Suicide Prevention: Londonderry

Adjournment – in the Northern Ireland Assembly at 4:15 pm on 12th May 2015.

Alert me about debates like this

Photo of Roy Beggs Roy Beggs UUP 4:15 pm, 12th May 2015

The proposer of the topic will have 15 minutes and all other Members who speak will have approximately seven minutes. As this is the first occasion that the Assembly will hear from Mr Gary Middleton, I remind the House that the convention is that a maiden speech is made without interruption.

Photo of Gary Middleton Gary Middleton DUP

Thank you, Mr Deputy Speaker. It is a great honour to give my maiden speech to the House as the new MLA for Foyle. First, I would like to take this opportunity to thank my party and constituents for their encouragement and support thus far.

Sadly, it gives me no pleasure to discuss the topic of suicide, specifically in my own constituency in Londonderry. The issue of suicide prevention is a matter of huge public importance. Every one of us in this Chamber will have known someone who has taken their own life or attempted to do so. I, of course, am no different. It is something that is close to my heart, and my sympathies go out to all those who have been bereaved through such tragic circumstances.

A 2014 University of Ulster study of 1,671 suicides and probable suicides in Northern Ireland from 2005 to 2011 showed that 77% of those who died were male and 23% female. Just half of those who died by suicide were known to have a mental health disorder. Despite high levels of contact, a considerable proportion of suicidal people appear to be undiagnosed and untreated for their mental health problems. The 2013 figures show that there were 303 registered deaths by suicide, with provisional figures for 2014 showing that there were 268 suicides. Whilst it is welcome that, in Northern Ireland overall, there has been a decline in the number of suicides, some constituencies are seeing a rise and an increase in calls to organisations that help people who have suicidal thoughts.

One death by suicide is, of course, one too many. Suicide is preventable. We all have a stake in suicide prevention. The collective efforts of Departments, local organisations, mental health practitioners and related professionals can reduce the prevalence of suicide in our communities. Evidence suggests that access to crisis support, intervention and education can have a major impact in reducing the levels of suicide and preventing it.

I wish to take this opportunity to thank all organisations that are working with individuals on their mental health and any difficulties that they may be facing in their lives. Thanks also to our health professionals for the essential service that they provide. Many in our society may never require these services; it is only when we need help ourselves that we truly realise and appreciate their importance.

In the Foyle constituency, we are all too aware of the effects of suicide. Lives are lost, families devastated and communities broken. Between January and March this year alone, two bodies were recovered from the River Foyle by Foyle Search and Rescue. They have also taken one individual out of the river alive and 13 away from the river edge and bridges, while also having 17 causes of concern. I am sure that you will all agree that these figures are deeply concerning. Thankfully, with the work of Foyle Search and Rescue, lives are being saved and interventions put in place.

Suicide cannot be fully prevented until we understand why an individual has suicidal thoughts and what the causes are. According to health professionals, most often, suicidal thoughts are the result of feeling like you cannot cope when faced with what seems to be an overwhelming life situation. Individuals face a sort of tunnel vision, where, in the middle of a crisis, suicide appears to be the only way out. Individuals need help and support. Issues such as alcohol and drug abuse, relationship breakdowns, addictions, bullying and even financial difficulties can have a serious effect on our mental health. It is worth noting that any one of us can face these types of issues during our life and find ourselves in crisis. We must work together to ensure that the necessary services and help are available for those who need it.

As Members of this legislative Assembly, I believe that it is our duty to ensure that we do all that we can to assist suicide prevention. I believe that there are a number of ways in which we can work towards that. The first is by publishing the new suicide prevention and mental health promotion strategy. I know that that is under development, and I look forward to hearing from the Health Minister where that is at.

The second is by increasing public awareness through media campaigns. We have seen the impact of those types of campaigns on road safety, and there is no doubt that they have helped to increase the public's understanding around road traffic collisions and therefore helped to reduce the number of traffic-related deaths. We should further develop those types of campaigns in the area of mental health awareness and suicide prevention. Many individual organisations, schools and youth groups have already done so and are actively promoting the importance of looking after your mental health. In my constituency, the Cathedral Youth Club in the Fountain will shortly release a DVD to raise much-needed awareness among the youth sector and to teach our young people that there is always help available no matter how difficult the situation is.

Thirdly, I believe that further safety measures are required along our river edges and bridges to support the work of organisations and, of course, to help individuals. Additional CCTV would be of significant importance, along with additional signage to help those who need assistance and to make them aware of the services that are available. When interventions are made on the river edges, one of the main concerns is what assistance is then available for the individuals affected. Many would say that there are, at times, only two choices: either the A&E department or the police station. In light of that information, I plan to further work with the Health Minister and meet him to discuss the service provision in the Londonderry area for those who find themselves in difficulty and, indeed, whether a detox facility would be feasible. I want to pay tribute to all those who have been campaigning. There is a strong campaign on the ground in my constituency to raise awareness, seek support for additional services and maintain the services that we have.

I believe that it is now time that we all work together to eradicate suicide. With this being Mental Health Awareness Week, it is timely that we are having this Adjournment debate. I hope that we can take stock from the debate and move forward together towards a brighter future for all.

Photo of Maeve McLaughlin Maeve McLaughlin Sinn Féin

Go raibh maith agat. I thank the Member for the opportunity to speak on this topic. However, it is a difficult and emotive subject for all of us but one that, nonetheless, requires the House's reflection and, indeed, action.

I want to take the opportunity to welcome and congratulate the new Health Minister on his appointment. I appreciate his attendance today and look forward to his response on this very important issue.

As the Member said, suicide is an issue that blights and has blighted our island, and almost every city and, indeed, village knows the pain of losing people through suicide. Right across the island and right across our health systems, mental health protection is considerably lower down the importance scale, and that is a challenge for our society in moving forward. The European average spend on mental health is around 12% of the budget, and there is an onus and responsibility on us to bring our budgetary lines into line with that average. It also needs to be reflected that the gap between suicide rates in deprived areas and less deprived areas can be as much as 73%. As the Member pointed out, the child poverty statistics for Foyle highlight that, in some areas, more than 60% of children are living in poverty. There is a direct correlation with some of these issues.

We should reflect on the statistics. In 2011, there were 39 deaths by suicide in the Western Trust. In 2013, there were 51. So, there is a challenge in our city and region. The Member quite rightly mentioned the University of Ulster study, which showed that 77% of all suicides that were looked at were by males and 23% were by females. There was evidence of alcohol consumption in at least 41% of the cases. That is across the Six Counties, but, nonetheless, we need to be mindful of that figure.

Another figure that was quite stark was that just over half of those who died by suicide — 50·1% — were known to have a mental health disorder. That is a direct correlation that needs to be reflected on.

When I reflect on my city, I think that, generally, although addiction is not always linked to suicide rates, it is nonetheless important for us to reflect that the nature of addiction has changed. For many generations, addiction in most cases was to either alcohol or drugs. Now it is polysubstance. Therefore, interventions, responses, rehabilitation and detoxification need to be altered accordingly.

There has been much very vocal debate, as the Member said, about the need for a detox facility for Derry. Detox, however, is only one very specialised part of treating the issue. Our city needs support for early intervention work that tackles the root causes of addiction, and it needs crisis intervention models. We collectively need to understand and target early the root causes of mental health problems and addiction, and we need to look at models of crisis intervention and at the crisis intervention services when those gaps appear.

Over the last year, Sinn Féin has established an addiction task force in the city. To date, 20 statutory, voluntary and other organisations have signed up to the urgency of that task force. The aim of the task force is very clear: to provide the evidence-based case for the city. In essence, it will examine what works — as the proposer said, a lot of services work — where the gaps are and how we can address them. That intervention is often about a crisis intervention model or what is increasingly being called a safe space model, where a young person can go with trained counsellors in a safe environment until the next intervention is agreed and not missed. That is a similar model to what is proposed through the FASA project in Belfast.

I will make this point about detox: what is ironic about the debate is that Derry has a purpose-built detoxification unit based on our doorstep. The White Oaks facility in Muff in County Donegal was purpose-built for detox in its layout, yet it is not in operation. I appeal to the new Health Minister to bring freshness and a fresh approach to the debate. I throw out an invitation to the Health Minister to visit the facility, which has been purpose-built for that function. I look forward to the Minister's response on that.

Addiction does not respect gender, class, disability, sexual orientation, religion or borders. It is vital that, as part of the debate in dealing with addiction issues, we reflect on and move towards making the facility in Donegal operational.

Photo of Roy Beggs Roy Beggs UUP

A number of additional Members have shown considerable interest, so I ask remaining Members to restrict their comments to five minutes.

Photo of Mark Durkan Mark Durkan Social Democratic and Labour Party

I begin by congratulating Mr Middleton, first, on his elevation, if you can call it that, to the Assembly but, more importantly, for bringing this extremely important and emotive subject to the Floor.

The scourge of suicide is not exclusive to our constituency. However, it is a problem that is extremely pronounced in the city of Derry. Suicide is, as I said, a massive scourge on society today. It takes lives, and it breaks lives. I can and will speak from personal experience of the devastation that a suicide brings to a family and the awful repercussions that it has across communities. Those who lose a loved one to suicide can never have full closure. In the darkness of night or even at random intervals throughout the day, you are haunted by questions to which you will never get answers. Should I have seen something? Could I have done something? Would things have been any different had I said something?

We, as legislators and leaders in our community, need to do all that we can to ensure that more lives are not lost and that more families are not left with those unanswered questions. We can do something, and we must do something. We must ensure that the groups and services working hard and working well on suicide prevention are supported and that people are made aware of them. Good work is being done by many organisations in our constituency, not least by Foyle Search and Rescue, Zest, Community Action for Locally Managing Stress (CALMS) and, of course, the Samaritans. There are many others, as well as community-based initiatives such as Sports Against Suicide, for which I recently participated in a fundraising and awareness-raising charity boxing match.

Good work is also being done by the statutory agencies. I, along with my colleague Pat Ramsey, recently met the Public Health Agency to hear about the initiatives that it hopes to bring forward aimed at reducing the harrowing suicide rates in our city. However, that work needs to be told to the public and needs to be sold to the public. Without doubt, the perception out there is that we, as a Government, are not acting and are certainly not acting fast enough to tackle this awful blight.

There is a groundswell of opinion in Derry around the need for a detox centre, and both Members who have already spoken referred to that. That debate has to take place in public, and we need the health professionals to outline and illustrate the services that exist and how they can best be availed of. We have to ensure that our agencies — our statutory agencies in particular — work in a joined-up manner. Recently in our constituency, a young man was rescued from the Foyle Bridge by the police, who just took him home. Twenty-four hours later, he was in the Foyle. There are serious gaps here that need to be filled and can be filled.

Maeve spoke about the need for increased investment in mental health, and, of course, there is a massive correlation between unemployment, economic inactivity and poor mental health. Members do not need to be reminded about the dire economic situation in our constituency. One thing that we can all do — I am not putting the onus on the Minister, as this is something that we all have to do — is work to tackle the stigma attached not just to suicide but to poor mental health. People need to be told and reminded at every opportunity that it is OK not to be OK, that it is OK to ask for help and that there are people whom they can ask to help.

I again congratulate Mr Middleton for bringing the issue to the House. I am keen to work with the Minister on it. I attend regularly the ministerial working group on suicide, and it is something that we all have to work on together across Departments, across parties and across communities.

Photo of Raymond McCartney Raymond McCartney Sinn Féin 4:30 pm, 12th May 2015

Go raibh maith agat, a LeasCheann Comhairle. I add my thanks to Gary Middleton for securing a debate on what is obviously a very important subject. To use his maiden speech in that regard is good testimony to how he sees the issue of people who take their own life, particularly in Derry and the rest of our constituency. It is good to see the Minister here. It is possibly his first engagement with the Assembly in his new role, and that highlights the need for the subject to get this type of attention.

There is absolutely no doubt that the subject of people who take their own life affects many, many people and families. As other Members have said, it is very complex, and we have to be very sensitive and take great care when we discuss it. It is hard to speak for other people, but in our daily work and daily life, we know many people who have been affected directly by it. We see how it devastates families, and Mark H Durkan spoke poignantly and movingly about his personal experiences.

To come to a forum like this and speak in that way is remarkable. I want to put that on the record.

I think that all of us this week would have received the briefing paper from the Bamford Centre at Ulster University. We know from daily life, our work, and particularly those on the Health Committee, that we are bombarded with statistics. While they help us to identify the problem, sometimes, particularly on an occasion like today, statistics may dehumanise what is a personal and human problem.

However, the paper provided an insight into the complexity of people who find themselves in a position where for them the only way out of a problem is to end their lives. When you see the breakdown in the statistics, perhaps there is a tendency for us to make assumptions. There is a complex mix of reasons why people find themselves in that position, so when we are looking for solutions or remedies, we also have to look at that complexity.

Resources will always add to our ability to combat suicide. We have heard from experts such as clinicians and people who work in statutory provision, as well as in the community and voluntary sector, that they all have a common theme, which is early intervention. All of us have a contribution to make, be it supporting clinicians, families or other initiatives to ensure that there is early intervention.

Mark H talked about a situation in Derry when a lad was rescued by the PSNI at the point of taking his own life. However, the police themselves, even in public comment, said that they had nowhere at that time to take that person. It is that type of intervention that we have to turn our attention to.

Mark H Durkan also talked about the stigma of mental health and people perhaps finding it difficult to discuss, even with family or friends. In recent times, we have seen high-profile people in sport, music or other professions talking about suffering from depression and dealing with mental health issues. That allows us all to realise that dealing with that issue is not down to the circumstances that you find yourself in. Depression pervades the lives of many people. Dealing with the stigma does not take much resource, but it can have a great impact.

Photo of Ross Hussey Ross Hussey UUP

I, too, welcome Mr Middleton to the House and thank him for bringing this subject to the Floor.

Like Mr Durkan's, my family has experienced suicide. That word on its own puts a shiver down your spine. I welcome the Health Minister here today and wish him well in his new role.

Is suicide preventable? In some cases, the answer is no, and we have to accept that. Yes, we want a suicide prevention strategy, but we have looked at that over the years. I have quite a few documents here. I will not read them all, Mr Deputy Speaker, as you have given me only five minutes, but I will do my best to get through as many as I can.

Is it a mental health disorder? Is it identifiable? Can you point at somebody and say, "Well, that person may or may not commit suicide"? You simply cannot do it. I have spoken to people who attempted suicide, and they will tell you that at the point when they make their mind up to commit suicide, everything in their world is rosy. They have dealt with all the issues in their head. Therefore, they have tidied everything away, and suicide is the option; they are gone. Of course, for those who are left behind, it is a horrible experience. My mother, who recently passed away, took the concern she had over my brother's death to her grave. What if she had done something else? My mother could not have stopped it. Nobody could have stopped it; but that stays with the family.

What are the causes? If we knew all the causes, we would know all the answers. Certainly, bullying is one of them. There are also legal highs, alcohol, depression, debt, marriage breakdown and work-related issues. We will see that more and more as post-traumatic stress disorder (PTSD) sets in to members of the security forces, for example, or perhaps to those who were involved in various actions over the years. People then have time to reflect, and some of their actions or some of the things they have seen come back to haunt them.

Sexuality is another one of the points that can cause someone to decide to commit suicide. I had a look at the Rainbow Project, which is based in Londonderry and in Belfast, because I decided when I was going to research this that I was going to look up as many documents as I could. It has a very interesting document by Malachai O’Hara called 'Through Our Minds: Exploring the Emotional Health and Well Being of Lesbian, Gay, Bisexual and Transgender People in Northern Ireland'. It states:

"The policy context in Northern Ireland relates to the historic Mental Health Promotion Strategy 2003-2008 and the current refreshed version of the Suicide Prevention Strategy – Protect Life, which ran from 2006-2011 and has been refreshed from 2012-2014."

Therefore, we have the various strategies. There is the shOUT report, 'The Needs of Young People in Northern Ireland who Identify as Lesbian, Gay, Bisexual and/or Transgender'. It says that they are at least three times more likely to commit suicide or to attempt suicide, two and a half times more likely to self-harm, five times more likely to suffer from depression and 20 times more likely to suffer from an eating disorder than their heterosexual counterparts. Northern Ireland Statistics and Research Agency (NISRA) figures show that, in 2013, 14,968 deaths were registered in Northern Ireland and that, of these, 303 were suicides, the second-highest number on record in Northern Ireland.

I looked at some of the debates that have taken place in the Chamber. In one, it was mentioned that each year around 300 people commit suicide in Northern Ireland, with the figure increasing every year since 2006. Some 72 teens and young men took their own lives in Northern Ireland in 2011, while 165 died by suicide in the Republic. A report by the Samaritans shows that the age range starts at 10 to 14 and that the majority of the people who commit suicide are between 16 and 40. We know all these facts and figures, but that does not bring us to a resolution.

Mental health issues have been raised, and people will say that suicide is caused by a mental health disorder. That is perhaps the case at the point when they commit suicide, but, up to that point, it is invisible and will not be seen. Again, I thank Mr Middleton for bringing this to the House this afternoon, and I thank the Minister for his attendance.

Photo of Trevor Clarke Trevor Clarke DUP

I join others in thanking Gary Middleton for using this opportunity for his Adjournment topic, and I think that it is fitting, given the topic, that so many Members are present.

This is not necessarily a constituency-based concern; indeed, it is a concern across the Province. I did not want to say this, but I have to say that I am glad that it was a young man who proposed the topic, because the tone of the Chairperson of the Health Committee disappointed me. Two other contributions, by Mark Durkan and Raymond McCartney, talked about stigmatising people. Much of the contribution of the Chairperson of the Health Committee was about drug and alcohol abuse and addictions.

I suffered from depression about 26 or 27 years ago. I was neither an alcoholic nor a drug addict, but I went for help and sought the help that was required. For me, this typifies some people's attitudes towards suicide, and labelling and stigmatising those who suffer from depression and people who are on the brink of taking their own lives.

I wanted to speak today because, when I looked at social media this week, I learned that a young girl in my constituency had committed suicide. I do not believe that she had alcohol or drug problems. She was a young girl, I am sure, who was living with the pressures of life. I have to say that her family were very brave. They said to the minister, "Give a sermon that will help people understand exactly what the family and friends are going through, so as to try to prevent other young people doing the same". What worried me today when listening to the Chairperson was that we are stigmatising. The sooner we can get away from that, the better.

I would never look at it from the point, as Ross said, that, if someone is on the point of suicide, there is nothing you can do and they have got their things in order; I do not think we should ever stop trying. We should never stop trying, because one death is one too many. Gary referred to his constituency, but this is right across the Province. In my constituency, it was just one after another last year, all of them young people. I definitely would not stigmatise them. They are all going through the pressures of life. You can talk about statistics and you can talk about reports, but what we need to do is try to reach out to these people and not write them off.

Photo of Trevor Clarke Trevor Clarke DUP

I will give one way in one minute.

We should encourage them to go to each and every agency. If they have not got help from one agency, they should go to another. After one of the deaths in my constituency last year, the young people themselves organised all the aspects from the health agencies, and all the different organisations were there. Some made the criticism that they were difficult to get. We all have a job to do and a role to play. The more we can do to encourage people to seek those organisations out, the better. We should never write them off. I give way now.

Photo of Mark Durkan Mark Durkan Social Democratic and Labour Party

I thank the Member for giving way. He mentioned social media and, more latterly, a spate of suicides involving young people. Quite a few years ago, a lot of work was done on media guidelines and how suicide had been reported in the Derry area. My concern was that there had almost been a deification of young people, in particular, who had taken their own life. The media have tightened up on that, but would the Member share my concern about the understandable outpouring of grief from other young people through the medium of social media, be it on Facebook or Twitter? Some young people who might never have had a nice thing said to them or about them see lots of nice things being said about a contemporary and think, "Maybe if I died, people would say nice things about me".

Photo of Roy Beggs Roy Beggs UUP

The Member has an extra minute.

Photo of Trevor Clarke Trevor Clarke DUP

I accept what the Member says. There is a danger with that. Of course, social media can also be used as a form of bullying.

I am trying to be positive and focus on the outcome. Where we get that message, we need to encourage people to be positive. We need to remind people that taking their life will not help those who are left behind. I did not know the individual I read about last week, but I was led to read her story about how the family bravely went to the clergyman and encouraged him to tell the story as it is to the young people it affects. Yes, they may have fixed their problem, but they have increased the problem coming behind them tenfold. They have brothers and sisters, a mother and a father and a wider circle.

Photo of Maeve McLaughlin Maeve McLaughlin Sinn Féin

Go raibh maith agat. I thank the Member for giving way, but I question his analysis of what I said. Those were Ulster University figures, and they were used to reflect the fact that only 41% of the cases looked at involved alcohol consumption. I make that point. The issue about addiction was raised in the context of the case made by the Member who introduced the topic about detoxification for Derry. The very point that was made was that detox is only part of a solution, and, if the Member reflects on my comments, he will find that they were very clear about early intervention and crisis.

Photo of Trevor Clarke Trevor Clarke DUP

I appreciate your clarification. Your party colleague hit it on the head much better. My concern was that your contribution was more about alcohol. I appreciate and accept your clarification that it is not only about alcohol or drugs. There are many aspects.

Really, what is key for me in all of this is the need to prevent any stigmatising of this illness. We need to assist people, give them direction and support them wherever we can and encourage our young people. For me, Gary Middleton as a young man should be seen as a peer for young people and someone to look to for securing this debate. It was very courageous of him to do so in his first contribution here today.

Photo of Gregory Campbell Gregory Campbell Shadow DUP Spokesperson (International Development), Shadow DUP Spokesperson (Cabinet Office)

I, too, pay tribute to my colleague Gary Middleton for his maiden speech. It is an exceptionally important but exceptionally difficult topic on which to make a maiden speech.

I wish to say a couple of things. Very often in the Chamber, we engage in very important topics that divide. The divide is sometimes subtle, sometimes very stark. This is a non-divisive issue that transcends communities and crosses all sorts of boundaries and communities.

Down through the years and in recent times, I have had to go to a family home after a young man or young woman — pre-eminently, it is young males — has taken his or her life. Inevitably, the conversation in the wake house, as we call it, turns, usually at the instigation of the family, to the fact that they saw nothing, detected nothing and saw no change in behaviour. They saw nothing that could have given them an early alert that something was wrong. They just did not see coming what hit them in the early hours of the morning or at whatever time they were told of the passing of their son. It seems to me that, as a society, we need to reflect on that and do whatever we can.

Hopefully, the Minister will refer to the suicide prevention strategy. We all need to understand that those facing suicide are in an exceptionally dark place and feel that there is no way out. We have heard discussions about what might be the root of the problem, but the main issue is that, whatever the problem, they feel that there is no solution. That is usually, but not always, why they end up taking their life. They need to know that, whatever their problem, somebody will be there to help them — whatever it is, there will be someone there to help them.

I will conclude with this, as I do not want to delay the proceedings. I came across the issue at first hand, as many of us have. I was not as close to it as, for example, Mr Durkan; I know that he has personal experience. Many of us have had second-hand experience. I had direct experience about two years ago when, out for an evening stroll along the Peace Bridge in Londonderry, a young man, before my eyes, tried to take his life by going into the river. I saw the excellent work that Foyle Search and Rescue did in coming to his aid and bringing him out, but I also saw the trauma felt by all of us who were doing whatever little we could do to help as we saw the drama unfold: someone trying to take their life. As they struggled in the water, there was nothing any of us could do because there was such a distance and height between us and the person in the river. Then the boat came to his rescue. Only when that happens to you do you begin to see the extent of the trauma that there would have been had that suicide attempt been successful. It has been replicated on hundreds of occasions.

I feel that this has been a worthwhile debate and hope that the Minister will respond positively. I hope and pray that we all, as a wider community, offer the prospect of hope and help to all those afflicted by the potential of suicide.

Photo of George Robinson George Robinson DUP

As a member of the Health Committee, I congratulate Gary on securing this debate on a very emotive and important issue and on his very commendable maiden speech. I express my heartfelt sympathy to all families who have been affected and left behind by a loved one whose death was in the most tragic circumstances.

In the debate, we must all be mindful of those relatives.

I recently saw figures that showed that two bodies were taken from the River Foyle this year. There were numerous operations by Foyle Search and Rescue and its colleagues in Bann Rescue, which saved the lives of other individuals. I express my sincere thanks to those in Foyle Search and Rescue for the difficult and dignified work that they carry out so efficiently and professionally.

The Northern Ireland Statistics and Research Agency figures make grim reading. One figure shows that, in 2013, there were 303 suicides in Northern Ireland, with 115 in the western part of Northern Ireland, including my home town of Limavady. In 2013, there were 56 road deaths, but the resources targeted at minimising the road death figures are wisely spent and value for money, as proven by the fact that, in 2000, there were 171 road deaths. That proves that adequate resources made available to prevention and education campaigns can have a positive effect on highly specific areas of difficulty. Can we find similar resources to help to address the appalling figure of people taking their own lives? That would benefit all of Northern Ireland, not just Londonderry.

I also believe that we may be able to utilise voluntary organisations to help on the ground with a local approach to suicide prevention. Indeed, we should employ every possible resource to tackle that growing problem. Remember that behind every tragedy is a human story and a human being. It is the ongoing effects of tragedy that make me realise how important it is that we address suicide. The distress for everyone begins with someone's decision to end their life, so that has to be the starting point. For me, prevention is better than seeing lives lost and families forever changed by an event that we may be able to avoid.

In my constituency of East Londonderry, suicides have increased and, as in Londonderry, there are river bridges. Perhaps we should take note of places that are used for this purpose and in some way provide a monitoring service at those locations — CCTV, perhaps, if none is already there.

The reasons why people end their lives are sometimes told by a note, or the reason may be apparent. If trends can be found as to what leads individuals to end their life, we must try to ensure that preventative help is available at all costs.

The entire topic of suicide has no easy answer, as individuals appear not to discuss their feelings with families or friends. Could organisations be available to step in? The organisation that comes to mind is Samaritans, whose work has saved many lives over many years. It should be congratulated on its specialised and traumatic work.

In conclusion, I repeat my thanks to the voluntary organisations and their staff, who do excellent and difficult work. I also appeal to anyone who has suicidal tendencies to come forward and speak to someone — maybe a relative, an organisation, a doctor or a social worker — who, hopefully, can help the individual.

Photo of Simon Hamilton Simon Hamilton DUP

I begin by joining colleagues on all sides in congratulating Mr Middleton on bringing this difficult but important subject to the Floor. I consider it an honour, in my first business as Minister of Health in the House, to be able to respond to Gary's maiden speech. I look forward to many similarly good contributions from Mr Middleton down through the years.

As was made very clear through contributions from all sides, suicide is a major concern not just for the people of Londonderry but for society right across Northern Ireland. Unfortunately, we have around 280 deaths each year as a result of suicide. Academic research estimates that, for every suicide, there are at least six members of the close family who are deeply affected and up to 60 other people who know the deceased and are touched by the death. That indicates that, over the past 10 years alone, some 17,000 people in Northern Ireland have been profoundly affected by suicide, and at least 10% of our population know someone well who has died by suicide. Sometimes it is perhaps easy just to talk about figures and statistics like that.

I have to pay particular tribute to the contribution by Mr Durkan, who has an all too real personal experience of this. I think that we are all very grateful for the very difficult contribution that I am sure it was for him to make to the House on this subject. Indeed, others highlighted their own experiences as well. We do not have to go too far. Sometimes I think that people look at us up at Stormont here and think that we do not have the experiences that the wider world would have. I think that Mr Durkan's experience and the experiences that were highlighted by Mr Hussey, Mr Campbell and others show that we do understand, we do know and we do see it in our own lives and communities.

Suicide is a burden which impacts unequally, given the fact that the suicide rate in the most deprived areas is almost twice the Northern Ireland average and three times that of the least deprived areas. The link with deprivation is well known and may go part of the way to explaining why Londonderry, together with north, west and east Belfast, experiences higher suicide rates than the rest of Northern Ireland. Emerging evidence also indicates a link between the legacy of decades of violence in Northern Ireland and high levels of suicidal behaviour here. Those areas that experienced the worst of the Troubles tend to correlate now with the areas that have high suicide rates.

I should add that there is also a gender aspect to this — again, an issue that was highlighted by many Members. Men are three times more likely to die by suicide than women. Indeed, the majority of people who die by suicide are not known to mental health services. We all know that men are reluctant to seek help, and one of the biggest challenges that we face is encouraging men who are experiencing emotional or mental problems to seek appropriate help.

Provisional figures for 2014 show an 11% reduction in suicides in Northern Ireland. Whilst this is encouraging, taken with the fact that suicide rates did not rise here over the recent recession, and may be an indication that our prevention efforts have had some success, we need to be cautious as rates can fluctuate from year to year and, clearly, the number of deaths remains much too high.

Suicide is a hugely complex issue, as Members have discussed at length. The factors that lead someone to attempt suicide are likely to have their roots in a chain of events and experiences that have begun years previously, which are themselves shaped by broader socioeconomic influences. Suicide is the result of highly complex interactions amongst various risk factors and protective influences which vary from one individual to another. The key to reducing suicide in our society is to minimise the risk factors and maximise the protective factors. This means addressing issues such as poverty, unemployment, substance misuse, family breakdown, violence, bullying and mental health stigma. It also requires building greater social connectedness, improving educational outcomes, promoting tolerance and enhancing mental health from the very early years.

Clearly, this goes way beyond the health sector. Indeed, there is a wide range of activity ongoing across Departments to address these issues. This activity is reported and updated at the regular meetings of the ministerial coordination group on suicide prevention, which Mr Durkan referenced. Suicide prevention is now on the radar of practically every Department in Northern Ireland, and it is essential that this approach continues to be strengthened.

The overriding aim is to improve the social circumstances and emotional resilience of potentially vulnerable individuals, thereby equipping them to deal with adverse life events in ways which are not self-destructive. There is also a broad range of programmes in place under the Protect Life strategy to tackle suicide and self-harm. Training is provided for GPs and those who are likely to come into contact with people who are vulnerable to suicidal behaviour. The aim is to identify those who are at risk at an early stage and ensure that they receive the help that is necessary to overcome their difficulties. This help can be provided by mental health services, addiction teams, primary care or the community and voluntary sector, according to the individual's needs.

The reduction of stigma remains a critical part of our strategy. People who have suffered from poor mental health often cite the associated stigma as one of the main barriers to recovery. We therefore work with the media to encourage responsible reporting of suicide and mental health. There is no doubt that inappropriate reporting can contribute to the general sense of hopelessness that is felt by vulnerable people. Media guidelines are in place to prevent this, although we still struggle to get it across to many people in the public eye that the term "commit suicide" is itself inappropriate and hurtful to bereaved families. I will use this opportunity to highlight that the more sensitive term "die by suicide" is preferable when discussing this topic.

We also take steps to make mental health services as safe as possible through learning from adverse incident reporting and implementing the recommendations from the National Confidential Inquiry into Suicide and Homicide. Timely, comprehensive and accurate data on suicide and self-harm is essential to identify trends and inform the development and delivery of prevention services. The self-harm registry is in place at every hospital emergency department in Northern Ireland. The registry provides valuable information on all aspects of self-harm and that information has been used to improve the response to patients who self-harm.

A sudden death notification process, which was developed by the police and the health sector, is now in place. This unique system provides early notification of suspected suicides, with the aim of providing bereaved families with immediate access to information and support. The sudden death notification process is being tested in the rest of the UK, with a view to making it a national surveillance mechanism. The process was developed out of early work between health care and the PSNI in Londonderry that was designed to provide a multi-agency response to suicide clusters in order to prevent further deaths. This multi-agency approach has broadened and there are now suicide cluster community response plans in every trust area in Northern Ireland. The latest activation of a community response plan in the Londonderry area was in March in response to a number of deaths on the river.

It is important that we turn specifically to Londonderry, and there is a clear need to address the reputation that the River Foyle is attracting as a suicide location. Previous investigations into technical options to improve safety at the Foyle Bridge proved inconclusive. However, the Public Health Agency has been working with partners to consider how technology, culture, arts, recreation and innovation could be used to change local people's perception of the river and its bridges to encourage a more positive interaction. I am pleased that a very innovative bid has been made to the UK Technology Strategic Investment Board for a £2 million grant to implement the first phase of a project drawing on experience from work on a bridge in South Korea, which, unfortunately, had prevalence for suicide. We await the outcome of that bid, and I am hopeful that it will be successful.

We remain aware of the high level of need within the Londonderry area. For example, Lifeline has responded to crisis calls from some 1,300 people from the area in the past three years alone, over half of whom were referred to crisis counselling. Recent statistics from the self-harm registry have also shown particularly high rates of hospital treated self-harm in the Derry area.

To address that need, almost £5 million has been invested in mental health promotion and suicide prevention initiatives in the Western Trust over the last five years. The majority of those programmes have been available to residents in Londonderry and the wider trust area, rather than being focused on one particular setting. That has included the SHINE community-based self-harm project, which has informed the commissioning of self-harm prevention across Northern Ireland. Planned investment for 2015-16 comes to almost £600,000, although budgets have yet to be confirmed. Other local developments have included the establishment of a liaison and support service for families who have been bereaved by suicide and the state-of-the-art crisis treatment centre Grangewood, which was opened in 2012.

The Public Health Agency has invested over £200,000 on direct initiatives to address the issue of suicides at the River Foyle. This has included substantial investment in Foyle Search and Rescue to support its work on suicide prevention, as well as rescue and recovery. The fact that Foyle Search and Rescue has stopped over 2,500 potential suicides and rescued over 300 people directly from the water is a credit to that charity and I join with other Members in paying tribute to it.

Looking ahead, a new initiative has been established to bring the 2019 International Association of Suicide Prevention biennial conference to Londonderry. My predecessor and the First Minister and deputy First Minister have supported that. The issue of a detox centre was raised by many Members. I do not have time to go into as much detail as I would like to, but it is certainly an issue that I want to familiarise myself with, along with some of the issues and opportunities that the Chair of the Health Committee mentioned.

I would argue that it is not possible to treat suicide in the way that we treat an illness. Suicide is a behaviour; it is not a condition. However, it is not an inevitable behaviour. We in the health sector can treat some of the underlying risk factors, such as depression, addiction, and intoxication. Others can help address the wider societal risk factors. Only by acknowledging that and working across government and in partnership with other sectors will we defeat suicide.

Adjourned at 5.09 pm.