young person, but he or she must first be referred by a psychiatrist with a large case load and perhaps too long a waiting time. Having spoken to people with direct experience of the service, it is clear that a more flexible system is required.
When suicide occurs in a family and community, many people who were close to the person concerned experience complex feelings of grief, sometimes guilt, and other responses. There must be a response for those who need it. Helpful booklets are produced by health boards and other bodies.
I thank my colleague, Deputy O'Sullivan, for giving me the opportunity to contribute to this debate. More people die by suicide in Ireland than in road accidents. It is accepted that an undetermined number of road accidents are suicides. In 2001, the Government spent an inadequate £22 million on road safety outside the cost of traffic duties by the Garda Síochána. In the same period, just £1.02 million was spent on suicide prevention, some 5% of that spent on preventing road accidents.
Suicide is the number one cause of death in young people. The Minister must initiate serious research to determine the reason, since the 1960s, the number of suicides has increased from an average of approximately 65 per year to the current figure of 450. We must examine the reason at a time of unprecedented prosperity so many people feel so despairing that they choose to take their own lives. This causes devastation to the family and friends of the victim, as well as the community at large.
Suicide is a terrible act against human nature. While the current fiscal health of young people may be better than years ago, the same cannot be said of the social and psychological pressures to which they are now being exposed. This is partly due to the increasing instability of family life and the changing sense of personal and family relationships. We need to seriously examine the situation regarding young people, especially young men, and the changes in society that have caused them to feel so depressed and despairing that some choose to take their own lives.
Serious research into this matter is required. Since May 2000, I have been seeking the establishment of a small-scale, inexpensive task force to examine what is happening with young people and the reason some of them are so despairing that they choose to take their own lives. The Minister should seriously examine this matter.
I thank Deputies O'Sullivan and Neville for raising this matter. We all agree that there is a need for ongoing investment in researching the issues that have been raised. This was outlined by the report of the national task force on suicide, published in 1998. It also outlined a comprehensive strategy to reduce the incidence of suicide and attempted suicide. Considerable progress has been made to date in the implementation of the recommendations contained in the report, which is reflected in the reduction in the number of recorded suicides for the past two years. Many of the recommendations of the task force, however, require continuous development, particularly in the area of training and the development of services relating to suicide and suicide prevention.
Central to the report of the task force was the provision of a national suicide prevention strategy which is now in place. The key components of the strategy include the implementation of measures aimed at high risk groups, provision of information and training on suicide prevention for relevant professionals and organisations, and research into suicide prevention.
The establishment of a national suicide review group by the chief executive officers of the health boards was central to the strategy to prevent and reduce the incidence of suicide and attempted suicide. It was a core recommendation of the task force report. The group was established in 1998. Its membership includes experts in the areas of mental health, public health and research. Its main responsibilities are to review ongoing trends in suicide and parasuicide, co-ordinate research into suicide and make appropriate recommendations to the chief executive officers of the health boards.
The group also publishes an annual report which provides a comprehensive overview of activities in suicide prevention. This publication includes the annual statistics on suicide as well as providing regional reports and overviews. It draws together progress reports from all the health boards, statutory bodies and the voluntary sector, and presents data as provided by the Central Statistics Office on both a regional and national basis. The Health (Miscellaneous Provisions) Act, 2001, provides that the Minister for Health and Children will make a report each year to each House of the Oireachtas on the measures taken by health boards in the preceding year to address the problem of suicide. The work of the National Suicide Review Group will inform the preparation of this report, which will be presented to the Oireachtas later this year.
Health boards have also established working groups to examine the implementation of the recommendations of the task force on suicide. The working groups are multi-sectoral and multi-disciplinary and engage in the promotion of positive mental health and the destigmatisation of suicide, provide information in relation to suicide and parasuicide, liaise with the media and provide training requirements for staff in relation to all aspects of suicide and parasuicide. Resource officers with responsibility for implementing the recommendations of the task force have been appointed in all the health boards. Their responsibilities include the provision of staff training in risk assessment, production of information literature and events aimed at raising public awareness of suicide and parasuicide.
In order to further reduce the number of suicides it is essential that people undergoing life crises should get appropriate support. In this regard over €4.9 million has been provided since the publication of the report of the task force on suicide for suicide prevention activities and for research aimed at improving understanding of this issue. Additional funding has also been allocated to the National Suicide Research Foundation in Cork to support its work in the development of a national parasuicide register.
The task force also recommended that steps be taken to make the mental health services more accessible to the public, particularly to young people. Concern was also expressed at the risk of suicide in older people. In this regard additional funding has been made available to further develop consultant-led child and adolescent psychiatry and old age psychiatry services to assist in the early identification of suicidal behaviour and provide the necessary support and treatment to individuals at risk. The level of capital funding which has been made available for the development of community – based mental health facilities has increased significantly in recent years and community services such as home nursing, day centres, family support, hostels and day hospitals, will continue to be developed in order to make services more accessible to people who may be at risk. I am also very conscious of the great work being done by a number of voluntary organisations and support groups throughout the country. I recently launched a very beautiful book called Echoes of Suicide, edited by Siobhán Foster Ryan and Luke Monaghan. It is a very sensitive treatment of the subject and will be of great use to many people. Deputy Neville was one of the contributors as I was myself.
In conclusion, I draw the Deputy's attention to the recently published health strategy, Quality and Fairness – A Health System for You , which includes a commitment to intensify the existing suicide prevention programmes over the coming years. The Government is fully committed to ensuring that further investment takes place in this area, building on the achievements to date.