There is not a single family across this island that has not been affected by the challenge of mental health issues. It is now accepted that one in seven adults will experience mental health issues in any given year.
Allied to this is the issue of suicide. It is now believed that the real figures for suicide across the island of Ireland are as high as 1,000 people annually. Under-reporting of suicide has always been a problem. Often deaths resulting from road accidents and drowning are impossible to classify.
The reality is that all sections and all generations of our society are affected, from the very young to the very old, and in rural and urban areas. Self harming is also a huge issue in Irish society today. Thousands are admitted to hospitals every year as a result of self-harm which in many cases go unreported.
The impact on families and communities is huge. Most are left wondering, Why? They are left asking what they could have done to prevent the death of a loved one. The emotional trauma is enormous. In the aftermath of a suicide, especially of a young person, the potential of others also taking their own lives is high. I still remember visiting the wake homes of four young victims from the Upper Springfield area in west Belfast who had all died from suicide within days of each other.
There is no single or easy explanation for someone deciding to take their life. In my experience the reasons can be many – mental health problems, loneliness, alcohol and substance misuse, an absence of hope for the future, can all contribute to suicide.
There is also a clear and direct correlation between deprivation and suicide. In every statistical analysis that I have read areas of high unemployment and deprivation suffer greater levels of suicide. At the same time suicide is no respecter of class or age or gender.
Last month the investigative on-line news website The Detail reported that there were 318 suicides registered in the North in 2015. This was, it said, the highest annual death rate in 45 years and it means that on average 6 people every day are taking their own lives in the North each year. 93 of those who died by suicide lived within the Belfast Health Trust area. Deprived areas in the six counties suffered from suicide rates that are three times higher than the least deprived areas.
Alarmingly The Detail reported that there had been a total of 7,697 suicides (5,666 were males) from the beginning of 1970 to the end of 2015. This is more than twice the numbers of citizens killed during the decades of war.
12 years ago I was the MP for west Belfast which had, along with north Belfast the highest suicide rates in the north. In October 2004 I lead a delegation of Sinn Fein and community activists to meet with the British Direct Rule Minister Angela Smith. Families bereaved by suicide were leaders in this endeavour. Amongst the proposals we tabled was the creation of a regional suicide prevention strategy and an all-Ireland strategy.
A series of meetings followed with the Department of Health, the Children's Commissioner in the north, and with the North and West Health & Social Services Trust. Protests were also held and on one occasion I wrote to Mary Harney, the Dublin Minister for Health, requesting a meeting to discuss a suicide prevention strategy for the island. I’m still waiting a response to that letter.
The intensive lobby in the North succeeded in 2006 in securing the establishment of the ‘Protect Life’ suicide prevention strategy and action plan. Since then over £50 million has been spent on suicide prevention. Undoubtedly many lives have been saved but the recent statistics are evidence that much more needs to be done.
Suicide is also a major issue in the South. In June the Mental Health Commission published its annual report. The State's mental health policy, A Vision for Change, has been in place since 2006 and the Mental Health Commission undertook a strategic review as part of developing a new strategic plan for 2016-2018.
The commission's report illustrates how much remains to be done. This includes a need for independent monitoring of the Vision for Change policy which is now ten years old.
There are also significant issues around the lack of funding. The current level of funding for mental health is still less than the 8.24% target based on the 2005 figures envisaged in A Vision for Change. The staffing levels are about 75% of the Vision for Change recommended number.
According to the Mental Health Commission's report, there is a serious deficiency in the development and provision of recovery oriented mental health services. This concept, which is about aiding a person's recovery rather than managing the illness, is crucial. The report also states that the reason for this is the combined effect of poor manpower planning, lack of change in professional training schemes, cuts in public expenditure, delays in recruitment and a shortage of appropriately trained staff.
The most recent statistics available for suicide in the South claim say that 459 persons - 368 males and 91 females - took their own lives in 2014.
In the North a new 'Protect Life 2' strategy is expected to be issued for consultation next month with final publication of the strategy being due in 2017. To be successful it needs to reflect the experience of those bereaved families and community and voluntary groups campaigning on suicide. It also needs to be properly resourced.
12 years after the commencement of the campaign for a suicide prevention strategy for the North and ten years after A Vision for Change, the need for an all-island suicide prevention strategy is even greater than ever. Such a strategy needs to be properly funded and coordinated and bring together all of the statutory agencies, including health and education. Voluntary and community groups cannot provide this. Governments must do so.
Lifeline is the crisis response helpline service in the North for people who are experiencing distress or despair. It can be contacted confidentially on 0808 808 8000.
The Samaritans can be contacted by telephone on 116 123 or firstname.lastname@example.org
Suicide Down to Zero can be contacted on email@example.com
Pieta House Freecall 1800 247 247. Or if you can simply text HELP to 51444.
Public Initiative For The Prevention Of Suicide And Self- Harm (PIPS) is a support service for people who need intervention or for those who have survived suicide loss. It can be contacted at T 086 193 3074: W www.pipsproject.com
The H.S.E. Suicide Prevention Helpline Free Phone 1800 222 282