There is a widespread desire across the community for more to be done to tackle this tragic situation. The Health Committee has already taken evidence on this matter from families of victims and also consultant psychiatrist at the Mater Hospital, Dr Paul Miller. It is intended that the committee will now pursue further work on suicide prevention.
If we are to make a genuine difference then all of society must play its part. If we look only to mental health professionals to deal with this challenge then it will not be dealt with effectively. However, if we accept that this is a social, biological, spiritual and mental health problem then we can look to all of these areas for the solution.
There has already been important work conducted by the Suicide Task Force and local implementation plans are being pursued across the Province. It is important that all stakeholders and experts in this area are engaged.
The key element that holds together a healthy society is the family unit. Effective policies that support the family are important in the healthy development and maturation of a child, but more than that the healthy, strong family also acknowledges the role of the older individual.
From the point of view of suicide the young and the old are at risk because they feel useless and worthless with little purpose in their lives and worst of all they have no expectation that this will change. Hopelessness has been shown consistently to be a strong risk for a person completing suicide.
Suicide has been described as a permanent solution to a temporary problem. As communities we need to show people that there is help and support there when they need it and that options are always available.
Investing in community infrastructure is important. The young mother for instance, who is geographically isolated from family and cannot access affordable childcare, needs a practical solution. While these aspects of social care seem distant from the topic of suicide, they are not and we neglect them at our peril.
It is important that in a society that has been historically divided over spirituality that we do not ignore this aspect of a person's life. While we consider suicide as a problem of the mind, we cannot divorce the mind from the body. Issues that impact the body, which have a significant role in suicide include alcohol misuse and addiction to other substances. Many people impulsively take their own life while under the influence of drugs or alcohol.
The 2006 Response from the Royal College of Psychiatrists on the Five Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness concludes "that it is up to commentators outside clinical practice to give up the culture of blame". If we are to make a difference in the area of suicide then all areas of society must work together: the state, voluntary sector, clinicians and families who have lost loved ones to suicide.
Suicides are a tragedy for victims, their communities, professional staff and their families. It is important that steps are taken at all stages to improve mental health and minimise risks. There is a need for robust systems, such as a better physical environment for inpatient services, with fully trained staff in all disciplines, and joined-up working.
There is agreement amongst professionals that all hospital attendance following self-harm should lead to a specialist psychosocial assessment. This should aim to identify motives for the act and associated problems that might be amenable to intervention, such as psychological or social problems, mental disorder and alcohol or substance misuse. There are already teams being developed to work in the area of self-harm, such as that at the Mater Hospital in Belfast and lessons must be learned from the experiences of such teams.
Effective mental health promotion is essential. This was highlighted in the Bamford Review of Mental Health and Learning Disability and in particular in the report of their Mental Health Promotion Committee entitled Mental Health Improvement – A Personal, Public & Political Issue which stated: "Promoting positive mental health and the prevention of mental ill health is a priority for the entire community. Central to the success of mental health improvement and well-being is recognition at all levels that mental health is everyone's responsibility. Mental well-being underpins all aspects of health and well-being. Mental health, like physical health, is a resource to be promoted and protected. To achieve this, increased cross-sectoral, collaborative work is required among key agencies and central government departments. Partnerships between health and social services and health agencies hold particular potential."
In Scotland £24 million has been allocated over three years to establish a Mental Health Improvement and Wellbeing Directorate there. Mental health promotion should take place in a range of settings for all stages of the life cycle and at various delivery levels. It must occur in schools, primary care, the workplace, further and higher education, rural areas and communities including marginalised groups and faith communities.
Mental health promotion must be delivered and accessible at all stages of life, particularly for children and adolescents, older people and people in receipt of statutory mental health services. The school setting is an obvious opportunity for cross-sectoral working. Schools have a significant influence on behaviour, attitudes and development of young people.
Mental well-being underpins all health and well-being. It is a precious resource which must be protected and promoted. Good mental health promotion can assist in efforts to reduce loss of life from suicide.