Speeches

Address by Mr. Micheál Martin T.D., Minister for Health and Children at the launch of the 2nd annual report of the National Parasuicide Registry

I am delighted to have been invited here today to launch the 2nd Annual Report on the National Parasuicide Registry. This important project is carried out by the National Suicide Research Foundation.

The National Parasuicide Registry

International studies have found parasuicide, to be one of the most significant risk factors associated with suicide – those who engage in self harm are twenty times more likely to eventually die by suicide. Studies have shown that at least one third of all suicides have a history of parasuicide. To this end the National Suicide Research Foundation launched the National Parasuicide Registry, and is now close to achieving their aim – to establish the extent of the problem of hospital-based parasuicide in Ireland. It is obvious from your findings that parasuicide is an increasing problem in this country and repeated acts of self-harm represent a significant problem. The findings in this report indicate that approximately 8,400 individuals presented to hospital due to deliberate self-harm in 2002. The development and delivery of interventions for this patient group is a priority for all health services.

The National Parasuicide Registry provides information on the general characteristics of people who attempt suicide. It also provides a better knowledge of suicidal behaviour and specifies trends in parasuicide over time and in the different regions of the country. The analysis of this information will be vital in the development of policies and the implementation of measures aimed at preventing suicide.

The Report indicates that drug overdosing was the most common method of self-harm, representing 77% of all parasuicide cases registered in 2002. It is interesting to note that minor tranquilisers, paracetemol and anti-depressants were involved in 95% of these cases as legislation restricting the sale of medicines containing paracetemol was enacted in October 2001. This information will enable the effects of this legislation on the use of paracetemol in deliberate overdoses to be assessed.

The report highlights the challenge that deliberate self harm and suicide prevention poses for our health system and our society as a whole. The Registry will also be very useful in the allocation of resources. It will help identify groups which are particularly vulnerable and will assist health boards to evaluate the impact of the preventative and clinical services being provided.

National Suicide Research Foundation

As you are all aware the National Suicide Research Foundation which was founded in January 1995 by the late Dr. Michael J Kelleher consists of a multi-disciplinary research team with contributions from a broad range of disciplines including psychology, psychiatry and sociology.

The primary aims of the Foundation are to define the true extent of the problem of suicidal behaviour in Ireland; to identify and measure the factors which induce and protect against suicidal behaviour; and to develop strategies aimed at preventing suicidal behaviour.

While the bulk of the Foundation´s work to-date has involved the monitoring of parasuicide other areas of their work include the carrying out of in-depth interviews with individuals who have engaged in parasuicide so as to be able to identify the social, psychological and psychiatric factors associated with suicidal behaviour. On a yearly basis, data relating to every suicide and undetermined death registered in Ireland is sent to the Foundation by the Central Statistics Office. This data is analysed so as to produce up-to-date age-specific and age-standardised rates with respect to demographic variables. These statistics are also provided in response to the numerous requests the Foundation receives from professional bodies, students and the public for information relating to suicide.

I am aware that due to the Foundation´s reputation for high quality research, it has been invited to participate in several important international studies, among them the WHO/Euro Multicentre Study of parasuicide.

Suicide Prevention

We cannot ignore or be complacent about the growing incidence of self harm and suicide in this country. Suicide prevention is an issue which we all must concern ourselves with.

Since the publication of the report of the National Task Force on Suicide in 1998, there has been a positive and committed response from both the statutory and voluntary sectors towards finding ways of tackling the tragic problem of suicide. In response to the recommendations of this report the National Suicide Review Group was established by the Health Boards and membership of the Group includes experts in the areas of mental health, public health and research.

Health boards, in particular, have a major role to play in co-coordinating efforts to help reduce the level of suicide and parasuicide in this country. In this regard, Resource Officers have been appointed in all the health boards with specific responsibility for implementing the Task Force’s recommendations.

There are also numerous regional initiatives that are currently being run by the health boards in conjunction with non-statutory organisations, which focus on mental health issues like stress management, depression, stigma reduction and suicide-related matters. These are issues of paramount importance which require further attention to ensure that positive mental health and the well-being of people is promoted.

Preventing suicide means influencing, in a corrective and constructive way, a person’s development and their own resources at different phases of life. Adolescence is traditionally viewed as a time of profound change when young people make the transition to adult status. This transition is not easy and for many young people is accompanied by levels of self-doubt, fear and stress. An important aspect of suicide prevention for young people will be to promote self-esteem and self-confidence and to ensure that they develop personal and social skills. Children and young people often need support in gaining control over their lives and coping with their problems.

One of the key components of the overall strategy aimed at reducing the number of suicides include the implementation of measures aimed at high risk groups, provision of information and training on suicide prevention to relevant professionals and organisations and the improvement of services which would benefit those at risk of suicide and those who attempt suicide.

Research is an essential element of prevention. Research defines choice, informs options and is important to determine which measures would be of benefit in helping our understanding of and our response to suicide and attempted suicide.

I am pleased to inform you that work has commenced by my Department together with the National Suicide Review Group and the Health Boards Executive (HeBE) on the preparation of a new National Action-oriented Strategy for suicide prevention. It is important to stress that this proposed strategy will be action-based from the outset as it will build on existing policy vis-à-vis the National Task Force on Suicide Final Report (1998).

Mental Health Promotion

At national level, priority is being given to education awareness and to promoting a better understanding among the public towards mental health.

There is a growing awareness and concern among the community about mental health matters and the National Health Promotion Strategy, 2000-2005 in conjunction with the new health strategy “Quality and Fairness” see mental health as being equally as important as physical health in the overall wellbeing of a person. Increasingly, mental health is being recognised as a major challenge facing health services in the twenty first century and my Department recognises the need for positive mental health promotion. Mental health promotion is a very broad concept as it emphasises the promotion of the psychological health and well-being of individuals, families and communities. I see it as a key task of the health services not just to treat mental illness but more importantly, using the principles of health promotion, to try and improve the mental health of the population.

Funding

My Department has, over the past few years given special attention to the resourcing of suicide prevention initiatives. Since the publication of the Report of the National Task Force on Suicide in 1998, a cumulative total of more than €13m has been provided towards suicide prevention programmes and for research. This includes funding to support the work of the National Suicide Review Group, The Irish Association of Suicidology and the National Suicide Research Foundation for its work in the development of a National Parasuicide Register.

Significant additional funding has also been made available to further develop child and adolescent psychiatry, adult psychiatry and old age psychiatry services to assist in the early identification of suicidal behaviour and to provide the necessary support and treatment to individuals at risk.

My Department also supports the ongoing work of many organisations such as Mental Health Ireland, Grow, AWARE and Schizophenia Ireland in raising public awareness of mental health issues.

Conclusion

I share the public concern about the level of parasuicides and suicides in this country. It is a worrying trend and I am fully committed to the further implementation of suicide prevention initiatives and the further development of our mental health services in order to prevent any further premature loss of life.

In conclusion, I would like to pay tribute to the work of National Suicide Research Foundation. The hard work, effort and dedication of all those involved is to be complimented. I would like to take this opportunity to wish all those associated with the Foundation continued success in their endeavours and I look forward to the 2003 Report.