Address by Mr. Tim O’Malley T.D., Minister for State at the Department of Health and Children at the Launch of the 4th Annual Report of the National Parasuicide Registry
I am delighted to be here today to launch the 4th Annual Report on the National Parasuicide Registry. This important project is carried out by the National Suicide Research Foundation and is based on data collected over the year 2004 on persons presenting to hospital with parasuicide (deliberate self-harm).
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 to establish the extent of the problem of hospital-based parasuicide in Ireland. The findings in this report indicate that approximately 8,600 individuals presented to hospital due to deliberate self-harm in 2004. While this figure is marginally lower than the figure for 2003 of approximately 8,800 individuals, it is nevertheless worrying. 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.
As in previous years, the Report indicates that drug overdosing was the most common method of self-harm, representing 77% of all parasuicide cases registered in 2004. While it was common for several drugs to be taken in the same act, minor tranquilisers, paracetemol and anti-depressants were involved in 43%, 31% and 25% of deliberate overdoses, respectively. It is interesting to note that in 42% of all episodes of deliberate self-harm register in 2004, there was evidence of alcohol consumption. Indeed, it has been noted that alcohol may in fact be one of the factors underlying the pattern of presentation with deliberate self-harm by time of day and day of week as it has been found that presentations peak in the hours around midnight and one-third of all presentations occur on Sundays and Mondays.
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 in the evaluation of the impact of the preventative and clinical services being provided.
As we are all aware, there was in the past a reluctance to even discuss the issue of suicide. Thankfully, this situation has now changed. In Ireland, the level of discussion and openness on mental health issues, including deliberate self harm and suicide has increased significantly in recent years. This is a very welcome development. However, we do need to ensure that public discussion and media coverage of suicide and deliberate self harm remains measured, well informed and sensitive to the needs and well-being of psychologically vulnerable and distressed individuals in our society. In particular, we need to continue to work as a society to create a culture and environment where people in psychological distress feel able to seek help from family, friends and health professionals.
I recognise the many challenges that lie ahead and I am aware that there are no easy or single interventions that will bring a guarantee of success. International evidence shows that reducing the suicide rate and preventing suicides requires a collective, concerted effort from all groups in society – health, social services and other professionals, communities, voluntary and statutory agencies and organisations, parents, friends, neighbours and individuals.
Reach Out–A National Strategy for Action on Suicide Prevention recently launched by the Tánaiste, builds on the work of the National Task Force on Suicide (1998) and takes account of the efforts and initiatives developed by the former health boards in recent years. Work was initiated on the development of this strategy in 2003 and wide ranging consultation took place throughout the country to draw on the experience, perspectives and ideas of the key stakeholders and interested parties. I would like to thank all those who took part in this process. This consultation process, combined with continuous monitoring of evidence and best practice, allowed the project team to take both an evidence-based and pragmatic approach in prioritising actions to be undertaken by the various agencies and groups in order to effect real change over the next 5 to 10 years.
A fundamental aim of the new strategy is to prevent suicidal behaviour, including deliberate self-harm, and to increase awareness of the importance of good mental health among the general population. Ongoing, quality, multi-disciplinary research will be an essential strand of the strategy and findings will be of greatest value where they can inform and stimulate action and service development. The Strategy identifies expected outcomes and sets targets which can be measured, monitored and revised. Continuous quality control and ongoing modification and improvement of the strategy will be central to its implementation.
At present, best international practice suggests that suicide prevention programmes should be developed on the basis of improving the mental health of the general population in combination with developing strategies for known high-risk groups. This new Strategy includes specific recommendations for action in relation to this area.
The HSE will take a lead role in overseeing the implementation of the strategy, in partnership with those statutory and voluntary organisations that have a key role to play in making the actions happen. Driving the implementation of the Strategy will be the National Office for Suicide Prevention which is located within the National Population Health Directorate of the HSE and is headed by Mr. Geoff Day.
I am pleased to inform you that funding of €500,000 has already been allocated in 2005 to commence the implementation of the Strategy. Additional funding will also be made available over the coming years to support the Strategy and to complement local and national efforts.
I note that one of the key recommendations of the Parasuicide Report is the need for a comprehensive national mental health promotion strategy. I understand that one of the priorities for the National Office for Suicide Prevention is a mental health promotion campaign. 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.
I would now like to touch on the issue of support for those who are bereaved by suicide. We need to do all we can to make it as easy as possible for those people who are bereaved by suicide to confront, face and deal with the situation. People often do not want to ask for help as they may feel that this will be perceived as a sign of weakness. Looking for and expecting practical help is not a sign of weakness rather it is in fact confronting your problems. Everyone can learn to cope with their tragic loss, but for some people this can be a long and very difficult process. The encouragement and support provided by the various organisations that work with those who suffer the intense trauma of bereavement through the suicide of a loved one is of immense importance. This has been recognised by this Government through the provision of financial support for groups active in this area. Further measures in this regard are also proposed in the new Strategy ‘Reach Out’.
In conclusion, I would like to pay tribute to the work of National Suicide Research Foundation and the National Parasuicide Registry. 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.