A report on the high levels of suicide rates in Irish society calls for large-scale State investment and policies on alcohol. Martin Wall reports.
A new Oireachtas report to be published next week will argue that large-scale State investment in child and adult psychiatry services and the implementation of policies to help people with alcohol problems are among the main measures required to reduce the level of suicide in Ireland.
The report of the Joint Oireachtas sub-committee on the high levels of suicide in Irish society says the stark increase in people taking their own lives over the past two decades demands decisive Government action.
It proposes a €60 million action plan and argues that a target to reduce the rate of suicide by 20 per cent by 2016 would be a fitting way to commemorate the centenary of the Easter Rising.
The report points to the close relationship between suicide and mental illness and the well-established role of alcohol in suicide and suicidal behaviour and it recommends major investment in both areas.
The report proposes that €40 million more annually be spent on the development of psychiatric services. It also calls for administrative integration between child and adult psychiatry.
"The close relationship of suicide and mental illness makes it imperative to make psychiatric services more accessible," it states.
"There is considerable disparity of funding of mental health services. Services for adolescents have tended to be poorly developed notwithstanding the serious mental health issues that emerge at this time in young people's lives."
According to the report, those with psychotic illnesses are at a 10-15 per cent risk of dying by suicide and this risk is greatest within the first five years after the onset of psychotic symptoms.
"Programmes of early intervention proactively detect and treat serious mental illness in a phased specific way, and impact on suicide rates in young people," it states.
The report also recommends that the Government invest €10 million in additional funding to provide effective and accessible alcohol treatment services in each HSE region.
It maintains that an additional €600,000 should also be spent annually as a priority to introduce a national screening protocol for early intervention of problem alcohol use for all sectors of the healthcare system.
The report criticises the Government for failing to implement its own alcohol policy.
"Alcohol produces a significant fall in mood and facilitates aggressive behaviour towards oneself and others," it states.
"An individual may not have a history of suffering from depression for this to come about, but those that do, are at increased likelihood of a reduction in mood.
"An opportunity exists of referring those with alcohol or substance misuse issues to treatment programmes from A&E departments following episodes of suicidal behaviour were such programmes to exist," it states.
The report says suicidal behaviour is largely concealed within the population and engaged in by up to 9 per cent of teenagers.
It says the majority of these had not sought help from the health services.
"The 11,200 annual presentations to A&E departments following suicidal behaviour is a gross underestimate of the true extent of this activity - a significant number of whom subsequently go on to die by suicide and thus contribute to our belief that 55 per cent of those who die by suicide do so on their first attempt - it is likely that for some, their previous attempts may not have come to light," according to the report.
"Not all of those that present to hospital following an episode of suicidal behaviour are assessed by a trained mental health professional given the haphazard dispersal of resources and, thus, an opportunity to reduce repeat acts that will have a fatal outcome for some is missed," it states.
It proposes the appointment of four regional training co-ordinators in the area of mental health promotion at a cost of €420,000.
The report also recommends the introduction of a sustainable anti-stigma and positive mental health promotion campaign at a cost of up to €1.5 million.
It also proposes that there should be protocols for the health services to respond where a community is affected by a cluster of suicides.
The report recommends that the Office of Public Works could establish whether there are specific places associated with suicide and, where feasible, implement ways of restricting access.
It suggests that such a policy could cost €5 million annually.
According to the report, economic policy that increases society's wealth but at the cost of society's fragmentation, family law that is weighted against fathers in non-marital situations or situations of marital breakdown, and our employment law that has led to less job security are all associated with the increase in the suicide rate.