2026-01-21

I thank the Ceann Comhairle for giving me the opportunity to raise the issue of the need, or demand, for a suicide crisis assessment nurse. A few years ago, I was speaking to a young man, Stephen McCarthy, who lived about 300 yd from where I live. A woman had seen us speaking, and she asked if she could have a word with him because her son was in school with Stephen. She said she remembered him as a smart intelligent boy and that he seemed to have a deep sense of fairness, because life had not been fair to Stephen. His mother was killed at an early age and his father brought him and his two siblings up. Stephen hanged himself the summer before last. He killed himself about 50 yd from where another member of his family killed themselves in the local GAA club. I am not an expert on people taking their own lives but I know we have the fourth-highest rate in Europe for males aged between 15 and 25 and experts say that is underestimated by 20% to 25%. On Friday, a 14-year-old boy will be buried in Tralee. I spoke to his mother and his grandmother last night. Obviously they are devastated. Their lives have been ruined forever. Stephen McCarthy's father said he is scarred for life. Recently I passed all the graves in Rath graveyard in Tralee and the number of people I knew who had taken their own lives was staggering. In County Kerry alone it was 25 people in 2022, 24 in 2023 and 38 in 2024. That is in one county alone. We do not have the statistics yet for 2025 but in those three years there were 87 deaths, which is phenomenal. There is a scheme, which I have mentioned, for suicide crisis assessment nurses, SCANs. The Minister of State is aware of it. It is in Cork and in Dublin. The HSE states it "aims to provide a timely response to appropriate requests for assessment of patients in suicidal crisis from named GP practices". It goes back to Sláintecare and the right care in the right place at the right time. This would be timely and it is necessary. Having spoken to people in the community mental health service in Kerry, they see the massive demand for it. It is particularly high in the Traveller community. I do not know why. Is it because of social exclusion? Is it discrimination? Is it a low sense of self-esteem? Is it unemployment? Are there other factors? Stephen's brother told me that as a young Traveller he would feel ashamed seeking help. Travellers, according to the experts I spoke to, will not go to the accident and emergency department. They are slow to say it to people within their community. Talking to women, they might find that difficult - there are culturally different experiences for them. However, something needs to be done. I spoke to Elma Walsh from the Donal Walsh #Livelife Foundation. She visits schools all over the country. There is a video the HSE prepared and Donal Walsh did great work just before he died asking people to have the courage to reach out. A HSE video was prepared but because of some battle, I understand with the Department of education, it has never been shown in schools. Elma Walsh is going to Derry this week and was in Dublin last week visiting schools. I am asking the Minister of State to set up this SCAN system in County Kerry to deal with the crisis there.

I thank the Deputy for raising this really important issue in relation to suicides in our country. I welcome the opportunity to respond to him because we do not spend enough time speaking about suicide. It goes without saying that even one death by suicide is one too many. I offer my condolences to the family of Stephen McCarthy and the 14-year-old child the Deputy said will be buried this week. It is a really difficult time for their families. One death by suicide has a huge effect on families, the community, neighbours and school and work communities. It is something I have been working very hard on for the past while. We are currently developing a new Connecting for Life strategy with the National Office for Suicide Prevention. I sat down last week with the deputy Chief Medical Officer Professor Philip Dodd and went through the first draft. I will launch it next month. We are very close to having it finalised. Reducing self-harm and suicide is a priority for this Government. That was evident in the way I tailored the budget for this year. An additional investment of over €15 million will fund new initiatives to support those in mental health crisis. These include new specialist nursing teams for all model 4 hospital emergency departments working out of hours to support the non-consultant hospital doctor, NCHD. We have nine model 4 and ten have been prioritised, namely, the nine model 4 hospitals and the Mercy Hospital in Cork, because it had 1,200 presentations last year relating to self-harm and suicide ideation. Each of those hospitals will receive four nurses each. They will be clinical nurse specialists and advanced nurse practitioners who can prescribe. They will work in the emergency department out of hours supporting the NCHD. This is important because we have really good teams in place in emergency departments but we always have that issue out of hours, which can be very difficult. I will continue to expand the model 3 hospitals in next year’s budget. As a result of not being able to fund the model 3 hospitals in this year's budget - because I have to do it step by step and incrementally - I prioritised three areas for a crisis resolution team and a solace café. One was Donegal, one was the midlands and the other was Kerry. There is recurring funding of €1.3 million that will put in place a crisis resolution team that will work out of hours from Thursday to Monday from approximately 4 p.m. or 5 p.m. until 11 p.m. A crisis resolution team makes an intervention that may not necessarily have to happen in a hospital or clinical setting. They can support the Garda with an incident its members may be called to. It will also provided funding for a solace café. I currently have six of those open around the country. I opened one in Sligo during the summer. There is one open in Galway quite a while, ones opened in Limerick and Galway in only the past couple of weeks, there is one in Dublin and one on Sullivan's Quay in Cork. What these cafés have been shown to do is reduce presentations to emergency departments by 18%. It is clinically-led but it is also peer-led and there are people with lived experience. It is an alternative to having to present to the emergency department, which is really important. I am very familiar with the SCANs and have built the scheme incrementally in all six budgets since coming into my role. I recently visited Donegal where we have the SCAN U scheme. The medics in Donegal did this all on their own. These are SCANs for people aged under 18. In last year's budget I secured the funding to put two SCANs in CAMHS for the first time ever. They are in Portiuncula up on that side of the country because the area had the highest presentations of young Travellers with suicidal ideation and self-harm. We are making a lot of steps but I will speak directly about SCANs when I come back in.

I should mention the name of the boy because I have his family's permission. It is Clancylee Casey, who was known as John. He is the boy who is going to be buried. I appreciate the crisis resolution team the Minister of State has put in place in the solace cafés and that there has been an 18% reduction, but the fact remains a lot of people are slow to go to the emergency department. While what she said is welcome, I ask her to review the situation and have a look at putting a SCAN system in place in Kerry. She is correct that we do not spend enough time talking about it and I am not the first and certainly will not be the last to raise the issue but because of the extent of the crisis. Suicidal ideation, in the words of someone on the community mental health team, "cannot wait". I ask the Minister of State to deal with it as a matter of urgency. There is also what they call a black escalation in the emergency department in UHK, so they are under enough pressure. If a SCAN system were put in place, it would take some pressure away from the ED. It is important for us in the House to say there is help there. People need to have, as Donal Walsh said, the courage to go out and seek it. I encourage anybody to look at the HSE video Donal did, which is only five or six minutes long, or the 19-minute interview he did on Brendan O'Connor's show before he died. The Minister of State mentioned CAMHS. We are still waiting for the report. There are still people excluded from the scheme. I have been saying for three years it is inevitable there will be a wider review of the system. Over €2 million has been spent on it. I am told it is completed. I do not know what is holding it up. We were told it was imminent last July but it still is not there I ask the Minister of State to publish it as soon as possible.

On the report, I do not have it yet but as soon as I get it, I will publish it.

I know that the Minister of State does not have it but I also know that it is complete.

Yes, but I do not have it and the Department does not have it either. I want to be clear on that. To revert to the issue at hand, I want to touch on something I did last September about which I am trying to get the word out as much as possible. In Ireland at the moment, four out of every five suicides are male. It is important to acknowledge that between 2000 and 2021 Ireland saw a 28% reduction in the suicide rate, falling from 12.9 per 100,000 in 2000 to 9.2 per 100,000 in 2021. Currently our figures are at nine per 100,000. I am not playing politics here but am just pointing to facts. I met recently with my counterpart in Northern Ireland and the figures there, believe it or not, are 13.5 per 100,000. We have made progress, for want of a better word, even though one death is one too many. We have seen a reduction in the numbers and the preliminary figures for 2023 are the most positive I have seen to date, notwithstanding the fact that of every five suicides, four are men. On 1 September last I launched free counselling supports for men across the country. I worked on these supports with the Traveller community in Exchange House in Dublin, the retired veterans association called ONE, the Irish Farmers Association and the College of General Practitioners. When a man who has been on the farm all day or working all day comes home in the evening, he is not going to hop into the shower and then drive into Tralee, Dungarvan or wherever to get counselling supports. He can self-refer to Connect Counselling from 5 p.m. until 9 p.m., seven nights a week. He can simply pick up the phone and have six counselling sessions. When I finish here I will make sure all of the information on this is sent to Deputy Daly. The most important thing I can say today to any man listening out there is that if, having received counselling supports, he needs to be seen by somebody, that can happen as well. Two thirds of all counselling supports today will be accessed by women. Women are much quicker to sit down, have a cup of coffee or tea and talk to each other. Information is available at yourmentalhealth.ie/men. For the first time ever there are free counselling supports available in this country and the fact that men can access those supports at their own kitchen table is so important. An awful lot of people will not go into a clinical setting for counselling supports. Connect Counselling is providing the supports for us and the take-up is very good. I am doing my best to work within the system. We have run and continue to run ads in the cinemas to make men aware that there are supports out there. I thank Deputy Daly for raising this issue and will send further details on those free counselling supports to him. It would be fantastic if every constituency office would spread the word. I am sorry for going over time.

That is fine. I did not want to cut in because you were making a very important point. I wish to pass on the condolences of the Ceann Comhairle's office to both of the families mentioned. I thank the Deputy for raising the issue which is quite personal.