Go raibh maith agaibh. Is cúis uafásach é seo agus cúis dhóchasach ag an am gcéanna.
I offer my congratulations to this sub-committee for putting in front of the people the darkest topic in the modern Irish landscape and for debating it in this manner. I am honoured to be invited here today.
My day job involves clinical work with patients suffering from mental illness. I also teach medical students in UCD and lead a research programme in the area of suicidal behaviour, including suicide. In my spare time, I am involved in a charity which I co-founded, Turning the Tide of Suicide, with a group of individuals who expressed concern about the problem and who wanted to learn whether those dedicated to this issue could advance a resolution. It is a pleasure to present to this informed sub-committee, which is cognisant of the statistics described by the Chairman.
Suicide is a global mental health issue. The top right part of the map before members demonstrates the distribution of suicide rates across communities internationally. Unfortunately, Ireland is one of the few countries in the developed world with suicide rates above 13 per 100,000. Ireland is fourth in Europe with regard to youth suicide and suicide is the leading cause of death among young males in Ireland. The figure on the bottom left is the EU total suicide rate, in which Ireland ranks 18th. The figure on the right, youth suicide, is disturbing because Ireland is fourth behind Lithuania, Finland and Latvia. The graph does not show that Finland used to have almost double its current youth suicide rate. For the past ten years, the Finnish Government and population have been dedicated to reducing suicide rates and are beginning to succeed. That is an important point.
The rise in youth suicide is depicted on the left of the next image and the national strategy for action on suicide prevention, which was launched this year with a completion deadline of 2014, is represented on the right. Those who read the document will be aware that it contains a desirable wish list. It is difficult to avoid the fact that, if one examines other countries, resourcing and supporting mental illness services will be a key pillar of this programme if it is to be successful.
I will not talk about statistics. I suspect everyone in this room has been touched by suicide in one way or another. The true devastation caused by suicide in Ireland goes far beyond the statistics. It includes the human costs, which are the lives lost, the shattered families, the fractured communities and the reflection on modern Irish society. The questions are who cares and whether we can galvanise all of them.
President Mary McAleese definitely cares. She attended a conference — Suicide in Modern Ireland: New Dimensions, New Responses — convened by Turning the Tide of Suicide in November 2004, where she stated: "It must remain an absolute imperative of society to do all that we can to reduce the incidence of suicide, to end the unconscionable suffering for everyone touched by it."
At this point, I will move away from my day job and show the committee a three minute DVD that the Turning the Tide of Suicide charity put together to help the launch of the "Be Not Afraid" bracelet campaign, which was launched by Daniel Philbin Bowman, who decided to donate the proceeds to two tragedies: Darfur and the problem of suicide in modern Ireland. The script of the DVD is as follows:
The word "suicide" in modern Ireland is just as bad as the word "cancer" was 30 years ago. It has the same effect on people. The number one killer of the young men of Ireland is not road traffic accidents or cancer; it is suicide and it is tearing communities apart across the island of Ireland.
Ireland has a very serious knowledge gap in its understanding of suicide. We know some of the frightening statistics: over 444 deaths from suicide in 2003, over 92 of which were young men. However, we know very little about the people behind these statistics. This is vital information if we are to advance the development of proper prevention and intervention programmes across the life cycle and communities.
The three Ts stand for Turning the Tide of Suicide, an umbrella charity that aims to help other charities in their work and to drive forward the awareness, education, intervention and prevention of suicide across life cycles and communities.
The current most pressing objective of the three Ts is to complete the suicide in Ireland survey. We must go to communities and talk to bereaved families as, in many instances, they are the experts. They have that knowledge that could be critical. They will be contributing to a national archive of information and understanding and, in a way, giving a meaning to the lives lost to suicide.
People do not conveniently become suicidal between 9 a.m. and 5 p.m., Monday to Friday. We must have a service right across the country that people can access at all hours in their times of suicidal crisis. The goal of the three Ts is that Ireland should be an international leader in the fight against suicide, not play second or third fiddle. We must lead on this issue so the legacy we leave to the next generation is that suicide was a problem but Ireland tackled it effectively.
"Be Not Afraid" is a message filled with hope, togetherness and solidarity, all of which we will need in great measure if we are to succeed, which we will. Let us face this issue together. This is our call to you and we thank you for supporting the three Ts.
I apologise there is not a copy of the DVD for everyone in the audience but we will leave a copy with the committee.
People care about this problem. We must tap into the resources around the country, there are many people who care about suicide in Ireland. Pádraig Harrington, who has been one of the spokespeople for Turning the Tide of Suicide, has said that it is an undercurrent of our society that people do not like to talk about but I am sure there is not a family in Ireland that has not been touched in one way or another by suicide, either directly or indirectly. Over 11,500 people took part in the three Ts golf tournament in golf clubs all over the country this year to raise awareness of suicide.
A component of the national suicide strategy is to develop research in Ireland to inform us about the problem. I will give the joint committee a brief overview of the top ten projects that are currently being run or are about to begin in University College Dublin. The university has sent a clear message that it cares about suicide and wants to develop a sustained programme of research, both with regard to understanding suicide and intervention strategies that can make a difference.
I am involved in several North-South projects and I currently have research fellows in Dublin, Ballinasloe, Letterkenny, Omagh and Belfast. Until recently, I had a research fellow in the midlands and Limerick. To date, we have gathered face-to-face information on over 500 new referrals to the psychiatric services and over 500 suicidal crises presenting to accident and emergency departments over the last three years. The DVD I presented to the joint committee contained information about an upcoming suicide in Ireland survey, entitled "A Thousand Lives Lost Behind the Statistics".
We are also well under way with a national study of rail and waterways deaths encompassing all deaths on railways, including suicides, of which there are quite a number. We have just completed a study which has been published in The American Journal of Psychiatry on suicide in the Defence Forces and we are at an advanced stage with regard to a study of suicide in the Garda Síochána and among physicians. These are groups of people who have occupation-specific risk factors for suicide that we need to understand more about in our community. Obviously, we want to follow up all the patients we recruited in studies one and two.
Project eight is a very novel international one that looks at brain imaging studies of patients with suicidal depression. We are at the forefront of international research with regard to brain imaging projects at University College Dublin and we recently received a distinguished investigator award from the American Foundation for Suicide Prevention to develop this project at University College Dublin. We are also looking at the immune system and how it functions in suicidal depression.
On intervention, I am collaborating with Professor Carol Fitzpatrick on a project — Working Things Out — which involves sitting down with young people who have been through suicidal depression to get their views on how they worked things out during their times of crisis.
The title of the suicide in Ireland survey, which is not currently funded by Government sources, is "From Awareness to Knowledge". We raised funding for the survey through private sources but the reality, to which the Chairman alluded, is that there have been more than 1,600 deaths by suicide in the Republic of Ireland and 2,200 deaths by suicide on the island of Ireland between 2003 and 2005. There is an enormous knowledge gap. The Chairman provided some statistics but there is a considerable amount that we do not know. Who are the people behind these statistics? The suicide in Ireland survey aims to discover this. In the course of the survey, we will talk to family members and relatives who have lost someone to suicide. We have already received expressions of interest from more than 400 families who wish to donate their stories in the hope that they will help other people understand more about suicide. If it helps prevent one suicide in Ireland, the families believe it is worth it. The message is "help us to help Ireland".
University College Dublin is committed to a programme of research, education, prevention and intervention. I have been assigned the leadership role in this programme and I am willing to step up to the plate on it. We should be an international leader on this issue and develop and share transferable knowledge for a global society.
We already have been involved in a number of projects we believe can impact on the community. Members can see information on the top left hand side of the screen about a research project where we have begun to explore what happens in the brain when people think negative as opposed to positive thoughts about the future. Very different brain areas are activated during these two states. Our next project is to conduct this research on patients with suicidal depression. We hosted a "three Ts" candlelit vigil on world suicide prevention day, 10 September 2004 and 2005. This was attended by more than 300 people. It was a moment of great sadness and grief but also of great hope.
I have mentioned the Be Not Afraid campaign. In light of the recent television programmes about lost asylums in Ireland, focusing on St. Ita's Hospital, it is important to say there is a future. There is a new inpatient psychiatric unit in St. Vincent's University Hospital, a purpose-built, state-of-the-art unit that should be the model for such units. This kind of service for patients with mental illness is long overdue.
Bricks and mortar are not enough to cure anybody but when I brought Professor Herbert Hendon, a director of the American Foundation for Suicide Prevention, to the hospital last Friday he exclaimed that the light in the building would cure people. Light is used extremely well in the building and there are no dark corners. He said it was the nicest psychiatric inpatient unit he had seen in 40 years of clinical experience.
In summary, the focus should be on going forward but giving back. My goal is to lead the way to reducing suicide rates by helping all the organisations involved in this process. The need is great, the timing is urgent, the yield is to individuals, communities, society and the economy. What is the cost of suffering if we do nothing? What is the value of saving one life if we do something? This problem does not belong to someone else it belongs to everybody.