| | | | | Special Report: Still waiting for answers on suicide | Irish Medical Times: Ian McGuinness (ian.mcguinness@imt.ie)
| | | Irish Medical Times reports from an Oireactas meeting on suicide prevention and finds that answers are still not forthcoming on the progress of implementing the Reach Out report.
There are just no answers to suicide. Or so it would seem. When the Director of the National Office of Suicide Prevention was asked to outline what progress has been made on 29 phase-one actions that were recommended in the 2005 document Reach Out, he simply declined.
The document, Reach Out — Irish National Strategy for Suicide Prevention 2005-2014, was published in 2005, which was the same year that the Office was established.
Mr Geoff Day, Director of the Office, was among a number of speakers who appeared before a recent meeting of the Sub-Committee on the High Level of Suicide in Ireland. That body is a sub-committee of the Oireachtas Joint Committee on Health and Children.
Dr Siobhán Barry, a consultant psychiatrist and Clinical Director of the Cluain Mhuire Service in south Dublin, also appeared before the sub-committee. She previously acted as a consultant to that sub-committee during the preparation of a report on high suicide rates.
Phase one actions
At the latest meeting of the sub-committee, however, Dr Barry stated: “It would be helpful to the committee if the 29 areas earmarked for ‘phase-one actions’ in the document were commented upon by Mr Day today. Actions were indicated in September 2005 and it was anticipated that they would be taken and completed within a short timeframe. It would be helpful to the sub-committee to investigate whether these were delivered or if obstacles had arisen. It would also be helpful if we knew on an annual basis the budget of the NOSP.”
Statutory obligation
Answering her requests, Mr Day told the sub-committee: “It would not be right for me at this stage to go through the 29 actions referred to by Dr Barry. They are covered every year in our annual report. As I understand it, it is the only part of the HSE which has a statutory obligation to produce a report for the Houses of the Oireachtas. The report examines the action areas identified in Reach Out. We will do so in our report to be issued on 10 September.”
However, Dr Barry returned to the issue of the Reach Out recommendations, the majority of which were to be delivered in phase two with just 10 more to be delivered in phase three.
She explained: “Certain phase-one actions were to be completed within approximately three years and we are now very close to the three-year mark. There are a total of 29 recommendations for action. While people often think ticking boxes is not a very worthy exercise, it is often a very good way of ensuring one is on course. There is no way that Reach Out can be implemented to its phase-two level, which will require partnerships with other organisations, if phase one has not been completed. Phase two has 57 recommendations.”
Off the Rails
The consultant psychiatrist added: “There has been a certain amount of discussion about reviewing the work of the National Office for Suicide Prevention which was to be commissioned in late 2007. It is now 2008 so we are already off the rails in this regard. It begins to worry me when things start getting delayed within such a short timeframe.” Earlier Mr Day said: “A review of the work of the Office and Reach Out would best be undertaken by somebody outside the Office — either by an independent academic organisation or another appropriate body.”
The 29 areas that Dr Barry referred to were wide-ranging and required co-operation with many other organisations. The organisations with which the Office was meant to co-operate on these 29 phase-one recommendations included: Mental Health Ireland, various voluntary and community groups, religious bodies, the Irish Association of Suicidology, the Samaritans, other sections of the Health Service Executive, the National Union of Journalists, the Irish Film Board, Schizophrenia Ireland, the Alliance for Mental Health, the Department of Health, the Irish College of General Practitioners, Gardaí, GP out-of-hours services, bereavement support groups, the National Suicide Research Foundation, the Mental Health Commission, the National Council for Ageing and Older People, the Coroner Service, the Coroners’ Society of Ireland and the Data Protection Commissioner.
Anti-stigma campaign
As indicated from this extensive list of organisations, the Office was to work on a wide variety of issues within the 29 recommendations in phase one, relating to suicide and deliberate self-harm. These included: training in mental health promotion and suicide prevention, matters relating to the media, an anti-stigma campaign, standardising and improving support and information for patients and their families, fast-track referral of patients from primary to community psychiatric care, improvements in casualty departments, awareness programmes, various protocols, and the exchange of health data.
When he was speaking at the Oireachtas Committee, Mr Day said that improvements were made in relation to patients who presented at casualty departments because they harmed themselves. In addition, he said a mental health awareness campaign was established throughout Ireland; almost 8,000 professionals will receive applied suicide intervention skills training; and two pilot projects for fast track referrals from general practices were established.
Explain how this was done
Irish Medical Times asked the HSE, under whom the Office operates, to explain which of the 29 first phase recommendations have been implemented and how this was done. The HSE was also asked what obstacles prevented any of these recommendations from being implemented.
However, IMT received no response by the time it was going to press, so it looks like the answers to those questions will have to wait be answered in the Office’s annual report on 10 September.
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