I welcome the Minister but am disappointed the Minister for Health did not see fit to take this matter because it is a very important issue of health. During the many years of debates in this House on the decriminalising of suicide, I constantly laboured the point that suicide is a public health issue and not a crime. In most European countries it ranks among the ten most frequent causes of death. In 1992 there were 354 official deaths from suicide in Ireland, the highest ever recorded. The suicide rate has increased dramatically since the early 1960s, particularly among the young. The purpose of raising this matter on the Adjournment is to call on the Minister for Health and the Government to identify suicide as a public health issue and to introduce suicide preventive programmes.
The British Government in its Health of the Nation paper has set two targets on suicide prevention — to reduce the suicide rate by 15 per cent among the general population and by 33 per cent among severely mentally ill people by the year 2000. The World Health Organisation has set the target of reversing by the year 2000 the current rising trend in suicide and attempted suicide in Europe. The WHO has called on all member states to take steps to develop national programmes for the prevention of suicide, establish national co-ordinating committees, promote the co-ordination of current research and stimulate further research. I call on the Government to respond to the WHO request.
Two approaches to preventive programmes are suggested by international experts. The first of these is the population approach whereby an attempt is made to reduce the prevalence of a risk factor for suicide for the whole population. The second approach is to concentrate primarily on high risk individuals. The difficulty with the second approach is the identification of such individuals. Also, the factors which prevent suicide in high risk individuals must be understood before they can be used to combat such risk. Suicide preventive programmes should be directed at the general population and individuals thought to be at high risk of suicide.
The most strongly associated risk factor for suicide is a diagnosis of psychiatric illness, as more than 90 per cent of suicides have suffered from mental illness at some time. The most common illnesses appear to be depression, alcoholism and schizophrenia. Depression is the most common psychiatric disorder. Thus, an important aspect of a suicide prevention programme is the recognition, prevention and treatment of depression.
It is well known that socio-demographic factors such as age, sex, marital status, employment status, living alone and social and cultural attitudes influence suicide rates. Employment opportunity has a considerable effect. Those most at risk are those whose employment has become insecure, with a real threat of redundancy, and those recently experiencing unemployment.
Access to means of suicide is regarded as a risk factor. In the UK, between the late 1950s and early 1970s, the incidence of suicide by domestic gas poisoning declined rapidly following the reduction in the carbon monoxide content of domestic gas. The availability of firearms is another factor which may influence suicide levels. Some studies have found that a reduction in availability has reduced the incidence of suicide.
I would say to the Minister that I have ten minutes in which to make my contribution.