We have travelled far, but there is still a long way to go in suicide prevention
Fully-supported services for those suffering from mental health difficulties must be a priority, writes Dan Neville
On July 1, 1993 - 25 years ago today - President Mary Robinson signed into law a bill to decriminalise suicide and attempted suicide.
Official deaths by suicide in 1992 were 311. The figure for 2017 was 392 deaths. 1993 was a different time in Irish society when suicide was the 'silent taboo'.
As a member of Seanad Eireann at that time, I introduced a motion that the Government allow a debate on decriminalising suicide. The debate was not granted. It would be unheard of at that time that suicide would be discussed in any public form.
From June 1991 to March 1993, I introduced three private member's bills to decriminalise suicide. The first, in November 1991, was defeated at second stage debate, the second fell with the dissolution of the Dail in November 1992. The Oireachtas passed into law an act to decriminalise suicide on June 9, 1993.
This was one of the first steps in Irish society recognising that suicide and mental ill-health are serious public health issues. It was the beginning of the long road to remove stigma from suicide, self-harm and mental illness, a journey that continues.
This opening-up of the discussion on suicide prevention led to the formation of non-government organisations to raise understanding of the complexity of mental illness and suicide.
In 1995, the late Dr Michael Kelleher, a consultant psychiatrist, established the National Suicide Research Foundation. In 1996, I, Dr Kelleher and another eminent psychiatrist, Dr John Connolly, formed the Irish Association of Suicidology to provide singular, authoritative, topical, safe, locally contextualised information and advice to all involved in the prevention and containment of the harm arising from suicide and self-harm.
There are now in excess of 250 NGOs involved in suicide prevention. These organisations and community groups make an invaluable contribution to reducing suicide in Ireland. These range from national to local community organisations which are often set up as a result of a local tragedy.
In 2013 the Irish Association of Suicidology proposed an accreditation process for voluntary groups in the field of suicide prevention. The University of Ulster was engaged to complete a report with proposals, which was presented to the National Office of Suicide Prevention of the HSE and adopted. This process would allow for advising and evaluating the operation of groups to establish best practice in conducting their valuable work. This has not been implemented by the HSE.
Society has moved significantly in the understanding of suicide. The media, silent before decriminalisation, is playing a very positive role in providing information and discussion in the area of mental and emotional issues.
This, and the role of prominent people, including sport stars, is of enormous help in reducing the stigma which prevents those suffering from mental ill-health from seeking help.
This is important as the silence around the experiences of mental illness inhibits the removal of stigma, which acts as a barrier to people seeking help. Many people still hold negative attitudes towards people with mental health problems. They do not understand the suffering and illness involved and rely on myths and misconceptions.
The bereaved of suicide face unique challenges different from other deaths. In addition to the inevitable grief and disbelief, also present are guilt, confusion, rejection and anger.
These feelings are normal in the circumstances. There are excellent suicide bereavement supports which are of great assistance to those travelling that sad and tragic journey.
Those who die by suicide do not want to die, but they just cannot bear to live in the terrible pain that their illness is causing them. It is important that people hear this message. Their life becomes too painful. Society and the services must move to a place where those in such a terrible place seek available assistance.
Suicide prevention and fully supported services for those suffering from mental difficulties must be a priority.
Early psychiatric and psychological intervention will yield 90pc cure. Late intervention may lead to difficulties for life.
It is not acceptable that any person, especially the young, has to wait for months or years to obtain treatment. Apart from limiting the suffering and distress of the people and their families which cannot be over emphasised, there are also economic reasons for doing so.
Connecting for Life is the national strategy to reduce suicide in Ireland over the period 2015-2020. It sets out the national vision, strategic goals, actions and outcomes required to be taken to prevent suicide and self-harm in Ireland over a five-year period.
Discussions around suicide is important. It should be done in a way that informs. It is important that such discussion does not 'normalise' the taking of one's life.
We must never forget that suicide is a terrible act against nature, causes extreme trauma to the bereaved family, friends and community and must not be considered as a solution to any problem in any circumstances.
Dan Neville is president of the Irish Association of Suicidology and former TD for Limerick and chairman of the Fine Gael parliamentary party