Dail Debate on Topical Issues – Suicide Rates for 2010 introduced by Dan Neville TD Wednesday 14th September 2011
Deputy Dan Neville
According to the recently published provisional figures on suicide rates for 2010, 486 people died by suicide that year. For every individual who died, ten people were directly traumatised. For the purpose of making accurate international comparisons, undetermined deaths are included in the suicide rates. The figure for undetermined deaths last year was 123. Chooselife, which is the Scottish programme for suicide prevention and is regarded as very progressive in this area, advises that “the inclusion of undetermined deaths protects against under-recording and provides more accurate figures for international and geographical comparisons.” If we take this formula into account, 603 people died by suicide last year.
The substantial increase in recent years is directly associated with our economic difficulties. International research indicates that suicide rates increase by approximately 25% during times of recession. In 2009, the incidence of suicide in Ireland increased by 25%. Research in this area goes back to the 19th century. Mental ill health resulting from recession, loss of employment, reductions in income or eviction can stress family relationships and people often take solace in drug or alcohol abuse. The incidence of mental illness, especially depression, and suicide increase.
I welcome the programme for Government’s commitment to ring-fence an additional €53 million per annum for implementing the recommendations set out in A Vision for Change. In 2010, only 5.3% of the total health budget was allocated to mental health services, compared to 13% in 1986, and A Vision for Change recommends that the allocation should be 8.4%. I suggest to the Minister for Health that €53 million per annum is inadequate to achieve the level of spending recommended and the commitment should be revisited.
Minister for Health (Deputy James Reilly
: I thank Deputy Neville for raising this important issue. I am aware that the number of deaths by suicide has increased in recent years. Discussing statistics in this context seems cold and unfeeling but we need to be aware of the increasing number of deaths by suicide. In regard to the Deputy’s assertion on the number of deaths that are not reported in the statistics as suicides, we must be consistent in making comparisons until we make a decision on moving in that direction. There is no doubt that the suspicion arises in certain incidents, such as single vehicle fatal accidents, that suicide was involved.
The suicide rate in Ireland had been undergoing a gradual decline, from 497 in 2003 to 458 in 2007. These decreases gave cause for optimism that the action taken at local and national level to prevent suicide was having a positive impact. However, the number of deaths by suicide increased to 506 in 2008, an increase of 10.5% over the 2007 figures, and the provisional figures from the Central Statistics Office are 527 for 2009 and 486 for 2010. These are staggering statistics and they show that more people lose their lives from suicide than on the roads. The increases in 2008 and 2009 were largely in the middle age groups, which we think were severely affected by the economic downturn. Male suicides outnumber female suicides by a ratio of 4:1 and in some younger age groups the ratio is 7:1. While welcome, the reduction between 2009 and 2010 still leaves us to deal with a high level of suicides.
Reach Out, our policy strategy on suicide prevention, outlines the actions that need to be taken to prevent suicide and deliberate self-harm and increase awareness of the importance of good mental health. The National Office for Suicide Prevention is responsible for the implementation of Reach Out. A number of suicide prevention initiatives have been progressed in recent years, including the development and implementation of the ASIST and Safetalk national training programmes and the development of mental health awareness campaigns through TV, radio, cinema and outdoor advertising and the production of websites and written material.
In 2011, mental health awareness campaigns will focus on young people and those in distress as a result of their economic vulnerability. There is continued support for voluntary organisations working in the field of suicide prevention; this year, with the additional €l million provided for suicide prevention, a further 25 programmes were funded. Specialist training has been agreed and implemented with the Garda, the Prison Service and the Defence Forces and work is under way with the fire and ambulance services. In addition, a “tough economic times” information and training programme has been introduced for the staff of organisations such as citizens advice centres, the Money Advice and Budgeting Service and so on.
During 2011, the National Office for Suicide Prevention will continue to develop both the number and range of training and awareness programmes, including the ASIST programme, to reach the most vulnerable in our communities; improve and standardise the response to deliberate self-harm presentations; develop the capacity of primary care to respond to suicidal behaviour and consider new models of response; and ensure that helpline supports for those in emotional distress are co-ordinated and widely publicised. Within each of these four areas an emphasis will be placed on the most vulnerable groups identified in Reach Out and more recent research.
Deputy Dan Neville
I thank the Minister for his response. While he has pointed to several positive developments, the reality is that we are coming from a very low base given the historical neglect in the area of suicide prevention and mental health service provision. I welcome the firm commitment given by the Taoiseach at the People of the Year Awards last weekend that the resources of the Government will be available to develop and improve mental health services in order to save lives and support the 70,000 people each year who attempt suicide or engage in self-harm.
Will the Minister comment on reports that the level of staffing at the National Office for Suicide Prevention has been reduced? While the budget for the office is currently in the region of €4 million, the programme for Government includes a commitment to increase the level of funding. I propose that it should be increased to €10 million over the lifetime of the Government, which would require an additional €2 million from the €35 million allocated to mental health services. I refer not to additional funding which must be found from somewhere else, but to the funding that is already committed to mental health services. An allocation of €2 million per annum should be given to the Office for Suicide Prevention from this funding line to deal specifically with suicide prevention.
I take this opportunity to thank the director of the office, Mr. Geoff Day, who has announced his retirement, for his excellent work since its establishment. Suicide prevention is an important arm of health service provision within the Health Service Executive and it is important that the Office for Suicide Prevention is given additional support. The current allocation of €4 million has been totally inadequate to deal with the issue nationally.
Deputy James Reilly
Deputy Neville’s commitment in this area is well known for many years. I accept that the service base is low and that much requires to be done. Nevertheless, I remind the Deputy that within our primary care strategy, it is our intention that each primary care centre will have a mental health facility so that people with mental health problems will be treated in the same way as any other patient, thus helping to remove the stigma associated with mental illness. It often seems to be acceptable to talk about one’s sore leg or chest pain but not to talk about mental health difficulties. That stigma must be debunked.
I too pay tribute to Mr. Geoff Day for all the work he has done. Some stories in the press have suggested he is leaving because of a lack of resources. This is not the case. I met him last Friday at the Console conference where he made clear to me, as he had done earlier to conference attendees, that he is taking the opportunity to pursue a master’s degree at Trinity College. He had intended to retire next year but has done so a little earlier in order to commence his studies. Mr. Day has generously and kindly offered his services to us in the coming years. I am grateful to him for that and have no doubt he will continue to be a very valuable resource.