We welcome the opportunity to engage in this discussion with the sub-committee. The seventh report of the Joint Committee on Health and Children was an important document for us and built on the work in which we were engaged in the development of the Reach Out strategy. Suicide prevention has a relatively short history in Ireland, given that suicide was not decriminalised until 1993. Therefore, some of the difficulties arising from the stigma associated with suicide prior to 1993 are still with us.
Three major reports have been prepared since which set out the direction for action and investment. These are the report of the national task force on suicide published in 1998; Reach Out, a National Strategy for Action on Suicide Prevention, published in 2005; and the Joint Committee on Health and Children's seventh report on the high levels of suicide in Irish society published in 2006 under the chairmanship of Deputy Moloney. The 1998 report was followed by the establishment of resource officers for suicide prevention; the provision of year-on-year funding for suicide prevention activities, amounting to €4.5 million by 2005; the establishment of the national suicide review group which I had the privilege of chairing for some years; and the allocation of funding for the ongoing work of two extremely important organisations in the field, namely, the Irish Association of Suicidology and the National Suicide Research Foundation.
Following the launch of Reach Out in September 2005, the Health Service Executive established the National Office for Suicide Prevention, NOSP. Its function is to co-ordinate suicide prevention activities, consult public organisations on future suicide prevention initiatives and commission and develop new services for suicide prevention, where appropriate. It employs six staff in offices in Dublin, Cork, Galway and Ardee. It has an annual budget of €4.5 million, comprising additional new moneys made available in 2005, 2006 and 2007 and money transferred from the former health boards to meet the historical funding arrangements of the Irish Association of Suicidology and the National Suicide Research Foundation. An additional sum of €l million was made available in 2006 to fund 20 projects through the dormant accounts fund administered by Pobal. The NOSP was involved in drawing up the criteria for selection of those projects. A second round of suicide-specific funding of €1 million will be made available later this year.
It is worth saying that although the NOSP did not seek bids for funding in 2008, many organisations submitted completely unsolicited proposals to the office. A total of 26 bids was received from a range of organisations totalling €3.8 million, which gives an indication of the need and commitment, particularly in respect of voluntary organisations, to develop specific suicide prevention initiatives
In respect of suicide data, suicide numbers and rates rose dramatically during the late 1980s and 1990s, peaking in 2001 at 519 suicides which represented a rate of 13.5 per 100,000 population. As Dr. Doorley said, this is probably average for the rest of Europe. Since 2001, the number of suicides has remained at just under 500 per annum, although it is probably too early to say whether the dramatic rise of the past two decades has reached a plateau. I suppose we all hope it has and that it is heading down but it is too early to read that from the data. Data on suicides in 2005 by year of occurrence is now available from the CSO. This indicates 481 suicides and a rate of 11.6 per 100,000 population; therefore, the rate of suicide has declined, although the numbers remain stable at around 480 and 490.
Of most concern to us is that Ireland now has the fifth highest rate of youth suicide in the European Union. Suicidal behaviour remains a major public health problem in Ireland. Every suicide is an individual tragedy for the person concerned, his or her family and community. Whatever we do in terms of our strategic approach, we must never forget that this is an individual tragedy. Dr. Doorley mentioned risk factors for suicide. They include alcohol and drug abuse and depression remains a major factor. Suicide trends over time in Ireland and many countries are also influenced by major social changes, particularly those which result in less social cohesion.
We are lucky here in that we have collected data in the past few years on form 104 which is completed by the gardaí. A research project was initiated and reported earlier this year. The research indicated a level of under-reporting of suicide which it was estimated could be at least 6%. We have nearly complete data on self-harm presentations through our accident and emergency departments since 2002. This is probably one of the best sets of data across Europe and has been collected by the National Suicide Research Foundation. The number of presentations for self harm has remained stable at around 11,000, of which 21% were due to repeat acts. We know that repeated self harm is a very strong indicator for completed suicide.
Targets for reduction in suicide and self harm have been agreed with Government since the production of the committee's report. The targets are to reduce the level of suicides by 10% by 2010 and, perhaps as importantly, to reduce the overall rate of repeated self harm by 5% by 2010 and to further reduce it by 5% by 2016. The programme for Government includes a further target of reducing the rate of suicide by 20% by 2012. These targets are in line with those adopted by our immediate neighbours in Northern Ireland, Scotland and England
The implementation of the actions in Reach Out can only be achieved through collective action by Government, statutory and voluntary bodies and individual communities. It is, therefore, everyone's problem. Many high-level commentators have made that point. The role of NOSP is to co-ordinate activities and this has been achieved by a combination of actions, including the NOSP annual forum; meetings with funded projects to monitor progress; ongoing discussions with voluntary groups at national and local level; regular meetings with HSE resource officers for suicide prevention; ongoing dialogue with the Departments of Health and Children, Education and Science and Justice, Equality and Law Reform; and the involvement of many agencies on a partnership basis.
The health service has a statutory obligation to report on suicide prevention activities to the Houses every year. The annual report was previously compiled by the suicide review group, but this role has been undertaken on behalf of the HSE by the National Office for Suicide Prevention since 2005. We will complete our report this year and we hope the Minister will present it to the Houses on 10 September, world suicide prevention day.
Since 2006, the NOSP has been working closely with colleagues in Northern Ireland on joint suicide prevention initiatives. The Northern Ireland strategy, Protect Life: A Shared Vision, was launched in 2006 following consultation with us and many other organisations. A ten-point plan was agreed the same year and an update on the plan was recently reported to the North-South Ministerial Council. The NOSP and the Department of Health, Social Services and Public Safety in Northern Ireland will continue to develop existing and new initiatives in this area.
It is important to stress the new areas of work since the publication of our reports. New technology as a means of communication has developed rapidly and is now one of the primary means by which young people communicate. If we are to reach those particularly vulnerable young people, we need to use their form of communication. We have already been in discussion with our Internet safety board about its role and the implications for suicide prevention. We accept the Internet is both a positive and a negative means to convey messages about suicide.
We have read the conclusions of the Byron report in the United Kingdom which makes recommendations in three areas, namely, reduce the availability of harmful and inappropriate material in the most popular parts of the Internet, control by parents and ICT suppliers to manage access to material and build resilience, particularly among young people, in order that they have the confidence and capacity to determine what is harmful themselves. We are working on a number of specific projects related to the use of technology and I am pleased that Mr. Fergus McGrath is in attendance, as he may be able to assist us all in this process.
We have our own profile for the Your Mental Health campaign on Bebo, the social networking site used by thousands of young people. The profile has had more than 35,000 hits and made 1,400 friends. The response from young people is almost entirely positive. The site is moderated by our staff to provide advice and to ensure no inappropriate content is accepted. We are working with the search engine company Google, the European headquarters of which is based in Dublin, to support voluntary organisations using the most up-to-date technology to interact with young people in particular. Google has also made some changes to its search approach, primarily led by representations from Samaritans in order that help services are advertised on the first page of Google. However, having examined the site today, not all parts of Google do so. Hence, we have some work to do.
Many organisations in Ireland are already using technology to reach young people, either by way of information or by on-line counselling. The NOSP and others have established the Technology For Well Being group, which is looking to co-ordinate and develop our approach to using this medium. We also provide funding to a number of groups using technological approaches as well as those using traditional help lines.
We work primarily to the recommendations set out in Reach Out. We hope to commission an independent review of Reach Out and the work of the NOSP in the near future. The NOSP has also taken into account the recommendations set out in the Oireachtas report on suicide. We have supplied for the committee's consideration a brief update on the recommendations, with the relevant cross-reference to Reach Out where appropriate.
Our key achievements include making some improvements in our self-harm response through our accident and emergency departments, establishing the HSE Your Mental Health campaign, setting up Headline, the media monitoring organisation, undertaking a significant review of bereavement services, researching the risk and protective factors for those affected by institutional abuse, researching data collection on suicide and self-harm and working with the Coroners' Society of Ireland to establish a pilot project to collect better data. We have established two primary care initiatives to fast-track responses to self-harm and suicidal ideation and we are funding some work with Travellers and the lesbian, gay, bisexual and transgender community. We are also funding the work of a number of voluntary organisations working in suicide prevention. As the Chairman knows, we wholeheartedly support the work of the successful world congress on suicide prevention which the Irish Association of Suicidology hosted in Killarney in autumn 2007. It was an opportunity to listen and contribute to the world debate on suicide prevention.
The challenges are many and I refer to some of them. It is important that we maintain the suicide prevention profile with the public and the Government. It is important also that we present the arguments internally for developing suicide prevention services within existing HSE resources. We should present the case for new and sustained investment to the HSE through the Government. We should support the vital and important work undertaken by voluntary organisations and communities, from within which many strong initiatives come. We must continue to support them. We must also seek to change public attitudes to mental health in order to create a more supportive society. We must recognise that young people, in particular, have different ways of communicating and that our approaches should respond to them. We need to ensure research findings here and elsewhere can be made applicable. Where possible, we will collaborate with our colleagues in Northern Ireland, elsewhere in the European Union and worldwide in order to learn from and contribute to knowledge on suicide prevention