Suicide in Ireland - update

Suicide rates in Ireland have continued to fall in 2013 and 2014, according to new provisional figures published by the National Office for Suicide Prevention.

The NOSP’s latest annual report shows there were 541 deaths by suicide in 2012, falling to 475 in 2013 and 459 last year.

The latest official figures show the suicide rate in 2012 was 11.8 deaths per 100,000 population. Provisional data suggests the rate fell to 10.3 deaths in 2013 and 10 deaths per 100,000 last year.

However, the NOSP said the pattern should be interpreted with some caution as data for the last two years is still provisional.

Nevertheless, it suggests a reverse of trend which had been particularly evident since the onset of the economic recession in Ireland in 2008 of a rising number of suicide deaths.

According to the NOSP, the increase over the period can be wholly attributed to an increase in the male suicide rate.

The annual number of deaths by suicide in the Republic peaked in 2011 with 554. On average males account for 4 out of 5 deaths by suicide.

“Ireland’s suicide rate is not high by European comparison. However, suicide rates among young males and females are high,” said NOSP director, Gerry Raleigh.

He said the suicide rate among both males and females aged 15-19 years was 10.5 per 100,000 population – the 4^th highest of 31 European countries.

“The methods by which people choose to end their lives in Ireland continue to be challenging,” remarked Mr Raleigh.

He pointed out that while there has been a 12% decrease in the overall rate of self-harm presentations in hospital emergency departments since 2010, the level was still 6% above the 2007 rate before the economic recession.

Mr Raleigh said he believed Ireland could achieve the World Health Organisation’s global target of reducing the suicide rate by 10% by 2020.

“Historically as a nation we have struggled to talk openly about suicide and how it impacts on us. However, our national conversation is growing and we are becoming better at discussing and addressing issues relating to our mental health,” said Mr Raleigh.

On a county basis, the most recent data shows the highest suicide rates are found in Limerick City, Cork City, Kerry and Wexford.

The highest rate in the state is found in Limerick city where there were 21.1 deaths per 100,000 over the period 2011-2013 – almost twice the national average of 11.4 deaths per 100,000.

Kerry has the second highest rate at 19.7  deaths followed by Wexford (19.4) and Cork City (16).

At the other end of the scale the lowest suicide rate in the 2011-2013 period is in Fingal at 5.4 deaths per 100,000 population – more than half the national average.

Other areas with below-average suicide rates include Donegal, Tipperary North, Dun Laoghaire, South Dublin, Meath, Wicklow and Waterford City.

At 15.4 deaths per 100,000 population, the suicide rate in the area of Dublin City Council is considerably higher that other local authority areas in the capital.

Rates are calculated on a three-year moving average to smooth out short-term fluctuations and highlight longer-term trends or cycles.

The latest figures indicate that the male suicide rate has declined from a peak of 20.2 in 2011 to 16.1 last year – the lowest rate since the start of the millennium.

The age group with the highest rate of male suicides almost consistently over the period has been those aged 45-54 years.

However, the female suicide rate increased slightly last year – up to 3.9 deaths per 100,000 from 3.4 in 2013 which was the lowest rate in the past 15 years.

According to experts, it is likely that a proportion of deaths classified as undetermined are also deaths by suicide. The latest provisional figures show there were 65 undetermined deaths in 2013 and 62 in 2014.

The NOSP also published details of self-harm statistics gathered by the National Self-Harm Registry Ireland from presentations to hospital emergency departments.

An increased risk of suicidal behaviour is associated with all episodes of self-harm.

According to the registry, an overdose of drugs was the most common method of self-harm in last year, accounting for two-thirds of all cases.

A total of 11,126 presentations to hospital of self-harm involving 8,708 individuals was recorded in 2014. It equates to around 200 incidents of self-harm per 100,000 population.

The NOSP said self-harm rates in Ireland had now levelled off after three successive years of a decrease. However, the 2014 rate of self-harm is still significantly higher than the pre-recession rate in 2007 when it stood at 188.

Self-harm is more prevalent among younger age groups.

The highest rate last year was found among teenage girls aged 15-19 years at 678 incidents of self-harm per 100,000 population.

It translates as one in every 147 girls in that age group needing hospital treatment last year as a consequence of self-harm.

Repeated self-harm is a significant risk factor for suicide. More than one in five cases of self-harm recorded in Irish hospitals last year were repeat acts of self-harm.

A total of 1,264 individuals made at least one repeat presentation to hospital with self-harm during 2014.

A recent study concluded that the recession had an impact on suicide and self-harm rates in Ireland.

It found the rate of male suicide was 57% higher than it would have been had the economic downturn not occurred.

The rate of male and female self-harm was respectively 37% and 26% higher.

“In absolute numbers there were an additional 476 male suicides during 2008-2012 than we would have expected to see had the recession not occurred,” said Mr Raleigh.

Similarly there were over 5,000 more males and more than 3,800 extra females engaged in acts of self-harm than might others have been expected due to the economic crisis.

Top Marks for Civil Servants!!!

They might be the focus of much public cynicism but Ireland’s civil servants have a pretty high estimation of their own value.

The results of the latest annual review of their own work performance shows almost 60% of staff across all Government departments and other State bodies achieved above-average ratings in 2014 with just under 7% being classified as “exceptional.”

A ranking of “fully achieved expectations” is the minimum required by all civil servants in order to receive annual increments to their salary – a target achieved by more than 99% of them last year.

Just 0.6 % were rated as either “unsatisfactory” or “needs to improve” – in other words “below-average” under the Performance Management and Development System (PMDS) overseen by the Department of Public Expenditure and Reform. The figure in 2013 was 0.8%.

In normal distributions, up to 30% of all staff in any organisation could be expected to receive a below-average rating.

Despite promised reform of the system in 2013, the latest results reinforce the findings of a 2010 evaluation of the PMDS which concluded the civil service is out of line with normal distribution of results. It concluded that “the award of too many high ratings and too few low ratings is the established practice.”

Across the entire civil service, 59% of workers obtained an above-average rating – up from 56.2% in 2013, with the figure rising to almost 82% in the Department of Health.

The Department of Foreign Affairs reported that 22.2% of its staff – more than three times the civil service average – obtained an “exceptional performance” rating.

A total of 21% of employees in the Department of Health achieved the same classification, while almost 18% of staff at the Department of the Taoiseach scored the top mark.

The Department of the Environment, which has been widely criticised over its role in establishing Irish Water, gave an “exceptional performance” rating to over 13% of its staff.

No member of staff was recorded having a below-average performance last year in the Departments of  Children and Youth Affairs, Defence, Health and the Taoiseach.

Other State bodies to achieve the same high standards were Met Éireann, the National Council for Curriculum and Assessment, the National Council for Special Education, the Public Appointments Service, the Law Reform Commisson, the State Laboratory, the National Share Services Office, the Office of the Ombudsman, the Office of Government Procurement and staff attached to the President, Michael D Higgins.

The highest proportion of staff to receive below-average ratings in the civil service last year was found in the Property Registration Authority where the work of 5.2% of civil servants was categorised as either unsatisfactory or needing to improve. The next highest was the Valuation Office (2.7%) and the National Library (2.5%)

The latest figures on the PMDS also show the number of civil servants completing the performance assessment fell last year with a compliance rate of 82.1% - down from 86.4% in 2013.

The PMDS applies to approximately 30,000 civil servants.

The Department of Finance was the only one out of 41 departments and State bodies to conduct a PMDS on all its staff last year. The lowest compliance rates were in the Departments of Health and Children and Youth Affairs where just less than half of civil servants had their performance assessed in 2014.

In July the Minister for Public Expenditure and Reform, Brendan Howlin, said the current ratings scheme would be replaced in 2016 with a new model of performance assessment.

Mr Howlin said the new scheme would be focussed on “identifying excellent performance, leadership potential and underperformance and that encourages regular and constructive feedback.”

He said PMDS would also be integrated with learning and development through focused training for managers on the effective management of performance.

“PMDS places a strong emphasis on individual performance and accountability through the setting of goals and the monitoring of performance,” said Mr Howlin.

The Minister acknowledged that a key challenge across the civil service was the delivery of high performance and to fully engage staff and managers in the management and improvement of performance.