Dáil Éireann - Volume 579 - 04 February, 2004

Adjournment Debate. - Parasuicide Incidence.

Mr. Neville Mr. Neville

  Mr. Neville:I thank the Ceann Comhairle for allowing me to raise this issue.

I welcome the national parasuicide registry's report which was launched by the Minister for Health and Children on Monday. I congratulate Professor Ivan J. Perry, director of the national parasuicide registry and the National Suicide Research Foundation in Cork, and his staff on the report.

In 2002, there were 10,337 parasuicide presentations at accident and emergency departments in hospitals in the State. Of this figure, 8,421 individuals were involved. Of the 8,304 recorded presentations at accident and emergency departments, 42.3% were men and 57.7% were women. Parasuicide episodes were generally confined to younger age groups. Slightly under 90% of them were by people less than 50 years of age. In most age groups, the number of parasuicide acts by women exceeded the number by men. This was most pronounced in the ten to 19 year old group where there were 2.4 times as many as self-harm acts by women. To illustrate this, there were 458 parasuicides by men and 1,094 by women. The ratio of completed suicides of men to women is 5:1. The only notable exception to this female preponderance were in the 25 to 34 year age group where there were almost equal numbers of episodes involving men and women.

600

I want to impress upon the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, that investment in research to know why this is happening is vital if we are to deal with the problem. Up to 257 parasuicides were by residents of homes and hostels, 102 by in-patients in psychiatric hospitals and 32 by prisoners. Repeated acts of self-harm represent a significant problem. In 2002, one in five of those who attempted to take their lives were repeat acts. The development and delivery of [600] interventions for this difficult patient group must be prioritised by the Department.

Parasuicide is an increasing problem in Ireland. Each of the five health board areas from which substantial data were collected in 2001 experienced increases in the number of individuals and episodes of parasuicide treated in hospital in 2002. Rates among women are approximately 40% higher than among men. Every possible research facility should be given to the National Suicide Research Foundation to ascertain why this is occurring because only then will we be able to deal with the issue. Rates are particularly high among young people, with 90% of all presentations under 50 years of age. While the male peak rate for parasuicide is between 20 and 24 years of age at 407 per 1,000, the peak rate for women is between 15 and 19 years of age, at 626 per 1,000. The high rate of deliberate self-harm in adolescent girls poses a particular problem for the health services, as individuals in this group may fall between the child and adult mental health services. We need to know why girls between 15 and 19 years of age have such a high rate of self-harm.

Compared to the national rate, the incidence of parasuicide were significantly higher for men residing in the Midland and Mid-Western Health Board areas and the Eastern Regional Health Authority area. Rates of parasuicide are higher in urban than in rural areas. This is the opposite to completed suicides which tend to be more prevalent in rural areas.

I ask the Department to provide funding for research into parasuicide incidence and introduce ways to reduce the level of self-harm among young men and women.

Mr. T. O'Malley Mr. T. O'Malley

  Mr. T. O'Malley:I thank Deputy Neville for raising this matter on the Adjournment.

I welcome the publication of the second annual report of the national parasuicide registry. This important project is carried out by the National Suicide Research Foundation. Parasuicide is increasing in this country and repeated acts of self-harm represent a significant problem.

International studies have found parasuicide to be one of the most significant risk factors associated with suicide. Those who engage in self-harm are 20 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. It is now close to achieving its aim to establish the extent of the problem of hospital-reported parasuicide in Ireland. 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 the health services.

601

[601] 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 different regions. The analysis of this information will be vital in the development of policies and the implementation of measures aimed at preventing suicide.

The report highlights the challenge that deliberate self-harm and suicide prevention poses for our health system and our society as a whole. The work of 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 preventive and clinical services being provided.

We cannot ignore or be complacent about the growing incidence of self-harm and suicide. Suicide prevention is an issue with which we must all concern ourselves. 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 the task force, 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-ordinating 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 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.

The national suicide review group and the Health Boards Executive, HeBE, together with my Department, have commenced work 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 as outlined in the national task force on suicide's report of 1998.

My Department has given special attention in recent years 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 in excess of €13 million 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.

602

[602] Significant additional funding has also been made available to develop further 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 Schizophrenia Ireland, in raising public awareness of mental health issues.

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.

Mr. Neville Mr. Neville

  Mr. Neville:May I thank the Minister of State and make one comment——

An Ceann Comhairle An Ceann Comhairle

  An Ceann Comhairle:There is no provision for comments. I am sorry but we cannot go outside the Standing Orders.

Mr. Neville Mr. Neville

  Mr. Neville:Even on this issue?

An Ceann Comhairle An Ceann Comhairle

  An Ceann Comhairle:On any issue. The Standing Order is quite specific and there has never been provision for supplementaries.

Dáil Éireann 579 Adjournment Debate. Parasuicide Incidence.

General Debate

20040204