8. Deputy Mick Wallace asked the Minister for Health his plans to increase resources for suicide prevention services in County Wexford in view of the number of recent suicides in the county and the county’s high suicide rate compared with national averages; and if he will make a statement on the matter. (Question 6379/18 asked on 08 Feb 2018)

Deputy Mick Wallace: According to the Central Statistics Office and National Office for Suicide Prevention, Wexford consistently has one of the highest suicide rates per capita in the country. At times in the past ten years, the suicide rate in the county has been almost double the national average. Will the Minister provide an update on his plans to increase resources for suicide prevention services in Wexford given the number of recent suicides in the county, its high suicide rate when compared with the national average and the abysmal services currently in place in Wexford?

Deputy Jim Daly: I thank Deputy Kelleher for the opportunity to address this serious issue. Suicide prevention is a priority for the Government. Since 2012, we have increased the funding for the National Office for Suicide Prevention from less than €4 million to more than €12 million.

While there has been a very welcome reduction in national suicide rates, I acknowledge that the rate in County Wexford is higher than we would hope. In order to reduce the rate, we have put in place a number of support services in the county. Support is available in the Wexford region for people who are feeling suicidal and for families or friends who are concerned. There is a range of services available in the area of suicide prevention, as well as support in the aftermath of a suicide.

Each community health organisation, CHO, has at least one resource officer for suicide prevention based within its area. This includes CHO area 5, of which Wexford is a part. The HSE’s suicide crisis assessment nurse service, SCAN, is also available in Wexford. This is an expert mental health nursing service which is available within primary care and which offers an accessible and speedy response to GP requests for assessment of those who are self-harming or in suicide distress. Wexford also has the HSE’s self-harm intervention programme, SHIP. This is a free service offering short-term counselling to individuals aged 16 and over who are experiencing suicidal ideation or the impulse to self-harm. Referral is through a person’s GP or other medical professional.

The HSE continues to work not only through its professional staff in mental health services but also through GPs, within counselling services and in the community and voluntary sector, in developing various responses to the incidence of suicide in Wexford. Training programmes are offered to HSE and other relevant front-line staff in Wexford in partnership with voluntary organisations and the National Office for Suicide Prevention. These training programmes include e-suicide TALK, safeTALK, applied suicide intervention skills training, or ASIST, and understanding self-harm.

Connecting for Life is Ireland’s national suicide prevention strategy for the period 2015 to 2020 and the National Office for Suicide Prevention is tasked with its implementation. This strategy sets out a vision of an Ireland where fewer lives are lost through suicide and where communities and individuals are empowered to improve their mental health and well-being. Connecting for Life local plans are developed by communities for communities. The local plans align with the national strategy in terms of vision, with a core component being local implementation and empowerment of communities. The Wexford Connecting for Life local plan was updated and relaunched in 2017.

Deputy Mick Wallace: I do not know how much the Minister of State knows about what it is like on the ground but it is abysmal. The HSE web page for Wexford mental health services lists two mental health hospitals and five day services. There are no links to provide more information but there are phone numbers. If one Googles the names of the five day services, only one has a website, and it - like two of the other five day services - is clearly not a mental health service. At the bottom of the page there is a note on a regional suicide resource office, with a phone number for St. Patrick’s Hospital in Waterford, which was highly criticised in a report by the Mental Health Commission in 2016. If I were in crisis and I needed some help after 6 p.m., there are three numbers I could call and one is in another county. I would have no idea what would happen, the kind of care I would get, if somebody would talk to me, who I would speak with and if the relevant person could prescribe medication or if I would be kept overnight. It would be money well spent to simply provide some information on web pages relating to these services on the HSE website. I am sorry but the people in Wexford would say this to the Minister of State. Several people have been affected by this lately and it can be devastating. They will say the services are not there.

Deputy Jim Daly: I appreciate that this is a sensitive matter and one about which the Deputy is very passionate. One of the challenges I have seen since coming to the Ministry is the myriad services which exist but which are not joined up. There is no up-to-date or real directory of services available. If I wake up with a mental health issue in west Cork or the Deputy wakes up with one in Wexford, the question is who to call. Does a person call Aware, ALONE, the Samaritans, Childline, Pieta House or Jigsaw? There is a variety of different services. Nobody in a perfect state of health, let alone with a mental health challenge, could figure out the myriad of services and what is most appropriate.

One of the first actions I asked of the HSE since starting in this job is to have one national helpline that would be as identifiable as the 999 number that we know. This should refer everybody who calls it to the most appropriate local service in the area suitable to their needs. Work is ongoing and I hope we can make significant progress on it before the year is out. It will be a very positive step towards remedying what the Deputy is highlighting.

Deputy Mick Wallace: In 2010, when the acute beds were closed at St. Senan’s hospital in Wexford and the service moved to Waterford, we had the same suicide rate as Waterford. Now, however, the rate in Wexford is double the rate in Waterford. This is an issue and St. Patrick’s Hospital in Waterford is not even fit for purpose. I understand that not everybody presents with suicidal ideation. It is not always easy for the State to know somebody will kill himself or herself; that cannot be known unless a person presents. In Wexford there is a lack of emergency response to those who present. I spoke in this Chamber last year about a 14 year old girl, a ten year old boy and a seven year old boy who presented with suicidal ideation but all of them had to wait almost two years to see a child psychiatrist. Surely there should be some kind of “break-glass-in-case-of-emergency” service for such children. The problem is compounded by a lack of a joined-up mental health and disability service. The mother of one of these kids has said her son repeatedly tells her he wants to be dead but she is still awaiting an autism assessment for her him , with no clear date as to when that will take place. She has been told her son is sixth on the list but the psychologist left before Christmas and no replacement has been found. I am not saying this is the Minister of State’s fault but there is a serious crisis in Wexford. Not enough is being done.

Acting Chairman (Deputy Eugene Murphy): I am sorry to curtail the Deputy on such a sensitive matter and I appreciate how he is speaking on it but I must move on.

Deputy Jim Daly: We are aware of those challenges. We are trying to give GPs access to consultants so they can immediately advise them. GPs will be the front line in many of these cases. To be fair, they cannot know everything that is right to do so if we can get them immediate access to a consultant in the mental health area, it would be a positive step. The Connecting for Life strategies are very important as they devolve responsibility and authority locally to joined-up thinking. The Deputy argues there is a lacking in that regard. In fairness, Wexford’s plan has been revised and relaunched. Some counties are better than others at keeping everybody in the loop, including gardaí, local authorities, health services, schools and the agencies working together. There is a challenge in tidying up the directory of services and making a more accessible single list. Access is one of the biggest challenges and people must be signposted to the most appropriate service. There are many services not being utilised that people are not aware of.

Acting Chairman (Deputy Eugene Murphy): If Members stick to the allocated times, we might get to deal with four more questions.