Attempted suicide is particularly common in urban areas and is increasing, according to latest figuresin the annual report of the National Parasuicide Registry - it is due to be published next month.
Based on data collected as a result of accident and emergency attendances at hospitals across the State by people who attempted suicide in 2002, the report concludes that parasuicide is "particularly common in large urban settings in Ireland, most notably in Limerick city".
While data was not collected from all hospitals in the Eastern Regional Health Authority area, the authors of the report extrapolate from the data collected in the region to estimate numbers and rates of parasuicide for the region.
The report said: "There was widespread variation in male and female parasuicide rates when examined by county/city of residence. The male rate varied from 63 per 100,000 for Leitrim to 429 per 100,000 for Limerick city. The lowest and highest female rates were also recorded for Leitrim and Limerick city residents at 97 and 419 per 100,000 respectively.
"Above-average parasuicide rates were recorded for male and female residents of the cities of Cork (plus 30 per cent - above the average - for men, plus 28 per cent for women); Galway (plus 51 per cent for men, plus 6 per cent for women); Limerick (plus 157 per cent for men, plus 77 per cent for women); and Waterford (plus 36 per cent for men, plus 34 per cent for women).
The report notes that low rates of parasuicide were found in Connacht. "For men and women, the six counties with the lowest parasuicide rates included four of the five Connacht counties (Galway, Roscommon, Mayo and Leitrim for men and Sligo, Galway, Mayo and Leitrim for women)".
This is the second annual report from the National Parasuicide Registry. The first report in 2001 included full-year data from hospitals in just four health boards - the Midland, Mid-Western, South Eastern and Southern - and when this is compared with the 2002 data for these regions, the report says it suggests parasuicide is an increasing problem in Ireland.
The rate of individuals presenting to hospital A&Es due to attempted suicide increased by 5.7 per cent in the midlands, by 11.9 per cent in the mid-west, by 8.5 per cent in the south-east and by 12.7 per cent in the south between 2001 and 2002.
The report states that overall the incidence of parasuicide is significantly higher among men living in the Mid-Western and Midland Health Board areas and significantly higher among women living in the Mid-Western and Eastern Regional Health Authority areas. It does not say why this is so.
Meanwhile, the report also states that rates of parasuicide among women are approximately 40 per cent higher than among men. The peak rates for women are in the 15-19 age bracket (625 per 100,000) and for men in the 20-24 age bracket (407 per 100,000).
"The high rate of deliberate self-harm in adolescent girls poses a particular challenge for our health system as individuals in this age group may fall between child and adult mental health services," the report says.
Taking a drug overdose was the commonest method of self- harm, representing 77 per cent of all acts registered in 2002. There was also evidence of alcohol consumption before the act in 42 per cent of cases. This was higher among men, but the report stresses there is evidence that alcohol is an increasingly important factor in parasuicide by women. "This may simply reflect broader trends in alcohol consumption in Ireland. Alternatively, it may be that the increase in alcohol consumption levels observed in the past decade in Ireland have accentuated the already high rates of deliberate self-harm in young women."
The report also points to these attendances at A&E as "the tip of the iceberg of mental distress".