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In a statement in the Seanad on suicide prevention Minister Lynch said:
I welcome this opportunity to make a statement to the House on suicide prevention. The importance of exploring the causes of and ways of dealing with suicide cannot be over emphasised. A suicide is a tragic and shattering occurrence that not only brings a life to an untimely end but also has a devastating impact on family, friends and communities.
The increasing number of deaths by suicide is of great concern to me. Discussion around suicide tends to be dominated by statistics but it is very important that we remember the human factor. Each death is someone’s loved one – statistics cannot capture the grief and desolation of those left behind. The unanswered questions of – why, what if, if only – will always remain in their minds. There is not a community in Ireland that has not been affected by the trauma and despair that surrounds suicide. We know that reducing suicide rates requires a collective, concerted effort and most importantly a collaborative approach. This Government is committed to fostering and building on the existing levels of all- island cooperation in the interests of promoting positive mental health and tackling the issue of suicide.
In saying that, it is impossible to have a debate about suicide prevention without recognising the number of people who have died by suicide. Provisional data for 2009 shows a record number of 527 recorded suicides. There was a slight decrease in the provisional figures for 2010 to 486 but the number of deaths remains unacceptably high.
Suicide is not just a mental health issue – many factors contribute to the rise in suicides e.g. economic downturn, unemployment, breakdown of relationships, financial difficulties, etc. One study shows that a 1% increase in unemployment leads to a 0.79% increase in suicides.
It is important that we recognise that since 2007, there has been a particularly high increase in the number of deaths by suicide of men in the 35 to 54 age group. While there is an increase in the number of women dying by suicide, the numbers are still significantly lower than in men.
The current economic situation is, undoubtedly, having an effect on people’s mental health and well being. Our young adult population who grew up in a time of prosperity when work and opportunities were plentiful are particularly affected by this downturn in our financial circumstances. One readily understands the devastation that can occur when you think of the relative speed with which the recession hit, the severity of it and the very high impact on lives particularly for those who acquired large mortgages in the preceding years, maybe had a very young family and then suffered the hardship of unemployment. In these circumstances, the shock to the system for many was overpowering.
As Minister with responsibility for mental health, I am working closely with the HSE and voluntary agencies to introduce initiatives to deal with much more effectively and appropriately with the issue of mental health and suicide.
The total funding available in 2011 nationally through the HSE for suicide prevention was about €9 million of which €4.1 million was available to the National Office for Suicide Prevention and approximately €5 million was available regionally to fund Resource Officers for Suicide Prevention, Self-Harm Liaison Nurses in Hospital Emergency Departments and local suicide prevention initiatives. The funding provided in this area in 2011 included a special allocation of €1 million specifically to target initiatives to address the increasing incidence of suicide and deliberate self harm which allowed the HSE to focus on further developing skills based training and awareness programmes in suicide prevention, improving the response to those who deliberately self harm, developing the capacity of primary care to deal adequately with those presenting with suicidal behaviours and improving inter-agency coordination.
The challenge of suicide prevention is now one of the most urgent issues facing society. However, it is important to acknowledge the suicide prevention initiatives that are in place and which are being developed: -
Since 2004, approximately 25,000 people have been trained in the 2 day ASIST (Applied Suicide Intervention Skills Training) programme in suicide first aid, which is an internationally recognised effective course. This training programme is provided to health workers, teachers, community workers, Gardai, youth workers, Defence Forces, veterinary organisations, volunteers and people responding to family friends and co-workers.
A half day training programme called Safetalk which prepares participants to identify persons with thoughts of suicide has been provided to over 3,000 participants.
In response to the economic downturn the HSE National Office for Suicide Prevention (NOSP) has launched a “tough economic times” programme following requests from organisations such as Citizens Advice and MABS for information and training for staff because of the increasing numbers of people presenting in distress. Farmers’ marts were targeted with similar information as well as the major National Ploughing Championship events.
Mental Health Awareness Campaigns including the ‘Mind Your Mental Health’ and ‘Let Someone Know’ awareness campaigns and the ‘See Change’ and ‘Make A Ripple’ Stigma Reduction Campaigns are being ramped up with the objective of achieving a significant change in attitudes to mental health, to encourage people to be more aware of their mental health and, above all, to seek help.
The HSE Clinical Care Lead for Mental Health is working with key stakeholders to develop a uniform approach to self harm assessments in emergency departments so that patients can receive the best care and treatment available. A pilot project is also underway in the Cork Hospital Group to train all appropriate clinical staff in self harm/suicide management and it is hoped that this will be in all other hospitals in due course.
The HSE National Office for Suicide Prevention has also funded a number of Suicide Community Assessment Nurses (SCAN) who work within primary care to provide an effective and co-ordinated response at healthcare professional level in that setting to deal with the issue directly and to avoid admissions to hospital. These projects are currently being evaluated.
The NOSP also supports a number of voluntary organisations working in the field of suicide prevention.
The Jigsaw programme, developed by Headstrong, is another example of an initiative aimed at making mental health services more accessible to those who need them. Jigsaw creates safe spaces in communities where young people can access a wide range of mental health supports for free. It works by engaging young people, organisations, families and other support agencies in the community, so that we are all better able to respond to the mental health and well being needs of young people aged from 12 to 25.
The most powerful thing I can say about this project is that it works. Jigsaw is up and running in 5 counties – (Galway, Roscommon, Kerry Meath and Ballymun in Dublin) and the HSE in partnership with Headstrong will progress six new Jigsaw sites (Donegal, Offaly, Clondalkin, Tallaght, Balbriggan and Dublin 15) through the allocation of €1m Innovation funding.
Following on from the special consideration which was given to mental health in Budget 2011 with a maximum reduction in funding of 1.8% for this sector, Budget 2012 provided an additional €35 million for mental health services in line with our Programme for Government commitments. Details of how this funding will be apportioned are still being worked on in the context of the HSE’s draft National Service Plan for 2012 which is currently under consideration. Final decisions in relation to funding of individual care programmes will become clear when the Minister approves the National Service Plan for 2012 in accordance with the Health Act 2004.
What I can say is that funding from the special allocation for mental health will be used primarily to strengthen Community Mental Health Teams in both Adult and Children’s mental health services. It is intended that the additional resources will be rolled out in conjunction with a scheme of appropriate clinical care programmes based on an early intervention and recovery approach. Some of the funding will also be used to advance activities in the area of suicide prevention and response to self-harm presentations and to initiate the provision of psychological and counselling services in primary care specifically for people with mental health problems. Some provision will also be made to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change. I am committed to ensuring that mechanisms are put in place to ensure that the funding is used only for the purposes for which it is specified in the HSE National Service Plan.
You will be aware that the Government has already approved the drafting of legislation to give effect to changes in the governance of the HSE. This involves radical reform of the health service generally which will see the introduction of Universal Health Insurance (UHI). Significantly the new system of governance will involve seven Directorates, including a separate Directorate for Mental Health which will have full responsibility and accountability in that area. In this context, my colleague, Minister Reilly intends to bring forward detailed proposals at a later date for the re-organisation of the HSE at directorate, regional and local levels in a manner which facilitates a smooth transition from the current governance arrangements to the proposed new structures. This, to my mind, is a significant step forward for mental health and finally puts it on a par with all other healthcare services. It is equally important. In fact, I would argue possibly even more important. This in certainly a critical move in the right direction and one which I have fought hard for since taking on responsibility for this area on assuming office last year.
Of course, we need to get best value for our available resources. Duplication of mental health services and suicide prevention initiatives need to be avoided in order to provide a more streamlined service. We need to co-ordinate our efforts and work together to stop the tragedy of the loss of life through suicide.
I recognise the many challenges that lie ahead and I am aware that there are no easy interventions that will guarantee success. However, I can assure this House that I am totally committed to tackling the high incidence of suicide and deliberate self harm in this country and to working with the HSE and voluntary organisations to introduce initiatives that will reduce the number of deaths by suicide.