Timmy Dooley
Ceist:76. Deputy Timmy Dooley asked the Minister for Health the way he plans to deal with the increasing problem of suicide; and if he will make a statement on the matter. [30426/13]
Amharc ar fhreagraTuesday, 25 June 2013
Ceisteanna (76, 131)
Éamon Ó Cuív
Ceist:131. Deputy Éamon Ó Cuív asked the Minister for Health the way he plans to deal with the rising numbers committing suicide; and if he will make a statement on the matter. [30447/13]
Amharc ar fhreagraFreagraí ó Béal (15 píosaí cainte)
I propose to take Questions Nos. 76 and 131 together.
Suicide is a tragedy that we are constantly working to prevent, and we are also working to give more support to the families affected. Dealing with the current high levels of suicide and deliberate self-harm is a priority for this Government, and significant additional funding has been provided in recent years to address this issue. Reach Out, our national strategy for action on suicide prevention, makes a number of recommendations, including fast-track referrals to community-based mental health services, effective responses to deliberate self-harm, training, reducing stigma and promoting positive mental health, initiatives aimed at helping young men, and further research. The National Office for Suicide Prevention, NOSP, has implemented most of the Reach Out recommendations in a four-way strategy: delivering a general population approach to mental health promotion and suicide prevention; using targeted programmes for people at high risk of suicide; delivering services to individuals who have engaged in deliberate self harm; and providing support to families and communities bereaved by suicide.
Funding for suicide prevention is provided to the NOSP by the HSE from its overall budget for mental health. The annual budget for suicide prevention increased this year to €13.1 million. Of this, €8.1 million is provided to the NOSP to fund voluntary and statutory agencies delivering services in the areas of prevention, intervention, postvention and research.
The remaining €5 million for suicide prevention measures is available regionally to fund HSE resource officers for suicide prevention, self-harm liaison nurses in hospital emergency departments and local suicide prevention initiatives.
The National Office for Suicide Prevention, NOSP, has been reviewing its current activities to make the most of available resources, including looking at best practice internationally to inform evidence-based policy decisions. This review will result in a revised strategic approach to suicide prevention for the remainder of 2013 and inform the final phase of the Reach Out strategy which runs until 2014. I expect the HSE will approve the revised approach in the very near future.
To get maximum benefit from the investment in suicide prevention measures and ensure a co-ordinated response to the needs of those at risk of or affected by suicide, the NOSP will continue to co-ordinate the work of the many voluntary, statutory and non-statutory organisations working in this area. By promoting cross-organisational collaboration, the development of networks and partnerships, skills sharing and service development, the NOSP hopes to maximise the impact of suicide prevention measures and support networks to ensure it reaches and responds effectively to people who are vulnerable. It is working to integrate current programmes to reduce duplication within the sector and provide a strategic framework for the co-ordination of the extensive range of actions in this area.
Priority suicide prevention initiatives identified for this year include the further development of existing national mental health awareness campaigns to promote help seeking, increased training for general practitioners and practice staff, building the capacity of communities to respond to suicide, implementation of the clinical care programme on self-harm which will include the funding of nursing posts in hospital emergency departments, training of acute hospital staff on suicide and self-harm intervention measures and the development of the SCAN, suicide crisis assessment nurse, model which allows for crisis interventions at primary care level and continued investment in voluntary agencies providing front-line services.
The Minister of State is well aware of the significant problems posed by suicide. It is a silent crisis facing every community. In 2011, 525 people died by suicide. There are alarming statistics and something needs to be done quickly about it. I do not question the Minister of State’s commitment or knowledge in this area, but we certainly need to do more. It is time we looked at establishing a mental health authority in the same way that the Road Safety Authority tackled the issue of road deaths. We need such an overarching authority which could direct Government policy, request resources and act with an independent remit to address the issue. Up to 550 people will die by suicide by the end of this year. We have to do more, yet, for example, the number of counsellors in schools was reduced. Although there is a commitment from the Minister, I do not believe we are getting traction in terms of delivery on the ground to ensure there is a focus point. Many voluntary organisations have been established on an ad hoc basis in communities where there has been an increased prevalence of suicide. We need to harness all of these groups into one organisation under the umbrella of a mental health authority whereby there could be genuine direction and a focus on suicide prevention. It should be a statutory authority, just like the Road Safety Authority, to really make an impact and save lives.
Every time a Member stands up to discuss the issue of suicide, he or she refers to an overarching authority like the Road Safety Authority. The Road Safety Authority has done an incredible job and I have no particular issue with it. However, we have a statutory overarching authority already, the National Office for Suicide Prevention, which develops policy and is now co-ordinating the activities of all the different groups that are desperate to help, a measure which should have been taken several years ago. These groups grow organically, usually from either a personal or community tragedy. However, this is different from the Road Safety Authority which can introduce laws that state that if one drives recklessly, one will receive penalty points. In this regard, I am conscious of the Members opposite. This is a criminal penalty, but we do not want to do that in the case of suicide.
We are investing enormous amounts of money in a focused way. People tell me that the Germans are addressing the issue this way and that the Scots are addressing it that way. Our suicide prevention plan is exactly what the Germans and the Scots have. We needed co-ordination. The one thing I discovered on taking up this job was that the one piece that was missing was co-ordination. We cannot have one agency delivering the service people want in their community in every village, but we have the service. We need to ensure people stay in their community, but we also need to co-ordinate the service and ensure, above all else, that the right message - the one message - is given. That is what the National Office for Suicide Prevention is doing. The Deputy saying he does not question my commitment is a type of backhanded insult. That does not work anymore.
I do not question the Minister of State's commitment-----
I know the Deputy does not, but it is as if commitment is not enough.
-----but this is not about her on her own. The point I am making is that I do not question her commitment, but some time ago the Minister for Education and Skills cut the number of career guidance counsellors in schools throughout the country. They are front-line staff working at the coalface in dealing with people who have difficulties. That is a fact. Therefore, I question the Government's commitment. This was an appalling way in which to try to reduce what was a key component in providing for an effective response in schools for vulnerable pupils.
That is not true.
It certainly is true. I have met career guidance counsellors who have told me that they are very concerned about this. We were waiting for one year for the appointment of a director to the National Office for Suicide Prevention. If there was a sense of urgency about this issue, one would have thought that decision would have been made well in advance of having to wait one year to make the appointment. These are two areas to which I can point in which the Government's commitment is questionable.
I will take questions from Deputies Caoimhghín Ó Caoláin and Luke 'Ming' Flanagan.
I draw the Minister of State's attention not to what is best practice in Germany or Scotland, although I recognise that we have similar issues to our Scottish neighbours, but to the fact that today the outgoing mayor of South Dublin County Council, with representatives of the HSE and Comhairle na nÓg, is launching a smart phone app entitled MindMindR. I have seen it and I am hugely impressed by it. It has been developed by South Dublin County Council and acts as an information port with all of the salient details of local mental health services. I commend it to the Minister of State as something that is an example of a powerful initiative and best practice. Will she take the time to inform herself of it and consider its potential for roll-out nationally, suitably adjusted to local area needs? If she has not done so already, would she or her officials be prepared to meet its initiators? I have no doubt that those who are behind this initiative would very much welcome a positive response from her today. It is what they and the rest of us deserve, namely, that it be adopted and released nationally.
I am sure the Minister of State is well aware of the tragic suicide that took place in Roscommon psychiatric hospital and the calls made by many people in the area for an independent investigation into it and what it might reveal, rather than having an internal investigation which is never very satisfactory. Will the Minister of State seriously consider this request to increase confidence in the area?
I call on the Minister of State for a final reply.
I wish to reply first to Deputy Caoimhghín Ó Caoláin's point about the app. Last year when we discussed how to reach people - they are not sitting down to watch the "Nine O'Clock News", as the Deputy and I know, rather they are in different places - one of the suggestions made was that an app be developed to give people, whether they were living in County Donegal or Dingle, at the press of a button telephone number to ring, details of where services were to be found and what was available. If the Deputy has seen that app, he will know that the range of services available is incredible. It is a question of co-ordination. I would love the people concerned to come and show us exactly what they are doing. It is something that could be transplanted or moved to any other area, with details of the relevant information.
In response to Deputy Billy Kelleher's point on schools, we conducted research into what was made available in schools because we were interested in reaching young people where they are.
We discovered that a whole-of-school approach is required and that is what we launched and developed. The entire school is trained in what to do if a young boy or girl approaches a member of staff. When I had this discussion previously with Deputy Boyd Barrett he nodded profusely, probably because he had had a similar experience to mine. What if a student does not get on with the designated person? What if the principal put him or her outside the door with an instruction to approach the designated person and the student is feeling down because he or she feels unable to speak to that person? Surely the caretaker and the secretary should also be involved.
In regard to the repeated accusation that we waited a year before appointing a new director, that office was never vacant. A women called Catherine Brogan did an incredible job in dealing with much of the development work, the outcome of which we are now seeing. We now have a new director who is making further progress on that work. It is not as simple as finding the right person for the right job. The work moves on and the different groups with whom we must deal also move on. This will not be the last Government to deal with the issue. It is a community issue and all of us must play a role. It cannot be left up to one person in an office in a school.
The Minister of State did not answer my question.
I apologise. I have received several reports on the matter. I have discussed the issue with a number of professionals, not all of whom are employed by the HSE or the Department of Health; nor were they all from Roscommon or Galway. All of them have said that awful things happen when one is dealing with very vulnerable people. That is why we provide the services in the acute unit. Without any request for an inquiry, the HSE critical incident unit commenced an investigation. The Mental Health Act required that an investigation take place, and an investigation is never carried out by the staff of the unit.