Connecting for Life
Donegal
Suicide
Prevention
Plan
Preventing
SuicideAction
Together
2017 - 2020
Action PlAn 2015 - 2020
Connecting for Life Mid West 2017 - 2020
Are you, or someone you
know, in crisis now and need
someone to talk to?
If you are worried about yourself or someone you know it is important to get help
as soon as possible. Please do not be alone. Everyone needs help from time to time
and in fact, asking for help is a sign of personal strength. Do one of the following;
• Contact your local GP. If it’s late in the evening or night-time, contact
ShannonDoc at 1850 212 999
• Go to the Emergency Department, University Hospital Limerick
061-301 111
• Contact emergency services by calling 999 or 112
• Call the Samaritans on 116 123, a FREE 24 hour listening service;
you can talk to someone now about what’s on your mind.
2
Connecting
Connecting for Life
Life Mid
MidWest
West2017
2017- -2020
2020
TABLE OF CONTENTS
Foreword4
Acknowledgements5
Introduction6
SECTION 1: Context for Suicide Prevention in Ireland and the Mid West
8
SECTION 2: How Connecting for Life Mid West was Developed
21
SECTION 3: Priority Groups, Risk and Protective Factors
27
SECTION 4: Connecting for Life Strategic Goals, Objectives and Actions
32
SECTION 5: Implementation of Connecting for Life Mid West71
Appendices
74
References
82
FIGURES AND TABLES
Figure1: Suicide rate per 100,000 by gender, 2001-2015*
Table 1: 3-year moving average rate of suicide per 100,000 population
by county of residence of deceased Table 2: Number of Residents and Rate per 100,000 of the Population in
2015 National Self-Harm Registry, Ireland
10
11
12
Table 3: Presentations by Age and Gender in the Mid West associated
with Self-harm in 2015
12
Table 4: 2011 Population
13
Table 5: Education, Unemployment, Lone Parents &
Local Authority Rented Housing
14
Table 6: Student Numbers Third Level Institutions - 2016
14
Table 7: Findings of the Literature Reviews carried out for Connecting for Life
18
Table 8: Findings of the Literature Reviews carried out for Connecting for
Life Mid West
19
Table 9: Individual, Socio-cultural and Situational Risk Factors
29
3
Connecting for Life Mid West 2017 - 2020
FOREWORD
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. However, to ensure that actions and
outcomes are relevant to each area, a local area action plan was developed in the Mid West to enable
implementation of the Connecting for Life in the Mid West area.
Recognising that every death by suicide is a tragedy for family, friends, workplaces and communities
the development of the Mid West plan involved the engagement of a broad range of statutory, non
statutory, community and voluntary groups in identifying agreed strategic priorities, and setting
clear goals and actions relevant to the national goals identified in Connecting for Life. This was
done following extensive consultation with members of the general public and the approach used
has ensured that we have a strong grouping of people and agencies committed to and willing to
implement Connecting for Life Mid West.
While the HSE will lead on implementation of the Mid West plan, it is a shared responsibility and this
is recognised by all those involved.
I would like to extend thanks to everybody who contributed to the development of the plan so far but
particularly all those who worked on and participated in the extensive engagement process which
took place throughout May 2016.
Bernard Gloster
Chief Officer, HSE Mid West Community Healthcare
A word from Gerry Raleigh, the Director of the National Office for Suicide
Prevention
Connecting for Life sets a minimum target of a 10% reduction in the suicide rate in Ireland by 2020. The
achievement of this challenging target will rely upon an all of government, all of society approach.
The key challenge of translating national policy into local implementation in a consistent, effective
and efficient manner is acknowledged.
Connecting for Life Mid West connects all key partners from the statutory, Non-Governmental
Organisations (NGO’s) and the community and voluntary sectors. It has taken the national goals and
objectives and, taking on board the views of the people in the counties of Limerick, Clare and North
Tipperary – the Mid West, agreed a detailed local action plan. It is important that we continually
monitor and learn from the implementation of Connecting for Life Mid West. There is a focus on
outcomes and measuring improvement relating to the targets set for each action, which will be
developed in detail as the plan is implemented. This is important not alone for the communities in
the Mid West, but also so that improved learning and understanding can be shared nationally and
internationally. It is only by connecting and pooling our expertise, resources and energy and by
working together in a spirit of real cooperation, that we can achieve our goals together.
Gerry Raleigh
Director, National Office for Suicide Prevention
4
Connecting for Life Mid West 2017 - 2020
ACKNOWLEDGEMENTS
The development of Connecting for Life Mid West was a truly collaborative and inclusive process
involving a wide ranging group of people and representatives from the statutory and non-statutory,
community and voluntary organisations working in the area of suicide prevention in the Mid West.
This is evidenced in the membership of the Steering Group and the two sub groups set up by it
(Appendix A). The energy and enthusiasm of all those involved in these groups was always to the
forefront. Thank you for your input and commitment.
Particular thanks are due to the two Resource Officers for Suicide Prevention in the HSE Mid West,
Ms Mary Kennedy and Ms Ciara Dempsey. They deserve particular mention as they both worked
diligently and played a central role in the development, co-ordination and finalisation of this local
action plan which it is hoped will help in the reduction in the incidence of suicide in the Mid West
over the coming years.
Thank you to the staff of HSE Mental Health Division and NOSP in supporting and guiding us.
Thank you to the general public for responding to the survey in such large numbers. Most especially,
thanks are due to the people representing the priority groups and the bereaved families who
contributed in a very open way to the public consultation process which was undertaken throughout
the Mid West in May 2016. You shared painful experiences and insightful reflections on the impact of
suicide and the services and interventions that are needed to ensure that we are responsive to those
in need. Your inputs were invaluable and enhanced our work.
Teresa Bulfin
Senior Manager, HSE Mid West Community Healthcare
Chairperson of the Suicide Prevention Steering Group
5
Connecting for Life Mid West 2017 - 2020
INTRODUCTION
Every death by suicide is a tragedy for family, friends, workplaces and communities. As a result the
prevention of suicide is a shared concern for individuals, communities and organisations throughout
Ireland and in the Mid West, that requires a collective response. Connecting for Life is the national
strategy to reduce suicide in Ireland over the period 2015 – 2020 (1). It sets out the national vision,
strategic goals, actions and outcomes required that will be taken to prevent suicide and self-harm in
Ireland over the five year period.
Implementation of Connecting for Life will depend on the effective delivery of a broad range of health
and social policies and strategies including:
•
A Vision for Change: Report of the Expert Group on Mental Health Policy 2006 (2)
•
Better Outcomes, Brighter Futures: the National Policy Framework for Children and Young People
2014-2020 (3)
•
Healthy Ireland – A Framework for Improved Health and Wellbeing 2013-2025 (4)
•
The National Drugs Strategy 2009-2016, Report of the National Substance Misuse Strategy Steering
Group (5) and the Health Service Executive (HSE) National Drugs Rehabilitation Framework (6)
There are many other strategies and policies that have a role in reducing the risk of and preventing
suicide. This suicide prevention action plan is the local response to enable implementation of
Connecting for Life in the Mid West. Connecting for Life Mid West will be implemented from 2017
to 2020, over a 4 year period. Connecting for Life and Connecting for Life Mid West are grounded in
an approach that recognises the benefits of having a collective response involving multi-agency,
voluntary and statutory organisations and communities working together.
It is important that people feel confident and competent talking about mental health, self-harm,
suicide prevention and suicide and that everyone can recognise the signs and symptoms of distress
and suicidal behaviour, know how to support people and where to go for help. It is equally important
that the services providing support do so in a timely, effective and coordinated manner. Suicidal
behaviour is complex and usually cannot be explained by a single cause or risk factor. It is more
often the end point of a complex history of risk factors and distressing events.
It is recognised that many suicides are preventable and for national strategies and local action plans
to be effective, a comprehensive multi-agency, cross-sectoral approach is required. Connecting for
Life Mid West reflects the national vision for suicide prevention and identifies region specific and local
actions that will be implemented to achieve the vision and the expected outcomes over the next four
years. The approach in the preparation of Connecting for Life Mid West has been collaborative and
inclusive, involving a broad range of organisations and individuals from the statutory, non-statutory,
community, voluntary sectors and most importantly the general public.
6
Connecting for Life Mid West 2017 - 2020
7
1
Context for Suicide Prevention in
Ireland and the Mid West
8
Connecting for Life Mid West 2017 - 2020
SECTION 1:
Context for Suicide Prevention in Ireland and the Mid West
Notes, Caveats and Interpretation of Suicide and
Self-Harm Statistics
This is a brief explanation of suicide and self-harm data and the challenges associated with its interpretation.
This is important to consider when reading and interpreting suicide and self-harm data.
Suicide figures are collected nationally by the Central Statistics Office (CSO). When a person dies by
suicide, their death is recorded in the statistics of their actual county of residence. While it can be
helpful to know the number of people who died locally from a given cause, it is not helpful to compare
the numbers of deaths between counties, due to differences in population sizes. It is effective to use
rates per 100,000 of the population when reporting on suicide figures as this takes into account the
relevant population sizes. When comparing rates, due to fluctuations in data and population sizes,
it is also recommended to use a three-year moving average to give a more accurate reflection of the
rates.
It can also take time for provisional suicide rates to be finalised and there can be significant differences
between provisional and finalised rates. The data from the most recent finalised year should always
be used when reporting. The information presented in this plan is reflective of 2014 finalised suicide
rates, as these are the most recently available. All 2015 rates of suicide shown in this section are
provisional, whereas all 2015 rates of self-harm are verified.
The National Suicide Research Foundation (NSRF) is responsible for the National Self-Harm Registry
Ireland. This is a national system of population monitoring for the occurrence of self-harm, taking
data from every Emergency Department (ED) in the Republic of Ireland. However, this information
is likely to provide a large underestimation of actual numbers of cases of self-harm as many people
do not attend an ED for episodes of self-harm e.g. an Irish survey found that only 11.3% of teenagers
attended hospital after an episode of self-harm and even fewer sought help elsewhere (7).
Self-harm statistics are collected as the number of presentations, though a breakdown of the number
of people presenting at hospital and the number of people repeatedly presenting is also recorded.
The types of self-harm method(s) are recorded and reflect all means involved in one episode (for
example, one person may have used more than one method of self-harm for one episode of selfharm). Statistics on self-harm are collected by the area of residence of the individual and self-harm
figures are also recorded for each hospital group.
A list of acronyms is available in Appendix B and an explanation of some key terms used throughout
Connecting for Life Mid West is in Appendix C.
9
Section 1: Context for Suicide Prevention in Ireland and the Mid West
Suicide
In communities across Ireland and the Mid West, suicide generates feelings of grief and apprehension.
For every person who dies by suicide, many others attempt to end their lives, and many more suffer
the despair that leads them to consider suicide.
European Context
Ireland’s overall suicide rate is not high by European comparison (most recent figures available in
relation to Europe is 2013). Looking at the total rate of suicide for men and women of all ages, in
Ireland the rate in 2013 was 11.1 per 100,000 of the population which ranked 12th lowest of 33
European countries (8). However, in Ireland the suicide rates among young males and females are
relatively high in comparison to international rates for young people. Taking males and females
aged 15-19 together, the national rate in 2013 was 7.6 per 100,000 of the population, the 6th highest
suicide rate across the 29 countries studied (9). Between the years 2007 to 2011 and particularly since
the onset of the recession in 2008, there was an increase in the suicide rate in Ireland specifically
amongst men.
Suicide in Ireland and the Mid West
In Ireland, in 2014, 486 suicide deaths occurred. This was almost identical to 2013 figures of 487 (10).
The number of suicides in men was 399. The greatest decrease occurred in men aged 55 to 64 and the
greatest increase was among men aged 15 to 24. The number of suicides among women was 87, which
is a slight decrease on previous years. Figure 1 shows the suicide rate per 100,000 by gender from 2001
to 2015. In 2014 there were 48 deaths from suicide in the Mid West, accounting for 1.7% of all deaths
in the region (11). The actual numbers of suicides were highest in Limerick City and Clare, however this
should also be considered in relation to the numbers of people living in these areas.
Figure 1: Suicide rate per 100,000 by gender, 2001-2015* (12)
*Data for 2015 is provisional and subject to change.
Trends in suicide rates in the Mid West
Table 1 outlines the three-year moving average rate of suicide in the Mid West. Data for 2015 is
also presented; however, these figures are provisional and subject to future revision (12).
10
Connecting for Life Mid West 2017 - 2020
Table 1: 3-year moving average rate of suicide per 100,000 population by county
of residence of deceased (12)
Years
20042006
20052007
20062008
20072009
20082010
20092011
20102012
20112013
2012- 20132014 2015*
Clare
12.6
12.2
12.8
14.3
11.6
11.1
10.3
14.2
15.3
15.6
Limerick City
16.4
14.1
12.4
10.8
11.9
16.6
21.4
26.0
27.2
23.6
Limerick County
10.7
10.1
8.6
10.8
11.4
13.3
14.0
12.4
10.2
9.7
North Tipperary
19.1
14.7
14.8
14.8
14.7
14.6
9.9
14.0
12.6
14.6
National
11.6
11.0
10.9
11.3
11.4
11.7
11.6
11.5
11.0
10.3
*Data for 2015 is provisional and subject to change.
Deaths of undetermined intent
The CSO national mortality data (indicates numbers of deaths by place, time and cause) includes
data on deaths classified as ‘undetermined’ as well as deaths by suicide. It is likely that a proportion
of the deaths classified as undetermined are also deaths by suicide, but it is not possible to estimate
this. In the Mid West in 2014, the number of deaths of undetermined intent was 53. This is again
similar to the number of deaths of undetermined intent in 2013 (11).
Self-Harm
Self-Harm in Ireland
The term self-harm is used to cover various methods by which people harm themselves non-fatally.
For the period from 1st January to 31st December 2015, the National Self Harm Registry recorded
11,189 self-harm presentations associated with 8,791 individuals nationally. The national rate of
self-harm per 100,000 persons was 186 for males and 222 for females (13). In Ireland, more women
than men present to hospital emergency departments following episodes of self-harm (13). The
national overall rate of self-harm has increased by 8.5% between 2007 and 2015, from 188 to 204
per 100,000.
Self-Harm in the Mid West
During this same time period, the Mid West saw a decline in self-harm rates (adjusted for age) in
all counties and both genders. As the numbers are low, caution should be exercised in interpreting
this data (13). Table 2 shows the number of individual presentations for the Mid West by county of
residence and per 100,000 of population for 2015 (14, 15). Note, that the rate of self-harm in Limerick
City is more than twice the national average rate for males and twice the national average for females.
The self-harm rates for Limerick County, North Tipperary and Clare are below the national rates for
males and females.
11
Section 1: Context for Suicide Prevention in Ireland and the Mid West
Table 2: Number of Residents and Rate per 100,000 of the Population in 2015
National Self-Harm Registry, Ireland (14, 15)
Number of presentations by residence
Presentations by rate per 100,000
Male
Female
Male
Female
Limerick City
114
124
405
442
Limerick County
65
105
100
174
Clare
63
91
117
179
Tipperary North
52
48
160
163
4002
4789
186
222
National
Age and gender patterns associated with self-harm
Based on 2015 data for Limerick City and Clare; 71% and 59% respectively of all presentations
occurred in 20-44 year olds. In Limerick County, 65% of all presentations occurred in the 25-54 year
age group while in North Tipperary, the highest number of presentations, 38% occurred in males
and females aged 35-44 (14, 15).
Table 3: Presentations by Age and Gender in the Mid West associated with Self-harm
in 2015
Limerick City
<20
20-24
25-34
35-44
45-54
55+
Total
Male
13
38
47
33
16
<10
153
Female
32
32
46
29
13
12
164
<20
20-24
25-34
35-44
45-54
55+
Total
Male
<10
<10
24
21
13
<10
82
Female
23
17
31
27
14
<10
119
Limerick County
Clare
<20
20-24
25-34
35-44
45-54
55+
Total
Male
<10
15
12
18
14
<10
76
Female
23
20
21
27
<10
<10
115
North Tipperary
<20
20-24
25-34
35-44
45-54
55+
Total
Male
11
<10
10
15
<10
<10
60
Female
12
<10
12
18
<10
<10
56
Methods of Self-Harm
Information on self-harm methods is collected in relation to all means involved in one episode.
However, as previously stated, one person may have more than one method attached to their
episode. Drug overdose was the most common method across all four geographic areas of the Mid
West. Alcohol was involved in 45% of presentations in Limerick City, 40% in Limerick County, 38% in
Clare and 40% in North Tipperary. Self-cutting was the only other common method of self-harm used
in the four areas resulting in 32% of Limerick City presentations, 31% in Limerick County and 28% in
both Clare and North Tipperary (14, 15).
Repeat Presentations
Repetition of self-harm is important as it is a strong predictor of future suicide attempts and suicide.
While a significant number of males and females in the Mid West presented with a repeat episode of
self-harm, when rates are compared by the hospital group, the Mid West rates are one of the lower
rates nationally (13). In 2015, 21% of the presentations were repeat acts of self-harm in Limerick and
17% of the presentations from Clare and North Tipperary were due to repeat acts (14, 15).
12
Connecting for Life Mid West 2017 - 2020
General Information on the Mid West
Ireland’s Mid West region comprises of the geographic areas of Limerick (City and County), Clare and
North Tipperary. The 2011 national census recorded the population for the region as 379,327 (16).
Table 4: 2011 Population (16)
Area
2011 Population
Limerick City
57,106
Limerick County
134,703
Clare
117,196
North Tipperary
70,322
Total
379,327
Indications from the 2016 national census data is that these populations have increased marginally
in each area (17).
Health Services
Health services are provided by the HSE Mid West Community Healthcare and the University of
Limerick Hospital Group (ULHG).
Community Healthcare includes a range of health and social care services provided by the HSE
including but not limited to:
•
41 Primary Care Teams delivering primary care services through General Practitioners
(GPs), frontline nursing and therapy professionals.
•
Community and residential services for Older Persons.
•
Mental Health Services, which include services for adults, children, adolescents and older
persons.
•
Health and Wellbeing.
ULHG comprises of six clinical sites (as listed below) which provide acute care for the population of
the Mid West and surrounding counties:
•
University Hospital Limerick (UHL)
•
University Maternity Hospital Limerick
•
Croom Orthopaedic Hospital
•
Ennis Hospital
•
Nenagh Hospital
•
St John’s Hospital, Limerick
Local Authorities
The Mid West region comprises of three local authority areas. These are Limerick City and County
Council, Clare County Council and Tipperary County Council.
An Garda Síochána
The Mid West is served by three Garda Divisions. These cover Limerick, Clare and Tipperary. The
Garda Training College is also situated within the Mid West in Templemore, Co Tipperary.
13
Section 1: Context for Suicide Prevention in Ireland and the Mid West
Key Facts Relating to the Mid West
•
According to the 2011 census, Limerick City was the most deprived of the 34 local authority
areas in Ireland whereas Limerick County was the 8th most affluent area. Clare was the 13th
most affluent local authority area and North Tipperary ranked 19th out of 34 (18-21)
•
The dependency ratio, which shows the number of people younger than 14 and older than
65 as a percentage of the people aged 15 to 65, is considered to be low in Limerick City,
average or just above in Clare and Limerick County and high in North Tipperary (18-21)
•
Data from the local authority areas in the Mid West indicate that for people aged over 65
years, between 27% and 30% live alone (18-21).
•
Information on education, unemployment, lone parents and Local Authority rented housing
is outlined in Table 5.
Table 5: Education, Unemployment, Lone Parents & Local Authority Rented Housing (18-21).
Limerick
City
Limerick
County
Clare
North
Tipperary
National
Rates
Dependency ratio
45%
50%
53%
55%
49%
Proportion of population with
primary education only
19%
14%
14%
15%
15%
Unemployment rates
29%
14%
19%
19%
19%
Lone parent rates
14%
9%
10%
11%
11%
Local Authority rented housing
12%
5%
6%
7%
8%
•
The All Ireland Traveller Health Study data shows that there were 36,000 members of the
Traveller community in Ireland and that 10% of the Traveller population live in the Mid West
region (22). However, there is also a substantial increase (anecdotally, a threefold increase)
in the population of the Traveller community in Rathkeale, Co. Limerick between November
and February each year due to Traveller families returning for the Christmas period.
•
With four third-level institutions located in the region, the Mid West is home to over 27,000
students throughout the academic year (September to May). In 2016, student numbers at
the various third level Mid West institutions were as outlined in Table 6 below.
Table 6: Student Numbers Third Level Institutions - 2016
14,857
University of Limerick (UL)
Limerick Institute of Technology (LIT)
6,900
Mary Immaculate College (including St Patricks Campus, Thurles since July 2016) (MIC)
4,807
450
Shannon College of Hotel Management
Total
•
27,014
Limerick Prison is one of seven prisons located outside of Dublin. It is a mixed prison, housing
both males and females. It is one of the two prisons in the country which caters for women
in custody. It is a closed, medium security prison with an operational capacity for 220 males
and 28 females (23).
14
Connecting for Life Mid West 2017 - 2020
Supports and Services Available in the Mid West
There are a wide range of statutory, community and voluntary services available throughout the Mid
West area, including a number of both established and new, health and wellbeing, health promotion
and information, mental health and suicide prevention supports and services. The following is an
overview of what is available in the region, it is not an exhaustive list but rather offers an example of
what services are provided to help and support the population of the Mid West in relation to mental
health, suicide prevention and bereavement support.
Statutory Services
Health Services are provided through the HSE Mid West Community Healthcare and the ULHG.
The ULHG hospitals provide acute care for the population of the Mid West and surrounding counties.
HSE Community Healthcare provides a range of health and social care services, including:
•
41 Primary Care Teams (PCTs) are currently in existence in the Mid West comprising GPs,
Public Health Nurses, Occupational Therapists, Physiotherapists and other HSE staff.
•
Counselling in Primary Care (CIPC) provides short term counselling in primary care settings
to medical card holders aged 18 years and over, by professionally qualified and accredited
counsellors or therapists who work under the supervision of the Counselling Service.
•
Mental Health Services provide specific mental health services to children, adolescents,
adults and older persons.
•
The Resource Office for Suicide Prevention (ROSP) provides signposting to relevant
services and a suite of training programmes relevant to suicide prevention and self-harm
for service providers and the general public including;
• esuicideTALK
• safeTALK
• ASIST (Applied Suicide Intervention Skills Training)
• Understanding Self-Harm
• STORM Skills Training
•
Health and Wellbeing (Health Promotion and Information) offers a number of mental
health and wellbeing interventions at both primary and post primary school level including
Mind Out.
•
Social Inclusion provides services for the Homeless, Ethnic Minorities, the Traveller
Community and also people with drug and alcohol issues.
15
Section 1: Context for Suicide Prevention in Ireland and the Mid West
Tusla (Child and Family Agency) is the dedicated State agency responsible for improving wellbeing
and outcomes for children and families covering:
• Child Protection and Welfare
• Alternative Care
• Family and Community Support Services
• Educational Welfare Services
• Domestic, Sexual and Gender-based Violence Services
• Children and Young People’s Services Committee.
Local Authorities
Each Local Authority provides a range of supports in the areas of:
• Social Development, Housing and Accommodation
• Enterprise, Economic and Tourism Development
• Environmental Protection and Monitoring
• Community and Rural Development
• Social and Cultural Services
• Roads and Forward Planning.
An Garda Síochána
An Garda Síochána work closely with and support state agencies and voluntary organisations in the
implementation of initiatives which aim to reduce and prevent suicide. As first responders, An Garda
Síochána also provides information on services and supports available to persons at risk of suicide
hence providing a pathway to access help.
An Garda Siochana aim to provide safeTALK and ASIST training to all new Gardai to ensure they
have the appropriate skills and awareness required when engaging with persons at risk of suicide.
In respect of the wellbeing of staff An Garda Síochána provides a 24/7, 365 days independent
counselling service which is available to all staff.
Community and Voluntary Services
Bereavement Services
•
Pieta House Bereavement Service provide a 24/7 Suicide Helpline, a Suicide Bereavement
Liaison Service and a Suicide Bereavement Counselling Service
•
Living Links (based in Tipperary and Limerick) provide practical help, information and
support to people bereaved by suicide
•
Clare Suicide Bereavement Support is a group of trained, non-professional volunteers who
befriend and support individuals, families and communities bereaved by suicide.
Counselling
•
Pieta House is a non-profit organisation providing a specialised treatment programme for
people who have suicidal ideation or who participate in self-harming.
•
Limerick Social Services Council provides general one-to-one counselling for varied issues
such as difficulties in relationships, bereavement, depression and anxiety and more.
•
My Mind provides fast and easy access to counselling and psychotherapy services in Limerick.
Youth
•
Jigsaw support young people with their mental health.
•
The Limerick Youth Service Mental Health and Wellbeing project provides 1:1 counselling
and support, parental support and advice, and support youth groups in promoting positive
mental health.
•
Youth Work Ireland (Clare Youth Service (CYS), Limerick Youth Service (LYS) Youth Work
Ireland, Tipperary (YWIT)) provides a range of mental wellbeing related interventions for
young people. These include, but are not limited to, individual crisis support for young people,
mentoring, mental wellbeing programmes, cyber safety/anti-bullying programmes, Traveller
and LGBTQI+ supports, counselling and education/training and development opportunities.
16
Connecting for Life Mid West 2017 - 2020
Family
•
Eight Family Resource Centres (FRCs) exist in the Mid West, these are part of Ireland's
largest national community-based family support programme, which includes a Code of
Practice for Suicide Prevention
•
Strengthening Families Programme provides an evidence-based 14-week family skills
training programme that involves parents, teens and children
•
Bedford Row Family Project supports families of people in custody.
•
•
•
Clarecare provides a broad range of support services for people in Clare including Parents’
Support Groups, Family Support Services, Older Persons Services including Home Help, Social
Work and Day Centre services, Adoption Services, Citizens Information Centre, a Counselling
Service & Bushypark Addiction Treatment Centre
Limerick Social Service Council offers a number of family support services including;
Community Sisters, Counselling Service, Crèche & Pre-school, Family Advocacy Service,
Family Welfare Conference, Parent Support Programme, and services for Older People.
Barnardos Family Support Services work with vulnerable children and families and are
based at the heart of their local communities. Family support encompasses a very wide
range of specific services including, individual parenting support, parenting programmes &
breakfast/afterschool clubs for children.
Mental Health Supports
•
Mental Health Ireland is a national voluntary organisation whose aim is to promote positive
mental health and wellbeing in Ireland with 13 Mental Health Associations throughout the
Mid West.
•
GROW is a mental health organisation which helps people who have suffered, or are
suffering, from mental health problems. Members are helped to recover from all forms of
mental breakdown.
•
Aware provides a range of services including group meetings offering support and
information, a telephone and email support service, and a number of programmes based on
principles of cognitive behavioural therapy (CBT).
•
Samaritans are available 24 hours a day to provide confidential emotional support for
people who are experiencing feelings of distress, despair or suicidal thoughts
Groups working with Minorities
•
Doras Luimní is an independent, non-profit, non-governmental organisation working to
support and promote the rights of all migrants living in Limerick and the wider Mid West
region.
•
Clare Immigrant Support Centre (CISC) provides a range of free services and programmes
to immigrants including refugees and asylum seekers in County Clare.
•
Gender Orientation Sexual Health HIV (GOSHH) focus on the promotion of equality and
wellbeing of all with a positive and respectful approach to sexual orientation and gender
diversity across the LGBQI+ Community
Substance Misuse
•
Mid West Regional Drugs and Alcohol Forum was established under the National Drugs
Strategy 2001 – 2008 to research, develop, implement and monitor a co-ordinated response
to illicit drug use at regional level, based on evidence of what is effective. The Forum is
responsible for ensuring the development of a co-ordinated response to tackling drugs
problems in counties Clare, Limerick, North Tipperary and Limerick City.
Also, there are a wide variety of locally based groups and charities, who do very valuable work in
their communities’ e.g. active retirement groups, peer support groups, community companions,
bereavement support groups, patrol groups, community response, water and land based groups etc.
17
Section 1: Context for Suicide Prevention in Ireland and the Mid West
Evidence Base for suicide prevention, knowledge and awareness
Research has important implications for the work carried out as part of Connecting for Life Mid West. In
2014, the Health Research Board were asked by the National Office of Suicide Prevention (NOSP) to
examine the evidence base for suicide prevention to establish which suicide prevention interventions
were successful in reducing suicidal behaviour. The Health Research Board issued Suicide Prevention
– An evidence review 2015 (24). The review found the interventions that were effective in reducing
suicide behaviours were as follows: means restriction, cognitive behavioural therapy and dialectic
behavioural therapy. Emergency Departments are settings for the delivery of suicide prevention
interventions that show promise. Tele-mental health and web-based interventions have only emerged
recently so there is not enough evidence to comment on the success. Screening and gatekeeping
were effective when followed by referral to behavioural interventions. Overall the review found
the body of evidence on suicide prevention interventions to be limited. This does not mean that
interventions are ineffective, but rather there is little evidence of their effect in published papers.
In order to prove an intervention works it needs to be tested. In addition, the NOSP examined the
research on knowledge and awareness interventions and found that a number of these interventions
show promise. Table 7 provides an overview of the findings.
In 2016 the IRWG also carried out a literature search of published systematic reviews on interventions
which were aimed at prevention of suicide and self-harm in addition, to identify reviews published
since the HRB completed its work. This search was limited to systematic reviews published in the past
five years and the databases searched were; Cinahl, Embase, Psychinfo, Psychology and behavioural
science collection and Cochrane. There were no limitations with regards to patient age etc. This
search yielded 88 systematic reviews. These were reviewed by the IRWG and 32 were identified as
potentially relevant. Table 8 provides an overview of the findings.
Key challenges in relation to the evidence base were;
•
Lack of high quality studies on interventions that have been shown to reduce suicide and
self-harm
•
Many interventions are delivered within a wider strategy so it can be difficult to conclude
what intervention had an impact.
Table 7: Findings of the Literature Reviews carried out for Connecting for Life National Strategy
Connecting for Life National Strategy
Promote public awareness with regard to issues of mental wellbeing, suicidal behaviour, the consequences
of stress and effective crisis management.
Enable early identification, assessment, treatment and referral to professional care of people vulnerable to
suicidal behaviour.
Maintain a comprehensive training programme for identified first responders and frontline healthcare staff
(e.g. Gardaí, emergency department staff, educators, mental health professionals).
Promote responsible reporting of suicidal behaviour by media outlets.
Promote increased access to comprehensive services, including mental health services and Emergency
Departments, for those vulnerable to, or affected by, suicidal behaviour.
Provide supportive and rehabilitative services to people affected by suicide/suicidal behaviour.
Support the provision of therapeutic approaches such as dialectical behavioural therapy and cognitive
behavioural therapy to defined population groups, e.g. those who repeatedly self-harm.
Reduce the availability, accessibility, and attractiveness of the means for suicidal behaviour.
Support the establishment of an integrated data-collection system, which serves to identify at-risk groups,
individuals, and situations.
Allow screening for suicide risk among groups vulnerable to suicide.
Improve healthcare services targeting people vulnerable to suicide, including improvements in inpatient
and outpatient aftercare available to people who have attempted suicide.
Support a whole-school approach to mental health promotion.
18
Connecting for Life Mid West 2017 - 2020
Table 8: Findings of the Literature Reviews carried out for Connecting for Life Mid West
Connecting for Life Mid West
Mass awareness campaigns are “good practice” and promotion should be delivered at community and
population wide levels (25).
There may be a small/medium short term improvement in knowledge of suicide and confidence in
prevention. However there was no evidence of change in attitudes, long-term knowledge or suicide
behaviour (26).
Very little research on self-harm prevention in children and adolescents (albeit research in children is
complicated) (27).
Means restriction may be more important in those with bipolar due to impulsivity- particularly high risk
during and after hospital admission (28). Means restriction depends on context - cultural and availability of
means (29).
The effect on suicide and suicide related outcomes of primary suicide prevention interventions that
targeted students within the post-secondary setting; three studies of classroom instruction increased
short-term knowledge of suicide and may slightly enhance confidence in dealing with it. A study on
institutional policy (restriction of poisons, mandatory assessment of students who threatened for
attempted suicide) was found to significantly reduce suicides. (26).
A number of areas were identified by the IRWG as possible ‘gaps’ in the evidence base. These have
been collated and forwarded to the NOSP.
The Role of Alcohol and Drug Use in Suicide and Mental Health
As of 2014, the alcohol consumption rate for Ireland was one of the highest in the world, at 14th out
of 194 World Health Organisation member states (31). Ireland’s total consumption per capita for
over 15 year olds was 10.93 litres of pure alcohol (32). The Healthy Ireland Survey (33) found that
76% of Irish people drink alcohol and 53% of people, who drink, do so, on a weekly basis. The survey
found that men are more likely to drink than women and that 25-64 year olds were more likely to
drink than their older or younger counterparts. Furthermore, 39% of drinkers binge drink on specific
occasions with almost a quarter binge drinking once a week (33).
The use of alcohol and drugs can contribute to a person’s problems if they already have a preexisting mental health issue, and on-going misuse can lead to the development of mental health
issues. Alcohol exacerbates feelings of hopelessness and depression and can affect people’s ability
to cope, manage and overcome everyday stresses and significant life events e.g. unemployment or
bereavement. It can also reduce inhibitions enough for an individual to act on suicidal thoughts.
There is a clear correlation between hazardous levels of alcohol consumption and psychological
distress in young people (34), and 93% of suicides in people under 30 years of age have featured
alcohol as a factor (35).
In 2015, drug overdose was the most common method of self-harm and was involved in 67% of
cases presenting at hospital EDs. Alcohol was involved in just over one third of all cases (31%), a slight
decrease from 2014. Alcohol was significantly more often involved in male episodes of self-harm
than female episodes (34% vs. 29%) (13).
19
2
How Connecting for Life
Mid West was Developed
21
Section 2: How Connecting for Life Mid West was Developed
SECTION 2:
How Connecting for Life Mid West was developed
Approach
In December 2015, the HSE Mid West commenced the process of developing Connecting for Life Mid
West in response to the national strategy Connecting for Life. It was determined from the outset that the
Mid West plan would be developed as a region wide plan for the Mid West (Limerick, Clare and North
Tipperary). This decision was based on the recent alignment of the HSE into 9 Community Healthcare
areas. The Mid West Community Healthcare has retained the same geographical boundaries and
the presence of existing strong partnerships and previous shared experiences of many services and
agencies working together meant that this was the logical approach to developing the local suicide
prevention action plan.
Suicide Prevention Steering Group
A Suicide Prevention Steering Group (SPSG) was set up, chaired by the HSE and with representation
from over forty key services, sectors and communities within the Mid West area.
The HSE sought representatives from relevant agencies to represent their services/communities
who had the required skills, experience and expertise to actively support and inform the preparation
of Connecting for Life Mid West. Representatives were required to ensure that progress on developing
the plan was actioned in a timely manner made and that support was gained for the development
and subsequent implementation of the plan from their respective agencies/organisations.
The SPSG met in December 2015 and agreed the following terms of reference:
•
To work in collaboration to provide guidance, support and direct contribution and to lead the
development of Connecting for Life Mid West to reduce the numbers of suicide deaths and selfharm incidents in the Mid West region.
The SPSG met nine times in total, once in 2015, six times in 2016 and twice in 2017.
The SPSG formed two working groups to facilitate its work. These were an Engagement Working Group
(EWG) and an Information and Research Working Group (IRWG).
22
Connecting for Life Mid West 2017 - 2020
The following were the terms of reference for each of the working groups:
Engagement Working Group
•
To facilitate community and other stakeholder engagement and participation in the planning of
Connecting for Life Mid West.
•
To ensure that Stakeholders in the region, particularly the community sector have an opportunity
to contribute to and be involved in informing the preparation of the Connecting for Life Mid West.
Information and Research Working Group
•
To contribute to the information and research elements of Connecting for Life Mid West.
•
To prepare measurement indicators for the plan (if applicable/required).
•
To consider when the draft actions from the consultation process are available, if there is a need
for additional primary research to support the delivery of the actions identified.
Membership of all 3 Groups is shown in Appendix A.
The guiding principles of Connecting for Life (collaboration, accountability, responsiveness, evidenced
informed and adaptive to change) were used as a reference point as the work progressed. In
alignment with the national strategy the Connecting for Life Mid West’s actions were evidence led,
practical, achievable and developed in partnership with all stakeholders. It was also an imperative
that our process ensured we listened to and took account of the lived experiences of the priority
groups and in particular those who have been affected by suicide.
The National Office for Suicide Prevention (NOSP) played a key role by providing support and
expertise to the local process while ensuring that the work carried out was in line with the national
goals, objectives and actions.
Engagement Working Group Process
The Connecting for Life Mid West engagement process took place over a six month period from
March to September 2016. During that time the project went through a number of phases including
planning, consultation and data analysis culminating in feedback to the SPSG.
23
Section 2: How Connecting for Life Mid West was Developed
The membership of this working group was chosen to reflect the following skill mix:
•
Leadership and project management
•
Knowledge of suicide resource services and Connecting for Life
•
Knowledge of research methodologies
•
Knowledge of mental health, clinical expertise and the Non-Government Organisation
(NGO) sector
•
Knowledge of the community and voluntary sector
•
Knowledge of suicide history, public opinion, political context and change in the Mid West
over the years
The group reviewed the seven Connecting for Life goals, agreed consultation methodologies,
identified a consultation sample and a rollout mechanism as follows:
•
Public Survey: consisting of both qualitative and quantitative questions, to be distributed
online and in paper form using the snowball sampling method. The sample was identified
as being all members of the public over 18 years.
•
Service Providers Survey: consisting of both qualitative and quantitative questions,
distributed online only to all SPSG and EWG member agencies.
•
Postcards: placed in all FRCs, UHL Chronic Pain Clinic and three social welfare offices and
Áras Folláin.
•
Focus Groups: all priority groups identified in the national Connecting for Life were identified
for as appropriate and suitable for focus groups.
In order to conduct focus groups throughout the Mid West and meet as many priority groups as
possible, forty experienced facilitators were identified from a range of Connecting for Life partner
organisations and agencies. The facilitators participated in two workshops to ensure understanding
of Connecting for Life, the development of Connecting for Life Mid West and focus group methodologies.
The EWG worked with the facilitators to identify the priority groups in the Mid West as per Connecting
for Life. 59 focus groups took place in May 2016 involving 394 participants.
A media campaign was developed to support and promote the local consultation. During May
2016, the public survey was also circulated via email, social media and by post on request. Social
media platforms from partner organisations were used to promote participation. The survey was
completed by 1500 people living in the Mid West. The service provider’s survey was circulated to all
members of the Connecting for Life Mid West SPSG and EWG. In total 23 organisations completed this
survey. The postcards were distributed to all FRCs in the Mid West, the UHL Chronic Pain Clinic, the
Department of Social Protection and Áras Folláin, Nenagh (peer support centre). 103 postcards were
completed and returned.
Between June and August 2016 the EWG analysed the data. Findings of the public survey, the
service provider’s survey and the postcards were coded, themed and analysed. In order to ensure
a triangulation process, data was divided into sections and each section coded and themed by two
members of the EWG. On completion the coding was reviewed by another two members.
Key recommendations identified by the focus groups were then categorised into themes by the
EWG. All facilitators were invited to review this data to ensure that it reflected their focus group
discussions. Amendments were made where necessary and a narrative was created. The EWG
reviewed the narratives and key findings were then identified.
24
Connecting for Life Mid West 2017 - 2020
Information and Research Working Group Process
The IRWG also had their first meeting in March 2016. They accepted their terms of reference and
worked together until September 2016. The group compiled a Mid West demographic and suicide
information profile from four geographical Suicide Prevention Profiles prepared by HSE Public Health
(18-21), CSO data and a meeting with a local Coroner (18-21).
The IRWG considered ‘Suicide Prevention An Evidence Review’ (24) and also carried out a literature
review of published systematic reviews on interventions which were aimed at prevention of suicide
and self-harm. Their review was limited to systematic reviews published in the past five years and
the following databases were searched: Cinahl, Embase, Psychinfo, Psychology and Behavioural
Science Collection and Cochrane.
Aligning the work of the Subgroups
In August 2016 both the EWG and the IRWG met to align the key themes from the consultation
process and the research literature review. A joint presentation was made to the SPSG in September
2016. The format of the presentation involved an alignment of the findings from the consultation
phase and the research evidence to one of the seven Connecting for Life goals followed by suggested
actions for consideration. Each goal was presented independently and following the presentation
the members of the SPSG held round table discussions on potential actions for consideration for the
Connecting for Life Mid West.
Reports from both working groups were provided to the members of the SPSG and members
were tasked to identify their agencies/organisations/communities actions in consultation with
relevant partners.
Developing Connecting for Life Mid West
The actions which emerged were referenced to the strategic goals, objectives and actions in Connecting
for Life and were considered by the SPSG in late October 2016 and January 2017. In between SPSG
meetings, individual and collective meetings took place between lead agencies and partners and
actions were developed. Throughout the process stakeholders were provided with support from the
local Resource Office for Suicide Prevention and the NOSP.
25
Connecting for Life Mid West 2017 - 2020
26
Connecting for Life Mid West 2017 - 2020
3
Priority Groups, Risk and
Protective Factors
27
Section 3: Priority Groups, Risk and Protective Factors
SECTION 3:
Priority Groups, Risk and Protective Factors
Priority Groups, Risk and Protective Factors
Identifying risk and protective factors for mental health problems and suicide is important for the
whole population level and particularly for those vulnerable to suicide. Within this plan consideration
has been given to particular issues in the Mid West region which may contribute to risk, especially
for vulnerable groups.
Priority Groups as identified in Connecting for Life
Ireland’s overall suicide rate is amongst the lowest in the Organisation for Economic Co-operation
and Development (OECD) countries; however particular demographic groups have consistently been
shown by both national and international research to have increased risk of suicidal behaviour (1).
During the preparation of the Connecting for Life, CSO suicide statistics and data from the National
Registry of Self-Harm, as well as research on the incidence of suicide in various population groups
were examined to profile the groups most vulnerable to suicide in Ireland.
These included:
•
People with mental health problems of all ages
•
People with drug and alcohol problems
•
People bereaved by suicide
•
Members of the Traveller community
•
LGBTQI+ (Lesbian, Gay, Bisexual, Trans*, Queer, Questioning, Intersex and other gender
identities/expressions as defined by the individual) community.
•
People who are homeless
•
Health professionals
•
People in custody
Groups with potentially increased risk of self-harm or suicidal behaviour but where research
evidence is less consistent or limited include;
•
Asylum seekers, refugees and migrants
•
Sex Workers
•
People with chronic illness or disability
Priority groups may change over time. There can be a significant overlap between many of the groups
and it is important to note that even within a group where there is an increased risk, only a minority
will engage in suicidal behaviour.
28
Connecting for Life Mid West 2017 - 2020
Risk Factors for Suicide and Self-Harm
Suicidal behaviour is complex. Usually no single cause or risk factor is sufficient to explain a suicidal
act. Most commonly, several risk factors act cumulatively to increase an individuals’ vulnerability
to suicidal behaviour and risk factors interplay in different ways for different population groups
and individuals. International research has identified some common risk factors at individual, socio
cultural and situational levels (30). These are shown in Table 9.
Table 9: Individual, Socio-cultural and Situational Risk Factors (30)
Individual
•
Previous suicide attempt
•
Mental health problem
•
Alcohol or drug misuse
•
Hopelessness
•
Sense of isolation
•
Lack of social support
•
Aggressive tendencies
•
Impulsivity
•
History of trauma or abuse
•
Acute emotional distress.
•
Major physical or chronic
illnesses and chronic pain
•
Family history of suicide
•
Neurobiological factors
Socio -Cultural
Situational
•
Stigma associated with helpseeking behaviour
•
Barriers to accessing
healthcare, mental health and
substance abuse treatment
•
•
•
Job and financial losses
•
Relational or social losses
•
Easy access to lethal means
•
Certain cultural and religious
beliefs (e.g. the belief that
suicide is a noble resolution of •
a personal dilemma)
Local clusters of suicide that
have a contagious influence
Stressful life events
Exposure to suicidal
behaviour, e.g. through the
media, and influence of others
who have died by suicide
Many of these risk factors have been identified as significant in the Irish context with different
risk factors affecting different population groups in different ways. A review of Irish studies also
found specific risk factors for different populations such as young people, unemployed people and
marginalised groups like men living in rural communities, members of the Traveller Community and
survivors of institutional abuse. The complex interplay of factors is not yet fully understood.
29
Section 3: Priority Groups, Risk and Protective Factors
Protective Factors
Research conducted by the World Health Organisation (31), demonstrates that strong personal
relationships, religious or spiritual beliefs and a lifestyle practice of positive coping strategies and
wellbeing are the protective factors against the risk of suicide.
Strong personal relationships; Suicidal behaviour increases when people experience relationship
conflict, loss or discord. Equally, maintaining healthy close relationships can increase individual
resilience and act as a protective factor against the risk of suicide.
Religious or spiritual beliefs; Faith itself is a protective factor since it typically provides a structured
belief system and can advocate for behaviour that can be considered physically and mentally beneficial.
Many religious and cultural beliefs and behaviours may also contribute towards stigma related to
suicide due to their moral stances on suicide, which can discourage help-seeking behaviours. The
protective value of religion and spirituality may occur from providing access to a socially cohesive
and supportive community with a shared set of values.
Lifestyle practice of positive coping strategies and wellbeing; Personal wellbeing and effective
positive coping strategies protect against suicide. An optimistic outlook, emotional stability and a
developed self-identity assist in coping with life’s complications. Good self-esteem, self-efficacy and
effective problem solving-skills, which include the ability to seek help when needed, can mitigate
the impact of stressors and childhood adversities. Because of the perceived stigma of mental health
problems, people (especially males) may be reluctant to seek help. Healthy lifestyle choices which
promote mental and physical wellbeing include regular exercise and sport, sleeping well, a healthy
diet, consideration of the impact on health of alcohol and drugs, talking about problems, healthy
relationships and social contact and effective management of stress.
“Suicide does not end the pain it simply moves it to
someone who loves you”
Participant from the Public Consultation
30
4
Connecting for Life Mid West
Strategic Goals, Objectives and Actions
32
Connecting for Life Mid West 2017 - 2020
SECTION 4:
Connecting for Life Strategic Goals, Objectives and Actions
Connecting for Life Mid West is based on the same vision, goals and primary outcomes as the national
strategy outlined below. Connecting for Life Mid West sets out the local actions that were developed
based on the feedback received from the public engagement process in May 2016 and the best
available evidence relating to suicidal behaviour. All local actions are aligned to a national action. The
component actions for the achievement of each goal and objective are listed together with the lead
and other key partners for implementation clearly identified.
VISION
A Mid West region where fewer lives are lost through suicide,
and where communities and individuals are empowered to
improve their mental health and wellbeing
STRATEGIC GOALS
1. To improve the understanding of, attitudes to suicidal behaviour, mental health and wellbeing in
the region
2. To support local communities’ capacity to prevent and respond to suicidal behaviour
3. To target approaches to reduce suicidal behaviour and improve mental wellbeing amongst priority
groups
4. To enhance accessibility, consistency and care pathways of services for people vulnerable to
suicidal behaviour
5. To ensure safe and high quality services for people vulnerable to suicidal behaviour
6. To reduce and restrict access to means of suicidal behaviour
7. To improve surveillance, evaluation and high quality research relating to suicidal behaviour
PRIMARY OUTCOMES
•
•
Reduced suicide rate in the whole population of the Mid West and amongst specified priority groups.
Reduced rate of presentations of self-harm in the whole population of the Mid West
and amongst specified priority groups.
33
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
GOAL 1: To improve the nation’s understanding of, and attitudes
to suicidal behaviour, mental health and wellbeing.
In the past number of years there has been an increasing interest in and public awareness of mental
health and wellbeing across the Mid West. However, many people remain hesitant to talk openly
about their own mental health and misperceptions about suicidal behaviour persist. Mental health
problems are a major risk factor for suicide. By working with people and organisations across the
Mid West including the media, it is recognised that a greater understanding of suicide and the factors
that protect and improve our mental health and reduce stigma can be achieved.
Overview
Developing Connecting for Life Mid West was a collaborative and inclusive process and some of the
most important contributions came from our public engagement process with over 2,000 people
participating.
Findings from the engagement process
•
Coordinated campaigns at both national and local levels are required to address the need for
awareness and greater understanding of mental health and suicidal behaviour. Campaigns
should be targeted and should cross the lifespan from primary school through to the
workplace, community and sports clubs. The content and nature of the campaign materials
used should reflect the target audience.
•
Many reported having limited knowledge of who they should contact or what they should do
in the event themselves, a friend, or a family member experiences mental health difficulties
or suicidal behaviours.
•
Stigma was cited prominently as a contributory factor to the prevalence of poor mental
health and suicidal behaviour.
•
The media were seen as essential partners in disseminating information and also had a
responsibility in being sensitive around the topic.
Comments
“Make sure local organisations, especially the GAA, sporting clubs, and churches emphasise
mental health and wellbeing” (r638)
“A distinction needs to be drawn between targeting various groups. While social media suits
younger people, not all older people who may be vulnerable have access to net” (r81)
“Raise awareness and teach children and young people about stress, anxiety, depression to
‘normalise’ these conditions. Explain the signs and symptoms of the above to young people.
Educate people on the services available. Openly talk about suicide and its impact in schools”
(r349)
34
Connecting for Life Mid West 2017 - 2020
1: To improve the nation’s understanding of, and attitudes to suicidal behaviour, mental health
and wellbeing.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
1.1 Improve
population-wide
understanding of
and attitudes to,
suicidal behaviour,
mental health and
wellbeing.
1.1.3 Deliver
co-ordinated
communication
campaigns (such as
#littlethings, 2014)
for the promotion
of mental health
and wellbeing
among the whole
population with a
focus on protective
health behaviours
and consistent
signposting to
relevant support
services.
1.1.3.1 Continue to
deliver coordinated
communication
campaigns
in response
to national
communications
campaigns such
as the as the Little
Things campaign.
HSE
Communications
and HSE Mental
Health Resource
Office for Suicide
Prevention
All CfL partners,
(statutory
non-statutory,
community
and voluntary
organisations
and relevant
communities)
1.1.4 Build the link
between alcohol/
drug misuse
and suicidal
behaviour into all
communication
campaigns.
1.1.4.1 Implement
HSE Primary Care
national campaigns
locally when
available.
1.1.5 Promoting
physical activity
as a protective
factor for mental
health through the
National Physical
Activity Plan.
1.1.5.1 Promote
physical activity
across the
Mid West as a
protective factor
for mental health
through the
implementation
of the National
Physical Activity
Plan.
Regional
Regional
Regional
35
HSE Social
Inclusion: Drug and
Alcohol Services.
HSE
Communications.
Limerick, Clare and All CfL partners,
North Tipperary
(statutory
Sports Partnerships non-statutory,
community
and voluntary
organisations
and relevant
communities)
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
1: To improve the nation’s understanding of, and attitudes to suicidal behaviour, mental health
and wellbeing.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
1.1 Improve
population-wide
understanding of
and attitudes to,
suicidal behaviour,
mental health and
wellbeing.
1.1.5 Promoting
physical activity
as a protective
factor for mental
health through the
National Physical
Activity Plan.
1.1.5.2 Develop and HSE Health and
disseminate mental Wellbeing (HP&I)
health promotion
guidelines/
workshops for
sports and activity
clubs.
Regional
Limerick, Clare
and North
Tipperary Sports
Partnerships,
Mental Health
Ireland,
Tipperary County
Council and YWIT
1.2 Increase
awareness of
available suicide
prevention and
mental health
services.
1.2.1 Deliver
accessible
information on
all mental health
services and
access/referral
mechanisms
and make the
information
available online at
yourmentalhealth.ie
1.2.1.1 Update
and maintain
information
regarding local
mental health
services and
events on
yourmentalhealth.ie
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
All CfL partners
(statutory,
non-statutory,
community
and voluntary
organisations
and relevant
communities)
1.2.2 Deliver
targeted campaigns
to improve
awareness of
appropriate support
services to priority
groups
1.2.2.1 Deliver
nationally
coordinated
targeted campaigns
alongside
community
healthcare wide /
local initiatives to
improve awareness
of support services
with priority groups.
Regional
HSE Mental
Health Resource
Office for Suicide
Prevention/HSE
Communications
1.2.2.2 Develop
user friendly
communications
materials for
priority groups
promoting mental
health services in
the Mid West.
Regional
1.2.2.3 Annual
‘Mental Health
Week’ will be
promoted and
supported across
the region.
Regional
36
Lead
Key Partners
Pieta House,
Samaritans, ISPCC,
Farm and Rural
Helpline,
NTLP Youth Service,
LYS,
CYS, YWIT,
LIT, UL & MIC
GOSHH, Jigsaw
and Limerick and
Clare Education
and Training Board
(LCETB)
HSE Social Inclusion HSE Mental Health
Resource Office for
Suicide Prevention,
Limerick Diocese
and others as
required
Mental Health
Ireland
13 Mental Health
Associations,
Local Authorities,
HSE Mental Health
Resource Office for
Suicide Prevention,
YWIT,
community
and voluntary
organisations and
LCETB
Connecting for Life Mid West 2017 - 2020
1: To improve the nation’s understanding of, and attitudes to suicidal behaviour, mental health
and wellbeing.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
1.3 Reduce
stigmatising
attitudes to mental
health and suicidal
behaviour at
population level
and within priority
groups.
1.3.1 Deliver
campaigns that
reduce stigma to
those with mental
health difficulties
and suicidal
behaviour in the
whole population
and self-stigma
among priority
groups.
1.3.1.1Deliver
HSE Mental Health
national campaigns Resource Office for
that reduce stigma Suicide Prevention
locally for example
the ‘Green Ribbon’
campaign.
Regional
All CfL partners
(statutory,
non-statutory,
community
and voluntary
organisations
and relevant
communities)
1.4 Engage and
work collaboratively
with the media
in relation to
media guidelines,
tools and training
programmes
to improve the
reporting of suicidal
behaviour within
broadcast print and
online media.
1.4.4 Monitor media
reporting of suicide,
and engage with the
media in relation
to adherence to
guidelines on media
reporting.
1.4.4.1 Work
with local media
to organise an
annual event
to promote the
Samaritans and IAS
media guidelines
and responsible
reporting across the
region.
Regional
1.4.4.2 Work with
local media to
curb inaccurate
or misleading
headlines or
information
regarding reporting
of suicide.
Report irresponsible
articles or reporting
to the Press
Council.
Reduce
stigmatisation
around reporting of
suicide in particular
around images and
graphics used.
Regional
HSE
Communications
HSE Mental Health
Resource Office for
Suicide Prevention.
Samaritans, Irish
Association of
Suicidology (IAS)
and Media
HSE
Communications
HSE Mental Health
Resource Office for
Suicide Prevention
and Media
37
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
GOAL 2: To support local communities’ capacity to prevent and
respond to suicidal behaviour.
The Mid West has a vibrant and engaged community sector. Mental health promotion and suicide
prevention are currently a priority for many groups and organisations who are already engaged in
delivery of specific services and activities. This provides an excellent basis for continued development
of capacity within communities so that they are confident, informed and connected to support
services to prevent and respond to suicidal behaviour.
Overview
Over forty agencies and community and voluntary organisations were involved in the development of
Connecting for Life Mid West. New partnerships have been created, ideas shared and actions developed
that will further support local communities’ capacity to prevent and respond to suicidal behaviour.
Findings from the engagement process
•
The importance of the community in preventing and responding to suicidal behaviour.
•
The breakdown of traditional community spirit negatively impacts on mental health.
•
The benefits of community based physical activities such as walking and sporting activities
in buffering against poor mental health and suicidal behaviours.
•
Successful local community based interventions and initiatives were highlighted.
Comments
“Have a place you could drop in for a quick chat if you are not feeling the best, not formal” (r14)
“First responders trained in every parish. We had no issue getting 15 volunteers for defibrillator
training” (r57)
“Promote activities that bring people together on an on-going basis, that have a goal and involve fun,
physical activity, a sense of belonging” (r41)
Many of the training and education programmes outlined in the actions in Goal 2 are in existence
already and others have been developed as a direct result from the engagement process.
38
Connecting for Life Mid West 2017 - 2020
2: To support local communities’ capacity to prevent and respond to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local CfL Mid
West Action
Lead
Key Partners
2.1 Improve
continuation of
community level
responses to
suicide through
planned, multiagency responses.
2.1.1 Implement
consistent, multiagency suicide
prevention action
plans to enhance
communities’
capacity to
respond to suicidal
behaviours,
emerging suicide
clusters and
murder suicide.
2.1.1.1 Implement,
monitor and report
on the delivery of
Connecting for Life
Mid West developed
in response to
Connecting for Life
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
All CfL partners,
(statutory
non-statutory,
community
and voluntary
organisations
and relevant
communities)
2.1.1.2 Work
with partner
organisations
across the Mid
West to support
both the prevention
of and responses to
suicidal behaviour.
Regional
HSE Mental Health,
HSE Mental Health
Resource Office for
Suicide Prevention
and HSE Health &
Wellbeing (CHO
- Community
Healthcare
Organisation)
All CfL partners,
(statutory
non-statutory,
community
and voluntary
organisations
and relevant
communities).
2.2.1 Provide
community based
organisations
with guidelines,
protocols and
training on effective
suicide prevention.
2.2.1.1 Promote
NOSP guidelines
and protocols on
effective suicide
prevention when
they become
available nationally.
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
and Tusla
Community based
organisations as
appropriate.
2.2.1.2 Support all
FRCs in the Mid
West to adopt the
National FRC Code
of Practice for
Suicide Prevention.
Regional
Mid West Regional
FRC Forum
FRCs, National
FRC Forum, Tusla,
HSE Mental Health
Resource Office for
Suicide Prevention
2.2 Ensure accurate
information and
guidance on
effective suicide
prevention are
provided for
community-based
organisations.
“ ‘Committed suicide’ jars everytime I hear it as it adds to
the sense of shame and stigma implying a criminal act”
Participant from the Public Consultation
39
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
2: To support local communities’ capacity to prevent and respond to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local CfL Mid
West Action
Lead
Key Partners
2.2 Ensure accurate
information and
guidance on
effective suicide
prevention are
provided for
community-based
organisations.
2.2.1 Provide
community based
organisations
with guidelines,
protocols and
training on effective
suicide prevention.
2.2.1.3 Support the
13 Mental Health
Associations to
implement best
practice guidelines
and protocols on
suicide prevention,
and volunteer
recruitment.
Regional
Mental Health
Ireland.
13 Mental Health
Associations
2.3 Ensure
provision and
delivery of training
and education
programmes
on suicide
prevention to
community based
organisations.
2.3.1 Develop
a Training and
Education Plan for
community based
training.
2.3.1.1 Implement
the NOSP Training
and Education Plan
for Community
based Training in
the Mid West.
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
All non-statutory,
community
and voluntary
organisations,
communities,
groups and
members of the
public
2.3.2 Deliver
training and
awareness
programmes
in line with the
National Training
Plan prioritising
professionals and
volunteers across
community-based
organisations,
particularly those
who come into
regular contact
with people who
are vulnerable to
suicide.
2.3.2.1 Aligned
to the National
Training
Programmme
deliver safeTALK,
ASIST, ASIST Tune
up, Understanding
Self-Harm and
STORM training
programmes,
prioritising
professionals and
volunteers who
come into regular
contact with
individuals who
are vulnerable to
suicide.
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
All non-statutory,
community
and voluntary
organisations,
communities,
groups and
members of the
public
2.3.2 Deliver
training and
awareness
programmes
in line with the
National Training
Plan prioritising
professionals and
volunteers across
community-based
organisations,
particularly those
who come into
regular contact
with people who
are vulnerable to
suicide.
2.3.2.2 Complete
an audit initially
of social inclusion
staff and service
provider staff
to identify the
numbers that
have completed
suicide prevention/
positive mental
health training and
identify individual
training needs.
Regional
HSE Social Inclusion Section 38 & 39
Organisations and
HSE Mental Health
Resource Office for
Suicide Prevention
40
Connecting for Life Mid West 2017 - 2020
2: To support local communities’ capacity to prevent and respond to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local CfL Mid
West Action
Lead
Key Partners
2.3 Ensure
provision and
delivery of training
and education
programmes
on suicide
prevention to
community based
organisations.
2.3.3 Deliver a
range of mental
health promoting
programmes in
community, health
and education
settings aimed
at improving the
mental health
of the whole
population and
priority groups.
General Population
2.3.3.1 Work with
the general public
to develop targeted
local initiatives to
enhance effective
approaches to
reduce suicidal
behaviour and
improve mental
health across the
Mid West.
Regional
HSE Health and
Wellbeing (CHO)
HSE Health and
Wellbeing (HP&I)
2.3.3.2 Work
with community
partners in
Limerick City and
County to identify
and implement
collective actions
as part of Healthy
Limerick that will
enhance social
connectedness
for the people of
Limerick.
Limerick
Limerick Local
Community
Development
Committee and
Healthy Limerick.
_
2.3.3.3 Deliver
‘Mind Your Mental
Health’ Programme
Regional
Mental Health
Ireland.
_
2.3.3.4 Pilot
the ‘Wellbeing
Programme’ in
Limerick.
Limerick
HSE Health and
Wellbeing (HP&I).
_
41
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
2: To support local communities’ capacity to prevent and respond to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local CfL Mid
West Action
2.3 Ensure
provision and
delivery of training
and education
programmes
on suicide
prevention to
community based
organisations.
2.3.3 Deliver a
range of mental
health promoting
programmes in
community, health
and education
settings aimed
at improving the
mental health
of the whole
population and
priority groups.
General Population (Cont’d)
2.3.3.5 Deliver
training and
supporting
materials to
parents, early
year’s practitioners,
clinicians and
community
partners on
perinatal, parental
and infant mental
health and
wellbeing.
Limerick
Lead
ABC Start Right
under the auspices
of Limerick
CYPSC and PAUL
Partnership
Key Partners
Tusla, HSE Primary
Care, UL Maternity
Hospital Limerick,
Department of
Education and
Skills, LCETB,
Barnardos,
Limerick Social
Services Council,
Northside FRC,
Limerick City and
County Childcare
Committee, Early
Years’ Service
Managers,
Oscailt Network
and community
representatives
Priority Group: Carers
2.3.3.6 Provide
training to family
carers in mental
wellbeing through
Family Carers
Ireland.
Regional.
2.3.3 Deliver a
range of mental
health promoting
programmes in
community, health
and education
settings aimed
at improving the
mental health
of the whole
population and
priority groups.
HSE Older Persons
Services
Family Carers
Ireland
Priority Group: Youth
2.3.3.7 Deliver the
‘Friends Programs’
for 12 -16 years
olds’ within youth
services.
Regional
LYS,CYS and YWIT
2.3.3.8 Promote
physical and
mental health
and wellbeing
through education
programmes
and wellbeing
initiatives.
Limerick and Clare
Department of
_
Education and Skills
and LCETB
2.3.3.9 Deliver
a suite of
mental health
promoting talks
and workshops
to young people,
parents and adults
who have contact
with young people.
Limerick
Jigsaw
42
Youthwork Ireland
and Carlow
Regional Youth
Service
HSE Health &
Wellbeing (HP&I)
Connecting for Life Mid West 2017 - 2020
2: To support local communities’ capacity to prevent and respond to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local CfL Mid
West Action
2.3 Ensure
provision and
delivery of training
and education
programmes
on suicide
prevention to
community based
organisations.
2.3.3 Deliver a
range of mental
health promoting
programmes in
community, health
and education
settings aimed
at improving the
mental health
of the whole
population and
priority groups.
Priority Group: Men
2.3.3.10 Deliver
educational
workshops to men
of all ages, linking
positive mental
with physical
activity.
Regional
Lead
Key Partners
Limerick, Clare and
Tipperary Sports
Partnerships
Men’s Shed
Groups, HSE Health
and Wellbeing
(HP&I), HSE Social
Inclusion: Traveller
Health Unit, local
community groups.
Mental Health
Ireland, Ballyhoura
Development
CLG, Clare Local
Development
Company,
MWRD&AF,
Tipperary County
Council, Limerick
City and County
Council, Resolve
Counselling and
DEIS Secondary
Schools
Priority Group: Marginalised and
Disadvantaged Communities
2.3.3.11 Provide
training for
representatives
of marginalised
communities
to promote
positive mental
health, healthy
dialogue and raise
awareness of
support services.
Clare and East
Limerick
43
Clare Local
Development
Company/
Ballyhoura
Development CLG
Public Participation
Network, FRCs,
Ennis Mental Health
Association, CYS,
Clare Volunteer
Centre, Primary
Health Care Project
for Travellers
and Clare Sports
Partnership
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
2: To support local communities’ capacity to prevent and respond to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local CfL Mid
West Action
Lead
Key Partners
2.3 Ensure
provision and
delivery of training
and education
programmes
on suicide
prevention to
community based
organisations.
2.3.3 Deliver a
range of mental
health promoting
programmes in
community, health
and education
settings aimed
at improving the
mental health
of the whole
population and
priority groups.
Priority Group: Marginalised and Disadvantaged
Communities cont’d
2.3.3.12 Deliver
the Building
Experiential
Learning (BEL)
model of personal
development
and learning
with the view to
enhancing social
connectivity in local
communities to
improve mental
wellbeing and
reduce suicide.
Regional
MWRD&AF and HSE
Social Inclusion
_
2.3.3.13 Develop
evidence based
Traveller mental
health programme
including a physical
activity component.
Regional
HSE Social
Inclusion: Traveller
Health Unit
HSE Mental Health,
Primary Healthcare
Projects for
Travellers and
Sports Partnerships
Priority Group: Victims of domestic, sexual and gender
based violence
2.3.3.14 Provide
training to raise
awareness of and
promote positive
mental health
strategies to all
ADAPT service
users.
Limerick
ADAPT
UL: Graduate Entry
Medical School
Priority Group: People who work alone
2.3.3.15 Use
Clare Local
‘Farmer Information Development
Session’ to promote Company
positive mental
health.
Clare
44
Teagasc and Rural
Social Scheme
Connecting for Life Mid West 2017 - 2020
GOAL 3: To target approaches to reduce suicidal behaviour and
improve mental health among priority groups.
There are particular demographic groups that have consistently been shown by both national and
international research evidence to have increased risk of suicidal behaviour. The priority groups will
be reviewed regularly based on the most up to date evidence. Every effort was made to ensure that
as many of the priority groups are represented in the targeted actions below and that all priority
groups will be supported to access mainstream supports and services.
Overview
During the public engagement 59 focus groups were carried out with 394 people from the identified
priority groups. These groups made over 300 recommendations which added richness to the survey
and postcard information.
Findings from the engagement process
•
People respected that some groups are particularly vulnerable to issues of mental
health and suicide. Men, older adults, LGBTQI+ people, asylum seekers, people with low
socioeconomic status and young people in general were all identified as priority groups.
•
Those with a dual diagnosis of substance misuse and mental health issues were perceived
as not receiving appropriate attention and services need to be examined
•
There is a need to combat the societal correlates of poor mental health. Amongst the more
prominent of these was the effect that lower socioeconomic status has on the mental
health of people in deprived areas.
•
The effects of the recession were acknowledged to have been widespread – spreading
poverty and insecurity throughout traditionally middle class areas.
•
Social isolation amongst older adults was highlighted as a cause for poor mental health.
•
The importance of early intervention and prevention at an early age was stressed.
Comments
“Make every effort to combat loneliness in the elderly population” (r89)
“Professionals do not have enough knowledge on LGBTQI issues to support people who identify this
way” (r44)
“Wake up and realise what is going on in this country, it has had a severe and detrimental effect on a
lot of the population. Realise people are self-medicating with alcohol and drugs” (r9)
45
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.2 Develop and
implement a range
of agency and interagency operational
protocols (including
protocols for
sharing information
and protocols in
respect of young
people) to assist
organisations
to work
collaboratively in
relation to suicide
prevention and the
management of
critical incidents.
3.1.2.1 Gather
feedback from
partners on social
policy and forward
to Policy Unit in
Department of
Social Protection
(DSP) for
consideration on
DSP programmes
and schemes for
customers who are
at an increased risk
of suicide or selfharm.
Regional
Department of
Social Protection
CfL Partners where
appropriate
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: All Priority Groups
3.1.3.1 Explore
Pieta House
with healthcare
professionals how
priority groups
experience access
issues in using Pieta
House services.
Regional
Healthcare
professionals
and other service
providers
“Mental illness… Always make time for these people as all
wounds are not visible, walk gentle with them, giving them
a listening ear, a shoulder to lie on and a hug, this will
break down barriers and overcome stigma”
Participant from the Public Consultation
46
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: Healthcare Professionals
Key Partners
3.1.3.2 Work with
HSE healthcare
staff to develop and
deliver targeted
local initiatives to
ensure effective
approaches to
reduce suicidal
behaviour and
improve the mental
health of healthcare
professionals.
Regional
HSE Health and
_
Wellbeing (CHO)
and HSE Health and
Wellbeing (HP&I)
3.1.3.3 Extend
the ‘Mindfulness
Programme’
currently available
to nursing staff
to all disciplines
across the ULHG.
Regional
HSE Health and
Wellbeing (ULHG)
Mindfulness
Facilitators
3.1.3.4 Determine
HSE Health and
the feasibility of the Wellbeing (ULHG)
provision of a ‘Quiet
Room’ to support
staff to avail of the
Employee Support
Services across the
ULHG.
Regional
Staff Employee
Support Group and
Accommodation
Committee (HSE
ULHG)
3.1.3.5 Maintain
the current
‘Stress Control
Programme’
currently provided
by Clinical
Psychology across
ULHG.
Regional
HSE Health and
Wellbeing (ULHG)
_
3.1.3.6 Promote
physical activity
amongst HSE staff
in the Mid West.
Regional
HSE Health and
Wellbeing (CHO &
ULHG)
Sports and Social
Club, Limerick
and Clare Sports
Partnerships,
HSE staff in the
ULHG and Mid
West Community
Healthcare
3.1.3.7 Provide all
medical students
with Mindfulness
Training
Limerick
UL: Graduate Entry
Medical School
_
47
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: LGBTQI+
Key Partners
3.1.3.8 Provide an
LGBTQI+ Support
Liaison Officer to
deliver an outreach
program at UL &
MIC.
Limerick
UL & MIC
Counselling
The ‘Out in UL’
Group and
GOSHH
3.1.3.9 Provide
a Peer led group
for the LGBTQI+
community to help
openly express
their gender
without judgement
or fear.
Regional
HSE Social Inclusion GOSHH
3.1.3.10 Develop
a step by step
approach to
supporting young
people in coming
out to include
specific focus
on awareness,
resources and
education of peer
supporters.
Regional
HSE Social Inclusion GOSHH, Youth
Services, UL & MIC,
LIT, HSE Mental
Health, HSE Social
Inclusion: Traveller
Health Unit, CISC
and Doras Luimní
Priority Group: Older People
3.1.3.11 Assist older HSE Older Persons
people to identify
their wellbeing
issues and link with
services necessary
to enhance their
mental well-being.
Regional
48
Older Persons
Forum, Age Friendly
Alliance Group
and Age Friendly
Implementation
Steering Groups
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: Traveller Community
Key Partners
3.1.3.12
Appointment
of a chaplain to
work specifically
with the Traveller
Community.
Limerick
Diocese of Limerick
HSE Social
Inclusion: Traveller
Health Unit,
Primary Healthcare
Projects for
Travellers and
Limerick Enterprise
Development
Partnership
3.1.3.13 Design a
holistic approach
to Traveller mental
health.
Regional
Pieta House
HSE Mental
Health Resource
Office for Suicide
Prevention, HSE
Social Inclusion:
Traveller Health
Unit, Ballyhoura
Development
CLG and Primary
Healthcare Projects
for Travellers
3.1.3.14 Work with
young Traveller
men in Roscrea to
develop resilience
and coping skills.
North Tipperary
HSE Social
Inclusion: Traveller
Health Unit
North Tipperary
Leader Partnership,
Roscrea Primary
Healthcare Project
for Travellers and
Roscrea Wellbeing
Group.
Priority Group: People with Drug and Alcohol Issues
3.1.3.15 Deliver
an evidence
based model
and a business
plan around a
mobile health
unit which would
address access and
transport issues
among vulnerable
groups.
Regional
49
HSE Social
Inclusion: Drug and
Alcohol Services
MWRD&AF
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: People with Drug and Alcohol Issues
(cont’d)
3.1.3.16 Examine
the use of the
staged multidimensional
model of early
intervention
currently in place
in the Community
Substance Misuse
Team and Novas.
Regional
Lead
Key Partners
HSE Social Inclusion Community
Substance Misuse
Team and Novas
Priority Group: Refugees (including resettlement
programme) Migrants and Asylum Seekers
3.1.3.17 Develop a
suite of initiatives
to promote health
and wellbeing for
persons living in
direct provision
centres.
Regional
Limerick Sports
Partnership and
HSE Social Inclusion
Ethnic Minority
Service
HSE Mental Health
Resource Office for
Suicide Prevention,
HSE Health and
Wellbeing (HP&I)
and LYS
3.1.3.18 Investigate
the possibility of
Samaritans offering
support to those
in Direct Provision
initially in Limerick.
Regional
Samaritans
Doras Luimní and
HSE Social
Inclusion.
3.1.3.19 Develop
a range of
community based
targeted suicide
prevention and
mental wellbeing
initiatives to
support local
communities with
an initial focus on
Direct Provision
centre residents,
programme
refugees, Roma,
homeless hostel
residents and
others thereafter.
Regional
HSE Social Inclusion Sports
Partnerships,
CISC, McGarry
House and
HSE Mental Health
Resource Office for
Suicide Prevention
50
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: People in Custody
Key Partners
3.1.3.20 Provide a
‘Listener’ service to
people in custody
in Limerick Prison
Regional
Samaritans
Irish Prison Service
3.1.3.21 Develop
and disseminate a
resource on opiate
use to all people in
custody to address
the issue of opiate
naivety.
Regional
Irish Prison Service
HSE Social
Inclusion: Drug and
Alcohol Service,
Merchants Quay
Ireland Counsellors,
National Liaison
Pharmacist for
Drug Addiction,
Addiction GP,
Prison Education
Service and
Red Cross in Prison
Priority Group: Third Level Students
3.1.3.22 Initiate
a ‘peer support
programme’ in UL
& MIC and LIT for
students.
Regional
Samaritans,
UL & MIC and
LIT.
UL Counselling
Service, LIT
Counselling Service
and Student
Welfare Officer
3.1.3.23 Provide
specific stress
management
workshops/access
to counsellors
and ‘Mindfulness’
programmes for
students.
Regional
UL & MIC and LIT
_
3.1.3.24 Provide a
clear pathway of
care to counselling
for those in crisis
with daily crisis/
emergency
appointments
available.
Regional
UL & MIC and LIT
_
51
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: Victims of Domestic, Sexual and Gender
based Violence
3.1.3.25 Facilitate
targeted
programmes
for Women who
have experienced
domestic, sexual
and gender based
violence including
ASCEND personal
development, Let’s
TALK and the Road
to Recovery.
Limerick and North
Tipperary
North Tipperary
Leader Partnership
ASCEND and
ADAPT
Tusla,
HSE Mental Health,
GPs and
Pieta House
3.1.3.26 Carry out
needs and safety
assessments with
all service users
and implement ongoing monitoring
for risk in relation
to mental health
and/or self-harm.
Limerick
ADAPT
_
Priority Group: Mental Health Service Users
3.1.3.27 Support
Mental Health
the activities in the Ireland
two Peer Support
Centres Áras Folláin
and Le Chéile.
Limerick and North
Tipperary
Áras Folláin and
Le Chéile
3.1.3.28 Build
capacity within the
13 Mental Health
Associations to
support peer
led initiatives in
the community.
Regional
Mental Health
Ireland
13 Mental Health
Associations
3.1.3.29 Facilitate
and coordinate
delivery of the
communitybased Towards
Occupation (TO)
Programme, in
geographically
accessible
locations, to people
with mental health
problems.
Limerick
Ballyhoura
Development CLG
West Limerick
Resources CLG,
Department of
Social Protection,
HSE Mental Health
Services Cork, HSE
Primary Care, Local
Communities
52
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group : People Who Work Alone
3.1.3.30 Continue
to develop and
implement the
‘Social Farming’
Project.
Regional
Lead
West Limerick
Resources CLG
Key Partners
Leitrim Local
Development,
North Tipperary
Leader Partnership,
Clare Local
Development,
Ballyhoura
Development
CLG, South Kerry
Development,
Teagasc, ICMSA,
Rural Social
Scheme,
HSE Mental Health,
Brothers of Charity,
and Mental Health
Ireland
Priority Group: Socio Economically Disadvantaged
Communities
3.1.3.31 Target the
interventions of
the Social Inclusion
and Community
Activation
Program (SICAP)
on ‘deprived’,
‘very deprived’
and ‘extremely
deprived’ small
areas and district
electoral divisions
to foster positive
mental health.
Clare
53
Clare Local
Community
Development
Committee (LCDC)
Clare Local
Development
Company
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: Young People
3.1.3.32 Coordinate
services around
child and youth
mental health and
link to relevant
strategies.
Limerick
Lead
Limerick CYPSC
Youth Mental
Health Subgroup
Key Partners
LCETB, HSE Primary
Care, Tusla, LYS,
Jigsaw, Limerick
Social Services
Centre Counselling
Services,
Ballyhoura
Development CLG,
YPP, LIT, UL & MIC
and Foróige
3.1.3.33 Develop
Limerick CYPSC
and implement a
project for young
people on sharing
their views with
parents on a range
of issues to support
mental health.
Limerick
Parenting Limerick
Members
3.1.3.34 Develop
youth ministry
initiatives to reach
out to young
people with mental
health problems.
Limerick
Limerick Social
Service Council,
LYS and Jigsaw
Diocese of Limerick
3.1.3.35 Organise a LYS, CYS and YWIT
range of supports
for students at both
exam and results
time to support
reduced stress.
Regional
_
3.1.3.36 Continue
to roll out ‘Sports
Talk’ to Senior Level
Post primary DEIS
Schools.
Limerick
Limerick Sports
Partnership
Post Primary
DEIS Schools
3.1.3.37 Provide
1:1 counselling and
support to young
people in the area
of mental health
and wellbeing.
Regional
LYS, CYS and YWIT
Jigsaw
54
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.3 Develop and
deliver targeted
initiatives at
primary care level
for priority groups.
Priority Group: Men
3.1.4 Evaluate
as appropriate
targeted initiatives
and/or services for
priority groups.
Lead
Key Partners
3.1.3.38 Extend
Men’s Sheds to
more rural settings
in the wider county
to address social
isolation.
Clare
Clare Local
Development
Company
_
3.1.3.39 Continue
to roll out ‘Men
on the Move’
programme.
Limerick
Limerick Sports
Partnership
HSE Health and
Wellbeing (HP&I)
and Waterford
Institute of
Technology
3.1.4.1 Local
initiatives and/
or services for
priority groups
delivered under
Connecting for Life
Mid West will be
evidence informed
and evaluated as
appropriate.
Regional
HSE Mental Health
NOSP and all CfL
partners, (statutory
non-statutory,
community
and voluntary
organisations
and relevant
communities)
“Normalise discussions on mental health, make it easier
for people to interact and make it easier for people to
open up to each other”
Participant from the Public Consultation
55
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.5 Provide and
sustain training to
health and social
care professionals,
including frontline
mental health
service staff and
primary care
health providers.
This training
will improve
recognition of, and
response to, suicide
risk and suicidal
behaviour among
people vulnerable
to suicide.
3.1.5.1 Expand
the delivery and
range of suicide
prevention, positive
mental health
programmes
and education
programmes to
frontline Disability
Service Staff.
Regional
HSE Disability
Services
Section 38 &39
Organisations,
Dual Diagnosis
(Mental Health
and Intellectual
Disability) and
Acquired Brain
Injury and Physical/
Sensory Service
Users
3.1.5.2 Create
an awareness of
mental health
issues and
presentations to
Primary Care and
Acute Services
staff by providing
training/support as
required.
Regional
HSE Mental Health
HSE Primary Care
and HSE Health
and Wellbeing (HSE
ULHG)
3.1.5.3 Provide
HSE Mental Health
inputs on
awareness of issues
as they relate to
suicide and selfharm to each of
the 19 Community
Mental Health
Teams.
Regional
GOSHH,
HSE Social
Inclusion:
Traveller Health
Unit
Doras Luimní,
Homeless Unit
and ADAPT
3.1.5.4 Release two HSE Primary Care
staff members to
receive safeTALK in
each of the 41
Primary Care Team
(PCTs) across Mid
West Community
Healthcare.
Regional
HSE Mental Health
Resource Office For
Suicide Prevention
56
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
3.1 Improve the
implementation
of effective
approaches to
reducing suicidal
behaviour among
priority groups.
3.1.6 Continue
the development
of mental health
promotion
programmes with
and for priority
groups, including
the youth Sector.
3.1.6.1 Build
the capacity of
persons who
work or volunteer
with young
people through
the delivery of
‘Minding Youth
Mental Health’ and
‘Understanding
Youth Mental
Health’
Programmes.
Limerick
Jigsaw
HSE Health and
Wellbeing (HP&I)
3.1.6.2 Deliver the
‘Five-a-day’ mental
wellbeing and
the ‘Cyber Safety’
programme.
Clare and Limerick
CYS and LYS
Clare Local
Development
Company, Post
Primary Schools,
Youthreach Centres
and Community
Training Centres
3.1.6.3 Support
and facilitate
volunteers working
with young people
across volunteer
led youth clubs in
the area of youth
mental health and
wellbeing.
Regional
LYS, CYS and YWIT
HSE Mental Health
Resource Office For
Suicide Prevention
3.1.6.4 Provide
dedicated support
including suicide
awareness and
positive mental
health to young
people/adults
who have a
dual diagnosis
(mental health
and intellectual
disability) and
are vulnerable to
suicide.
Regional
HSE Disability
Services
Section 38 and
39 Agencies, HSE
Children’s Disability
Teams
57
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
3.2 Support in
relation to suicide
prevention, the
Substance Misuse
Strategy to address
the high rate of
alcohol and drug
misuse.
3.2.1 Continue
the roll out of
programmes
aimed at early
intervention
and prevention
of alcohol and
drug misuse in
conjunction with
HSE Primary Care.
3.2.1.1 Implement
the Mid West Third
Level Drug and
Alcohol Project.
Regional
UL & MIC and LIT
MWRD&AF
3.3 Enhance the
supports for young
people with mental
health problems
or vulnerable to
suicide
3.3.2 Guide and
encourage the
implementation
of the relevant
policies and
plans in schools,
including support
for development
of Student Support
Teams and for the
management of
critical incidents.
3.2.1.2 Maintain the UL & MIC
substance misuse
programme –
actively involved in
‘React Project.’
Limerick
_
3.2.1.3 Support
the provision of
youth led alcohol
and drug free safe
spaces for young
people.
Regional
_
LYS, CYS and YWIT
3.3.2.1 Deliver
Limerick and Clare
Student Support
Education and
Team and Critical
Training Board
Incident Training to
schools and centres
of education.
Limerick and Clare
58
National
Educational
Psychological
Service (NEPS)
Connecting for Life Mid West 2017 - 2020
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
3.3 Enhance the
supports for young
people with mental
health problems
or vulnerable to
suicide
3.3.3 Work
with the HSE to
develop national
guidance for
higher education
institutions in
relation to suicide
risk and critical
incident response,
thereby helping to
address any gaps
which may exist
in the prevention
of suicide in
higher education.
3.3.3.1 Achieve
Health Promoting
University status
by 2018
Limerick
UL
_
3.3.4 Implement
the National
Antibullying Action
Plan including
online and
homophobia.
3.3.4.1 Actively
support primary
and post primary
schools to stand up
and take action on
Anti Bullying week
each November.
Regional
HSE Health and
Wellbeing (HP&I)
Primary and Post
Primary Schools
and Department of
Education and Skills
3.3.5 Support
all schools to
implement a
new Wellbeing
programme, which
will encompass
SPHE, CSPE and PE,
in Junior Cycle and
encourage schools
to deliver an
SPHE programme
(including RSE
and mental health
awareness) at
Senior Cycle.
3.3.5.1 Deliver
‘Mindout’ to post
primary school
teachers.
Regional
HSE Health and
Wellbeing (HP&I)
Department of
Education and Skills
59
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
3: To target approaches to reduce suicidal behaviour and improve mental health among priority groups.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
3.3 Enhance the
supports for young
people with mental
health problems
or vulnerable to
suicide
3.3.6 Deliver early
intervention and
psychological
support service for
young people at
primary care level.
3.3.6.1 Assistant
UL & MIC
Psychologists will
be embedded in
stepped care model
of service delivery.
Limerick
3.3.7 Deliver early
intervention and
psychological
support service
for young people
at secondary care
level, including
CAMHS.
Lead
Key Partners
_
3.3.6.2 Develop and Jigsaw
deliver a brief, early
intervention mental
health service for
12-25 year olds
initially in Limerick.
Limerick
Jigsaw Advisory
Group
3.3.7.1 Continue
HSE Mental Health
the implementation
of the standard
operating
procedures in
CAMHS.
Regional
_
“All hands on deck, everyone working together,
government, families, religious leaders,
build a better way”
Participant from the Public Consultation
60
Connecting for Life Mid West 2017 - 2020
GOAL 4: To enhance accessibility, consistency and care pathways
of services for people vulnerable to suicide.
A person vulnerable to suicidal behaviour requires easy access to a continuum of support in
accordance with their needs at a particular time – from a sensitive response to a disclosure of
distress to crisis management or appropriate referral, psychotherapeutic interventions or longerterm support. Transition points between services need to be clear and easily navigated. This applies
to pathways between health services, but it also applies to pathways between health and other
statutory, community and voluntary services. The foundations of a sustained approach to preventing
and reducing suicide and self-harm are having consistently available services and integrated care
pathways, across both statutory and non-statutory services.
Overview
23 services completed the services online survey during the Mid West public consultation which gave
valuable insight into current local provision of services.
Findings from the engagement process
•
There were mixed views as to the benefits of having newer facilities attached to existing
health care centres to reduce stigma, or having separate structures to reduce shame.
•
There was frustration with the perceived lack of a 24/7 service for people who are
vulnerable to suicide and people with mental health problems.
•
Increased support for family members of people vulnerable to suicidal behaviour.
•
A more therapeutic and holistic attitude towards mental health is required.
Comments
“24 hour/365 days a year service is what is really needed. If people knew there was a constant
service available, that could be the difference between one outcome and another” (r47)
“Provide somewhere as a point of first contact other than a local GP who will most likely only
prescribe medication and who usually do not have the time to talk to people properly. This is
not the GP's fault but it is a burden that could be lifted from the GP if people had somewhere
else to go first. Promote counselling as a far better method of coping” (r222)
“...there should be a one stop shop where people can come for help and support where
different organisations feed into one central system e.g. if I Google mental health services I
would like one website to show me the different organisations in each county in Ireland - I am
tired and annoyed of hearing about people being passed from pillar to post trying to access
help and being stonewalled. Immediate action is required especially if someone is in dire
straits” (r226)
“Links to other services is crucial- i.e. from private psychiatrist to counsellor to CBT
opportunities, mindfulness etc. Joined up thinking and pathways” (r51)
61
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
4: To enhance accessibility, consistency and care pathways of services for people vulnerable to suicide.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
4.1 Improve
psychosocial
and psychiatric
assessment and
care pathways
for people
vulnerable to
suicidal behaviour.
4.1.1 Provide a
co-ordinated,
uniform and quality
assured 24/7
service and deliver
pathways of care
from primary to
secondary mental
health services for
all those in need of
specialist mental
health services.
4.1.1.1 Continue
to provide crisis
intervention
supports locally
and access to
CAMHS on a 24/7
basis to children
in crisis. To review
and develop out of
hours services.
Regional
HSE Mental Health
_
4.1.1.2 Review and
update the existing
written protocol
and care pathways
relating to access
to the mental
health service for
persons who are
homeless to ensure
better health
and wellbeing
outcomes.
Regional
HSE Social Inclusion HSE Mental Health,
Homeless Service
Local Authorities,
Mid West Regional
Homeless Forum
and Homeless
Service Providers
4.1.1.3 Develop
feedback
mechanisms for
persons availing of
homeless services
in conjunction with
homeless service
providers with a
view to improving
overall health
and wellbeing
outcomes.
Regional
HSE Social Inclusion Homeless
Homeless Service
Service Providers
4.1.1.4 Develop
care pathways
between Addiction
Services and the
Crisis Liaison
Service to
enhance referrals,
interagency work
and a shared
understanding of
the client.
Regional
HSE Social
Inclusion: Drug and
Alcohol Service
4.1.1 Provide a
co-ordinated,
uniform and quality
assured 24/7
service and deliver
pathways of care
from primary to
secondary mental
health services for
all those in need of
specialist mental
health services.
4.1.1.5 Provide
HSE Health and
advice to all
Wellbeing (PH)
HSE services
on appropriate
evaluation methods
and analysis to
ensure complete
care pathways
of high quality
services.
Regional
62
HSE Mental
Health Service
All HSE Services
Connecting for Life Mid West 2017 - 2020
4: To enhance accessibility, consistency and care pathways of services for people vulnerable to suicide.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
4.1 Improve
psychosocial
and psychiatric
assessment and
care pathways
for people
vulnerable to
suicidal behaviour.
4.1.2 Provide a
co-ordinated,
uniform and quality
assured service and
deliver pathways of
care for those with
co-morbid
addiction and
mental health
difficulties.
4.1.2.1 Implement
national model
of care for those
with co-morbid
addiction and
mental health
difficulties.
Regional
HSE Mental Health
HSE Social
Inclusion: Drug and
Alcohol Service and
MWRD&AF
4.1.2.2 Establish a
‘Trauma Informed
Care’ group in
the Mid West
region to deliver
improved services
and outcomes
to vulnerable
clients who have
experienced
significant trauma.
Regional
HSE Social
Inclusion: Drug and
Alcohol Service
Community
Drug and
Alcohol Services
4.1.3 Ensure
that those in the
criminal justice
system have
continued access
to appropriate
information and
treatment in
prisons and while
under Probation
services in the
community.
4.1.3.1 Continue
to provide staff
(0.8 whole time
equivalent) in
the Mid West
Community
Healthcare that
supports a service
to the local prison.
Regional
HSE Mental Health
Irish Prison Service
4.1.4 Deliver
a uniform
assessment
approach across
the health services,
in accordance
with existing
and recognised
guidelines for
people who have
self-harmed or are
at risk of suicide.
4.1.4.1 Continue to
monitor and review
the Mental Health
Service standard
community clinical
intake assessment
and risk protocol.
Regional
HSE Mental Health
HSE ULHG
63
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
4: To enhance accessibility, consistency and care pathways of services for people vulnerable to suicide.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
4.1 Improve
psychosocial
and psychiatric
assessment and
care pathways for
people vulnerable
to suicidal
behaviour.
4.1.5 Deliver a
comprehensive
approach to
managing selfharm presentations
through the HSE
Clinical Care
Programme for the
assessment and
management of
patients presenting
with self-harm
to emergency
departments.
4.1.5.1 Continue to HSE Mental Health
review and monitor
implementation of
standard operating
procedure, as per
the National Clinical
Programme for
assessment and
management of
patients presenting
to ED following selfharm.
Regional
_
4.1.5.2 Implement
HSE ULHG
a designated
area within the
new Emergency
Department for
people who present
with self-harm.
Limerick _
4.2.1 Deliver
accessible, uniform,
evidence based
psychological
interventions,
including
counselling, for
mental health
problems at both
primary and
secondary care
levels.
4.2.1.1 Support,
post training, the
implementation
of a DBT program
through Limerick
Community Mental
Health Teams.
Limerick
HSE Mental Health
_
4.2.1.2 Continue
to resource
community based
agencies through
Section 39 funding.
Regional
HSE Mental Health
Community
and Voluntary
Organisations
4.2.1.3 Improve
access to effective
therapeutic
interventions
(psychiatry
supports and
counselling) for
disability service
users and families.
Regional
HSE Disability
Services
Section 38 and 39
Agencies and
HSE Mental Health
Services
4.2 Improve
access to effective
therapeutic
interventions
(e.g. Counselling,
Dialectical
Behaviour
64
Lead
Key Partners
Connecting for Life Mid West 2017 - 2020
4: To enhance accessibility, consistency and care pathways of services for people vulnerable to suicide.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
4.3 Improve
the uniformity,
effectiveness
and timeliness of
support services
to families and
communities
bereaved by
suicide.
4.3.1 Deliver
enhanced
bereavement
support services
to families and
communities
that are known
to mental health
services and
affected by suicide.
4.3.1.1Deliver
enhanced
bereavement
supports services
to families and
communities
affected by suicide
including those
people known
to mental health
services.
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
and Pieta House
Bereavement
Services
Samaritans, Living
Links, Clare Suicide
Bereavement
Support,
Milford Hospice
Bereavement,
LIT and UL
4.3.1.2 Facilitate
an annual
networking event
of all bereavement
supports/
services across
the Mid West to
become more
knowledgeable
about each other’s
services and
to develop and
improve linkages
and referral
pathways.
Regional
HSE Mental Health
Resource Office for
Suicide Prevention
Pieta House,
Samaritans, Living
Links, Clare Suicide
Bereavement
Support and
Milford Hospice
Compassionate
Communities
“Depression does not make for a great story, it’s very
much a hidden struggle within a person for their own
peace of mind, their own happiness…it’s very difficult
to see and understand”
Participant from the Public Consultation
65
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
GOAL 5: To ensure safe and high quality services for people
vulnerable to suicide.
Having a range of high quality services to support people through a time of distress, and those who
are actively suicidal is a crucial element of a suicide prevention plan. This applies to statutory and
non-statutory, community and voluntary services. Good-practice guidelines, clear care protocols,
appropriate training and supervision mechanisms are all enablers to the provision of high quality
services. All services must promote a sense of hope, and an ambition for recovery, restoring the
individual’s health and independence built on self-worth and self-belief.
Overview
Over 40% of the public survey respondents were either Mental Health service users or the family
members/friends of service users, and eight of the focus groups comprised of Service Users and
Service Providers all of which provided valuable insights on service provision in the Mid West.
Findings from the engagement process
•
The multitude of services available in the region is confusing.
•
The quality of staff in state services is generally high, however it was felt that some front
line staff lacked training to deal appropriately and in an empathic way with service users
presenting with suicidal behaviour.
•
A lack of regulation in relation to counsellors and psychotherapists operating privately
without an affiliation to an association was also identified as a concern.
Comments
“There appears to be much duplication of efforts - too many groups trying to do the same
thing, e.g. establishing help lines - more co-ordination is required” (r462)
“More universally accessible mental health support services especially in rural, isolated
areas taking geographical obstacles/transport and poor economic circumstances into
account” (r211)
“Thank you for asking I am interested in the
findings of this questionnaire”
Participant from the Public Consultation
66
Connecting for Life Mid West 2017 - 2020
5: To ensure safe and high quality services for people vulnerable to suicide.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
5.2 To improve the
response to suicidal
behaviour within
health and social
care services with
an initial focus on
incidents within
mental health
services.
5.2.1 Develop and
deliver a uniform
procedure to
respond to suicidal
behaviour across
mental health
services.
5.2.1.1 Continue to
HSE Mental
apply and review as Health Services
appropriate existing
risk assessment
tool (Sainsbury Risk
Assessment Tool) as
available in standard
community clinical
intake assessment.
Regional
_
5.2.3 Implement a
system of service
review, based
on incidents of
suicide and suicidal
behaviour, within
HSE Mental Health
Services (and those
known to the mental
health service) and
develop responsive
practice models.
5.2.3.1 Continue
to implement the
HSE Safety Incident
Management
Policy (2014) and
review incidents
as required in
accordance with
same.
Regional
HSE Mental
Health Services
_
5.2.3.2 Monitor
behavioural hazard
incidents via the
quarterly aggregate
incident reports.
Regional
HSE Mental
Health Services
_
5.4.2 Deliver
training in suicide
prevention to staff
in government
departments and
agencies that are
likely to come into
contact with people
who are vulnerable
to/at risk of suicidal
behaviour.
5.4.2.1 Aligned
HSE Mental Health
to the National
Resource Office for
training Plan deliver Suicide Prevention
safeTALK, ASIST,
ASIST Tune Up,
Understanding
Self-Harm and
STORM training
programmes,
prioritising health
and social care
professionals who
come into regular
contact with
individuals who are
vulnerable to suicide
and self-harm.
Regional
All Statutory Services
(Tusla, An Garda
Síochána, Local
Authorities,
Department of
Social Protection,
HSE and LCETB)
5.4.2.2 Progress the
training of Gardaí in
safeTALK and ASIST
at Templemore
Garda Training
College.
National
NOSP
An Garda Síochána
and HSE Mental
Health Resource
Office for Suicide
Prevention
5.4.3.1 Participate
in and deliver
the Psychological
Counsellors in
Higher Education
Ireland (PCHEI)
training.
Regional
UL & MIC and LIT
PCHEI
5.4 Ensure best
practice among
health and social
care practitioners
through
(a) the
implementation of
clinical guidelines on
self-harm
(b) the delivery
of accredited
education
programmes on
suicide prevention.
5.4.3 Support
professional regulatory
bodies to develop and
deliver accredited,
competency based
education on suicide
prevention to health
professionals.
67
Lead
Key Partners
Section 4: Connecting for Life Mid West Strategic Goals, Objectives and Actions
GOAL 6: To reduce and restrict access to means of suicide.
Restricting, where practicable, access to means of suicidal behaviour has been consistently shown to
be effective in reducing suicidal behaviour across counties and settings. Implementation of strategies
to restrict means can occur at national level, via legislation and regulations, and at local level, for
example by improving safety at locations where people frequently attempt or complete suicide. This
also includes exploring additional interventions for the most frequently used methods of suicide
within the local context.
Overview
While the Mid West Public Engagement yielded limited discourse on means restriction, the IRWG
findings resulted in the development of a local collaborative multi-agency approach to identifying
frequently used locations and a commitment to address their findings.
6: To reduce and restrict access to means of suicide.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
Lead
Key Partners
6.2 Reduce access to
highly lethal methods
used in suicidal
behaviour.
6.2.1 Local Authorities
will be requested to
consider, develop
and implement
measures where
practical to restrict
access to identified
locations and settings
where people are at
risk of engaging in
suicidal behaviour,
and assist generally in
reducing risk factors
in public location
6.2.1.1 Identify
frequently used
locations for
suicide and selfharm in Limerick
City and County
initially. Identify and
implement useful
evidence based
interventions where
practical to restrict
access at locations
and settings where
people are at risk of
engaging in suicidal
behaviour, and assist
generally in reducing
risk factors in public
locations.
Limerick
HSE Health and
Wellbeing (PH)
Limerick City and
County Council and
An Garda Síochána
6.2.1.2 Erect signs
promoting positive
mental health along
walkways in the
county.
Clare
Clare County Council
HSE Mental Health,
Mental Health Ireland
and Comhairle na
nÓg
6.2.1.3 Limit
access to means
in accommodation
and retail outlets on
campus.
Limerick
UL
_
6.2.1.4 Create a safer
campus environment
to prevent suicidal
behaviour.
Regional
LIT
An Garda Síochána
6.2.2.1 Continue to
carry out ligature
audits in approved
centres and to
expand to other
mental health
residential centres.
Regional
HSE Mental Health
_
6.2.2 Implement a
strategy to improve
environmental
safety within the
HSE mental health
services (e.g. ligature
audits). 68
Connecting for Life Mid West 2017 - 2020
GOAL 7: To improve surveillance, evaluation and high quality
research relating to suicidal behaviour.
Responsive, cost-efficient and effective suicide prevention services depend on the widespread
availability of robust data from a range of sources. This data should include the services and
interventions that are effective in reducing or preventing suicidal behaviour for vulnerable groups
and trends in suicidal behaviour and key risk and protective factors. Improving the quality of the
evidence base for suicidal behaviour and suicide prevention in the Irish context, having real-time
and better integrated data surveillance systems for suicidal behaviours as well as accelerating the
transfer of research findings into practice are fundamental to the success of Connecting for Life Mid
West and other suicide prevention policies and practices.
Overview
Local Mid West actions such as the sharing of studies and the outcome research from the Mid West
third level education sector have the potential to contribute to the national body of knowledge.
7: To improve surveillance, evaluation and high quality research relating to suicidal behaviour.
National CfL
Objective
National CfL
Action
Local Mid West
CfL Action
7.2 Improve the
access to timely and
high quality data on
suicide and selfharm.
7.2.2 Collate
and report on
incidences of
suicide through
current and
expanded health
surveillance
systems over the
life of Connecting
for Life.
7.2.2.1 Use
HSE Mental Health
data collected
by the National
Suicide Research
Foundation
as a means
of addressing
opportunities for
the improvement of
local services.
Regional
_
7.2.2.2 Collate all
studies on suicide
and related issues
at UL into a single
report and submit
to NOSP annually.
Limerick
_
7.4.4 Evaluate
innovative
approaches to
suicide prevention
including online
service provision
and targeted
approaches for
appropriate priority
groups.
Lead
UL
7.4.4.1 Carry out
LIT Student
outcome research
Counselling Service
on the effectiveness
of counselling as a
preventer of suicide
at third level.
Regional
69
Key Partners
LIT: Department
of Applied Social
Studies
5
Implementation of
Connecting for Life Mid West
71
Section 5: Implementation of Connecting for Life Mid West
SECTION 5:
Implementation of Connecting for Life Mid West
Implementation Structures and Roles
Connecting for Life Mid West is a live, dynamic and flexible plan spanning 2017 to 2020. A multi-agency
Implementation Steering Group will be established, underpinned by the values and principles of the
partnership approach used throughout the development of Connecting for Life Mid West. Membership
of the implementation group will comprise of the lead agencies outlined in Connecting for Life Mid West.
The Implementation Steering Group will be:
•
chaired by the HSE
•
accountable for the implementation of the Connecting for Life Mid West
•
responsible for communicating Connecting for Life Mid West
•
responsible for monitoring and reporting of Connecting for Life Mid West in line with the
national system developed by NOSP for monitoring and evaluating local plans
•
flexible and take into account local and national needs which emerge during the life of
the Connecting for Life Mid West.
Specific details in relation to the working of the group and the requirement for subgroups will be
developed by the Implementation Steering Group. Local implementation structures will align with
national implementation structures.
It is envisaged that the implementation of Connecting for Life Mid West is and will be included in
strategic plans of all partner organisations, where possible.
Resourcing Connecting for Life Mid West
The actions in Connecting for Life Mid West are broad ranging and their implementation will be the
responsibility of all the named lead and partner organisations including the HSE. In the development
of the plan the various organisations taking the lead for particular actions were aware of the need to
identify and propose actions that were in keeping with the goals of the national strategy, responsive
to needs identified in the public consultation and could be achieved while working across a wide
range of partner organisations within existing resources. This approach can generate actions and
outcomes that may not otherwise be achievable working in isolation and thus provide for an effective
implementation process and more efficient use of resources.
Communicating Connecting for Life Mid West
All communications relating to the implementation of Connecting for Life Mid West will be the
responsibility of the Implementation Steering Group, supported by HSE Communications and NOSP
where required.
With over 120 actions across the region Connecting for Life Mid West has many lead agencies and
key partners and communication is a vital component of our implementation. When using the
Connecting for Life national brand, it is essential that all stakeholders use clear, consistent and
evidence informed messaging in relation to the prevention of suicidal behaviour.
72
Connecting for Life Mid West 2017 - 2020
73
Appendices
APPENDICES
Appendix A: Membership of Planning and Working Groups
Suicide Prevention Steering Group
Teresa Bulfin (Chair) Mark Sparling Ann Hogan Bedelia Collins
HSE Mental Health
HSE Mental Health
HSE Primary Care
HSE Health and Wellbeing, Health Promotion
and Improvement
HSE Disability Services
HSE Disability Services
HSE Resource Office of Suicide Prevention
HSE Resource Office of Suicide Prevention
HSE Mental Health
HSE Older Persons Services
HSE Primary Care
HSE Mental Health
HSE Mental Health
HSE Health & Wellbeing Public Health
HSE Mental Health
HSE University of Limerick Hospital Group
HSE University of Limerick Hospital Group
HSE CAMHS
HSE Social Inclusion
HSE Social Inclusion
HSE Social Inclusion
Diocese of Limerick
Diocese of Limerick
Clare Local Development Company
North Tipperary Leader Partnership
North Tipperary Leader Partnership
North Tipperary Leader Partnership
PAUL Partnership
PAUL Partnership
Limerick and Clare Education and Training
Board
Tipperary Education and Training Board
Tipperary Education and Training Board
An Garda Síochána, Templemore
An Garda Síochána, Tipperary
An Garda Síochána, Limerick
An Garda Síochána, Clare
Irish Prison Service
Department of Social Protection
Youth Work Ireland Tipperary
Youth Work Ireland Tipperary
Clare Youth Service
Limerick Youth Service
Tipperary County Council
Limerick City and County Council
Clare County Council
Clare County Council
University of Limerick
Limerick Institute of Technology
Samaritans
Carmel McLoughlin Fearghal Gray Ciara Dempsey Mary Kennedy
Eamonn Butler Ethna McTeague Jim Gallagher John O’Mahony Catherine Adams Marie Casey Nora Mullane Paul Finucane Mary Murphy
Rachel Davis Tony Quilty
Maurice Hoare Marie O’Flynn
Bishop Brendan Leahy
Catherine Kelly Darina Greene Michelle Putti
Michael Murray
Sean Mc Sweeney
John Buttery Anne Kavanagh Teresa Crawford Fionuala McGeever
Clodagh Kelly Ann-Marie McMahon Robert Noonan Helen Costello John Kerin Mary Blewitt Edel Browne Cora Horgan
Carmel O Neill Margaret Slattery Fiona O'Grady Deirdre Cox Seamus O'Connor Michael Neylon
Deirdre O’Shea Declan Aherne Noreen Keane John Downey 74
Connecting for Life Mid West 2017 - 2020
Emer O’ Neill Martin O'Sullivan Ger Brophy Micheál Lacey John McElhinney
Pieta House Bereavement Service
Pieta House
Tusla
Mid West Regional Drugs and Alcohol Forum
Mental Health Ireland
Subgroups of Suicide Prevention Steering Group
Information and Research Working Group
Prof. Paul Finucane (Chair) Dr. Marie Casey Elaine Harding Therese Hennessy Michelle Kearns Mary Kennedy Dr. Patricia Mannix-McNamara Dr. Niamh O’ Callaghan Sarah Watkins HSE University of Limerick Hospital Group
HSE Health and Wellbeing Public Health
HSE Mental Health
University of Limerick
University of Limerick
HSE Resource Office of Suicide Prevention
University of Limerick
HSE Health and Wellbeing Public Health
HSE University of Limerick Hospital Group
Engagement Working Group
Bedelia Collins (Chair)
HSE Health and Wellbeing Health Promotion
and Improvement
HSE Resource Office of Suicide Prevention
HSE Resource Office of Suicide Prevention
HSE Social Inclusion Homeless Service
HSE Mental Health Service
Pieta House Bereavement Service
Pieta House
Clare County Council
Tusla
Paul Partnership
Irish Association of Suicidology
HSE Mental Health Service
Ciara Dempsey Mary Kennedy
Marie O’Flynn
Eamonn Butler
Jim Meaney
Martin O'Sullivan Michael Neylon Margaret Mastriani
Helen Fitzgerald
Dan Neville
Garrett O’ Connor
Facilitators of Focus Groups
Daniel Butler Limerick City DEPS (Drugs Education &
Prevention Strategy)
Limerick City DEPS (Drugs Education &
Prevention Strategy)
GOSHH (Gender Orientation Sexual Health
HIV)
GOSHH (Gender Orientation Sexual Health
HIV)
HSE Mental Health Service
HSE Mental Health Service
Coláiste Phobal Roscrea
North Tipperary Leader Partnership
North Tipperary Leader Partnership
Pieta House Bereavement Service
Pieta House Bereavement Service
My Mind
Limerick Mental Health Association
HSE Resource Office of Suicide Prevention
HSE Social Inclusion Homeless Service
Clare Youth Service
Jack Griffin Patrick McElligott Gráinne Woulfe Ann Marie Murphy
Noreen Fitzgibbon
Fr. Lorcan Kenny
Deirdre Cahir
Valerie Hearne
Jim Meaney
Emer O’Neill
Michelle O’Connor
Patrick Fitzgerald
Mary Kennedy
Marie O’Flynn
Jean Tierney
75
Appendices
Brian McManus
Margaret Slattery
Terry Considine
Jim Prior
Joan Keehan
Zara O’Driscoll
Colette Bradley
Maurice Walsh
Dermot Troy
John Reale
Ciara Corcoran
Colin Clarke
Marianne O’Donnell
John Downey
Deirdre Power
Mary Blewett
Deirdre Ní Chinnéide
Anna Maria Murphy
Ciara McInerney
Liam Cantwell
Phelim Macken
Suzanne Moloney
Phil Canny
Gearóid Prendergast Bedelia Collins
Clare Youth Service
Clare Youth Service
Clare Youth Service
Southill Family Resource Centre
Southill Family Resource Centre
Croom Family Resource Centre
Shannon Family Resource Centre
Limerick Youth Service
Limerick Youth Service
Limerick Youth Service
University of Limerick Student’s Union
University of Limerick Student’s Union
University of Limerick Student’s Union
Samaritans
Clare County Council
Limerick Prison
Limerick Prison
Limerick Prison
Limerick Sports Partnership
Limerick Sports Partnership
Limerick Sports Partnership
HSE Communications
HSE CAMHS
Mid West Regional Drugs and Alcohol Forum
HSE Health and Wellbeing Health Promotion
and Improvement
76
Connecting for Life Mid West 2017 - 2020
Appendix B: Acronyms
CAMHS
CBT CfL CHO
CIPC
CISC CSO CSPE
CYPSC CYS
DBT
DES
DEIS
DSP
ED EWG
FRC
GOSHH
GP
HI
HIV
HP&I
HSE
IAS
IAUCC
IRWG
ISPCC
LCETB
LGBTQI+ LIT
LYS
MIC
MWRD&AF
NOSP
NSRF
NTLP OECD PCHEI PCT
PE
PH
SICAP
SPHE
TO
UHL UL ULHG
WHO
WSTCYS
YPP
YWIT
Child and Adolescent Mental Health Service
Cognitive Behavioural Therapy
Connecting for Life
Community Healthcare Organisation
Counselling in Primary Care
Clare Immigrant Support Centre
Central Statistics Office
Civic, Social and Political Education
Children and Young People’s Services Committees
Clare Youth Service
Dialectical Behaviour Therapy
Department of Education and Skills
Delivering Equality of Opportunity in Schools
Department of Social Protection
Emergency Department
Engagement Working Group
Family Resource Centre
Gender Orientation, Sexual Health HIV
General Practitioner
Healthy Ireland
Human Immunodeficiency Virus
Health Promotion and Information
Health Service Executive
Irish Association of Suicidology
Irish Association of University and College Counsellors
Information and Research Working Group
Irish Society for the Prevention of Cruelty to Children
Limerick and Clare Education and Training Board
Lesbian, Gay, Bisexual, Trans*, Queer, Questioning, Intersex and other
gender identities/expressions as defined by the individual.
Limerick Institute of Technology
Limerick Youth Service
Mary Immaculate College
Mid West Regional Drugs and Alcohol Forum
National Office for Suicide Prevention
National Self-Harm Research Foundation
North Tipperary Leader Partnership
Organisation for Economic Co-operation and Development
Psychological Counsellors in Higher Education Ireland
Primary Care Team
Physical Education
Public Health
Social Inclusion and Community Activation Programme
Social, Personal and Health Education
Towards Occupation
University Hospital Limerick
University of Limerick
University of Limerick Hospital Group
World Health Organisation
Waterford and South Tipperary Community Youth Service
Youth Participation Panel
Youth Work Ireland Tipperary
77
Appendices
Appendix C: Definition of Key Terms
Families/friends/communities bereaved by suicide
People who have been impacted, directly or indirectly, when someone has died by suicide.
HSE mental health services
The HSE provides a wide range of community and hospital based mental health services in Ireland.
HSE mental health services are delivered through specialist mental health teams from childhood to
old age.
Incidence of self-harm/Self-harm rates
In 2015, the Registry recorded 11,189 presentations to hospital due to self-harm nationally, involving
8,791 individuals. Taking the population into account, the age-standardised rate of individuals
presenting to hospital following self-harm in 2015 was 204 per 100,000. Between 2011 and 2013,
there were successive decreases in the self-harm rate. An essentially unchanged rate in 2015
indicates a further stabilisation of the rate of self-harm in Ireland since 2013. However, the rate in
2015 was still 9% higher than in 2007, the year before the economic recession.
Marginalised groups
Marginalised groups are people who are, or consider themselves, excluded or marginalised from
access to participate in activities which are considered the norm for other people in society.
Mental health and wellbeing
Mental health is defined as a state of wellbeing in which the individual realises his or her own
potential, can cope with the normal stresses of life, can work productively, and is able to make a
contribution to his or her community.
Mental health problems
Refers to a wide range of mental health conditions that affect mental health and impact on mood,
thinking and behaviour.
Mental health promotion
Mental health promotion aims to promote positive mental health among the population and those
who are at risk of experiencing mental health problems. This is a strategic approach, working in
coordination with a wide group of agencies and individuals, that can enable people at risk in general
to change their behaviour for the better by getting skills and knowledge that enable them to cope
with life’s difficulties and specific disorders.
Murder suicide
Murder suicide is murder followed by the suicide of a perpetrator within one week.
Non-statutory and community organisations
Community, voluntary and non-statutory services, organisations and groups.
People/groups who are vulnerable to suicide
People/groups who experience more of the risk factors of suicide.
People at acute risk of suicide/self-harm
People who are at high risk of suicide or self-harm. This may include frequent, intense and enduring
thoughts of suicide or self-harm, specific plans or high distress.
People/groups who are vulnerable to self-harm
People/groups who are more susceptible than other people/groups to the possibility of self-harm.
Primary care services
Primary care means all of the health or social care services in communities, outside of a
hospital setting.
78
Connecting for Life Mid West 2017 - 2020
Priority groups
In Connecting for Life, priority groups refer to the population groups identified as vulnerable to suicide
in Ireland. Over the lifetime of the Strategy, other population groups may emerge as particularly
vulnerable to suicide.
Protective and risk factors
In general, risk factors increase the likelihood that suicidal behaviour will develop, whereas protective
factors reduce this likelihood. In relation to mental health, protective factors include secure family
attachments, having one supportive adult during early years, positive early childhood experiences,
good physical health, and positive sense of self, effective life and coping skills. Risk factors include
physical illness or disability, family history of psychiatric problems, family history of suicide, low selfesteem, social status, childhood neglect.
Reducing suicide/Reducing self-harm
Reducing suicide, or self-harm, means lowering the number of deaths by suicide or the number of
self-harm incidents.
Resilience
Resilience is the ability to cope with adverse, or challenging, circumstances.
Responding to a suicide attempt
Response, or intervention, to support someone who attempts suicide.
Responding when someone has died by suicide/Postvention
Responding to suicide refers to the response, or intervention, to support relatives, friends and
communities after someone dies by suicide.
Self-harm
Self-harm describes the various methods by which people harm themselves. Varying degrees of
suicidal intent can be present and sometimes there may not be any suicidal intent, although an
increased risk of further suicidal behaviour is associated with all self-harm.
Service user
Person who uses the mental health services.
Social exclusion
Social exclusion refers to being unable to participate in society because of a lack of access to
resources that are normally available to the general population. It can refer to both individuals, and
communities in a broader framework, with linked problems such as low incomes, poor housing,
high-crime environments and family problems.
Stigma reduction
Stigma reduction refers to the process of minimising negative beliefs associated with different
types of mental health problems. It brings about a positive change in public attitudes and behaviour
towards people with mental health problems.
Suicide/die by suicide
Suicide is death resulting from an intentional, self-inflicted act.
Suicide attempt/attempted suicide/someone who has attempted suicide
A suicide attempt means any non-fatal suicidal behaviour, when someone has the intent to take their
own life.
Suicidal behaviour
Suicidal behaviour refers to a range of behaviours that include planning for suicide, attempting
suicide and suicide itself. For the purpose of this Strategy, the term suicidal behaviour also refers to
self-harm. (See above for a full definition of self-harm.)
79
Connecting forAppendices
Life Mid West 2017 - 2020
Suicide cluster
A suicide cluster refers to a number of unexpected suicide or attempted suicides that occur closer
together in space and time than one would normally expect in any given community.
Suicide mortality/Suicide rates
There were 486 deaths by suicide in Ireland in 2014 (the most recent year where finalised data
is available), representing a rate of 10.5 per 100,000 population. 800,000 people die by suicide
worldwide every year (WHO 2017).
Suicide prevention/Help prevent suicide
Suicide prevention aims to diminish the risk and rates of suicide. It may not be possible to eliminate
entirely the risk of suicide but it is possible to reduce this risk.
Targeted approach
Embedded in a whole population approach and focuses on 1) identifying the smaller number of
people who are vulnerable to suicide/self-harm and 2) putting in place appropriate interventions.
Whole-population approach
A whole-population approach focuses on suicide prevention for all members of society. It aims
to reduce suicidal behaviour by addressing the risk and protective factors at individual, family,
community and societal levels.
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Connecting for Life Mid West 2017 - 2020
81
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World Health Organisation. Preventing suicide: A global imperative: World Health Organization; 2014.
Photo Credits:
Page 7 Engagement Working Group (2016), HSE
Page 20 Tipperary Hurlers Team Huddle, Semple Stadium (2013), Courtesy of INPHO; Cathal Noonan
Page 26 Connecting in Ennis with Clare Immigrant Support Centre (2017), HSE
Page 31 Darkness into Light (2015), Courtesy of the Limerick Leader
Page 70 Connecting at Kilmallock Mart with Local Farmers (2017), HSE
Page 73 Dancing at Fleadh Cheoil na hÉireannn Ennis 2016, Credit: John Kelly
Page 81 Connecting in Roscrea with the Rosie Grey’s Singing Group (2017), HSE
Page 84 Pride Parade in Limerick (2016), Courtesy of Dolf Patijn/ilovelimerick
Page 86 Connecting in Limerick City with Limerick Youth Service (2017), HSE
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Resource Office for Suicide Prevention
Mental Health Services, HSE Mid West, St. Joseph’s Hospital, Mulgrave St, Limerick
061-461454
www.connectingforlifemidwest.ie
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Connecting for Life Mid West 2017 - 2020