HIQA ‘should audit services’

THE health watchdog HIQA or a similar body should be charged with checking on mental health and suicide prevention services, according to a professor of psychiatry who has researched suicide deaths.

Prof Kevin Malone of UCD’s School of Medicine and Medical Science and of St Vincent’s Hospital, said: “We still don’t know who is doing what, where, and how frequently, around the country... Until we know what we are doing and how we are doing it we can’t make progress.”

Prof Malone appeared before a meeting of the Oireachtas Joint Committee on Health this week to discuss a study which looked at the experiences of 220 relatives of 104 people who died by suicide in 23 different counties.

At that meeting he said provisional suicide figures for last year were an underestimation. Three and a half years ago, when speaking to the Irish Examiner about the now-completed project, he questioned whether Ireland was a suicide “cluster”, adding: “Ireland is a series of small communities. In that scenario, if suicide takes hold you can get a ripple effect and the idea that suicide begets suicide.”

He now says the study did not disprove this theory and that Ireland still has an “upside down” system where statutory bodies referred people to voluntary agencies for services.

“Where are the signposts to care and where are the obstacles to care for those in a suicidal crisis? At the moment, there are very few signposts and there are more likely to be obstacles.”

He said he was fearful that suicide in older age is going to increase and called for a national coroners’ study to improve data collection in the whole area.

“They [coroners] should not be counsellors but they should be afforded the facilities to hear the evidence and manage the bereaved families in as dignified, respectful and discreet a way as possible,” he said.

“Many families say it is the second worst day of their lives, so work needs to be done there.”

Prof Malone also said there was a clear need for HIQA (Health Information and Quality Authority) or another form of independent health audit to monitor mental health service provision and intervention.

“Other major health problems, they are taken very seriously, be they heart disease, respiratory lung disease, etc. HIQA is called in to adjudicate to see who is doing what and whether it is being done properly.

“I would be very interested to see what they would say about suicide prevention services. HIQA has teeth – it seems that if HIQA say it’s not right things seem to get done.”

He said the €5m allocated for suicide prevention in 2011, was “way below par” and reflected the lack of priority given to the area.

“You can’t have situation... where someone says I would rather kill myself than go into my local psychiatric institution. That is not a quote from 50 years ago, but from five years ago.”


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