I thank the Chairman and joint committee for inviting us to make a presentation today. I understand the invitation was made following a public presentation Mr. McGuinness and I gave on our work on suicide in Ireland to the College of Physicians just down the street in May last. Rather than present old or, if one likes, rehashed data, we wanted to present data that was live, new and compelling and which had come about through engagement, consultation and permission — informed consent — with families who had been bereaved by suicide in Ireland in recent years. The presentation represented a journey from a private story in people's kitchens into the public space of the College of Physicians. We are grateful for the invitation to do so again before the Houses of the Oireachtas.
Suicide is a traumatic loss which results, through our learning, in the deceased and the bereaved, the lived life and the lost life. Throughout our research we are acutely aware that we are not dealing with stocks and shares or commodities but with lived lives which have been lost to suicide. What can Irish research do in this field? Mr. McGuinness and I have recently returned from a major international suicide conference that is convened in Europe once every two years. We made five presentations at the conference but we do not propose to present our recent genetic findings, suicide modelling work, the paracetamol story or the waterways and railways studies in which we have been involved. Instead, we will present the family stories of the lived life and lost life, which were created through a unique collaborative science-arts project with bereaved families in the past 12 months, which I predict will have an international impact and implications.
At the conference, which was attended by representatives from Europe and all over the world, there was nothing remotely like the presentation, of which the joint committee will be given a brief excerpt today. This is a project about bringing the private, traumatic loss of suicide from the kitchen tables around Ireland into the public domain through informed consent, collaboration, dialogue and conversations. The point is to create a meaningful platform to discuss and articulate this loss in a place beyond stigma. Two short five-minute movies in the presentation present the voice of the families, which must be heard.
To put the issue in context, suicide is a global public health issue. Globally, someone dies from suicide every 40 seconds. The image on the bottom left of the slide represents suicide rates in Ireland for all ages in 2006, the most recent year for which official statistics are available Europe wide. Although Ireland is ranked 18th out of 25 countries in suicide incidence, unfortunately it is fourth in the area of youth suicide rates — the 15 to 24 year old age group — behind Lithuania, Finland and Estonia. Ten years ago, the Finnish youth suicide rate was ten points higher than in the most recent figure, which shows Finland has tackled the problem. Much can be learned from the manner in which it did so.
Moving on to the project we decided to undertake, internationally one way of understanding more about suicide is to conduct psychological autopsies, that is, talking to next-of-kin. We decided we did not want to approach this issue in a "me too" fashion, in other words, by simply doing what had been done in other countries. It was clear from the international conference that factors in suicide and suicide risk groups vary from country to country and community to community. We, in Ireland, have a large knowledge gap because very little research has been done either nationally or at a community level to understand more about suicide. Prior to our study, no systematic type of study had been done in which one spoke to relatives and consulted families and friends of suicide deceased to gain new knowledge and understanding via clinical science. Internationally, a study integrating science and arts had not yet been done. For this reason, such a study seemed the obvious thing to do.
Much has been made of the increase in suicide rates in recent years. Sometimes one is criticised for presenting raw numbers as opposed to rates per 100,000. However, the raw numbers are somewhat more compelling in that Ireland is not getting any larger but more suicide deaths are taking place in the same area of land. Therefore, the reverberations and fallout from an increase in suicide deaths will be felt more acutely in small communities such as those that we have in Ireland.
I draw attention to two lines on the slide, the top red line which is the combination of suicide and undetermined deaths in Ireland, and the bottom orange line which is the undetermined deaths as reported in Ireland over the past 30 years. These show that on average ten undetermined deaths were reported per annum in the 1990s. In 2009, more than 160 undetermined suicide deaths were reported. We have done a coroners' study of 400 coroners' cases of suicide and open verdict. Despite a suicide note featuring in at least 20% of the open verdict or undetermined deaths, the coroner in the case returned an open verdict, in other words, in his or her estimation, it could not be determined beyond reasonable doubt that the death was a suicide. The top line adds the suicide rate with the undetermined rate. One can see the blue line represents what has been referred to recently, namely, the 527 suicide deaths in 2009. If the suicide and undetermined deaths are added it comes to 709 suicide and open verdicts in 2009. Can we sit idly by while this is happening?
This is a study that I referred to. We started out with great assistance from a couple of coroners, from whom we got 400 suicide and open verdicts. We decided to interview a sub-group of those, 104, and talked to the relatives of the suicide bereaved, focusing in particular on young suicide death where the problem has been identified. That was the plan we started out with, until I met Mr. Seamus McGuinness, who is an artist in Galway Institute of Technology. He created this piece of work in 2003 and I had the privilege of seeing it when it was installed in his home in Ballyvaughan. He explained it to me just like he is going to explain it to the committee now and it made complete sense for us to join forces, as it did for him.