Professor Ella Arensman:

I fully agree with the points made by Dr. Griffin. To take one small step back, I have concerns about the overlap. I am not talking about the entire population who present with self-harm or suicidal ideation but I am greatly concerned about the group we have worked with over the last 35 years, those who undertake highly lethal acts of self-harm and come close to death but who survive by chance. It is interesting that, when you speak to these people at length after their suicidal crisis and recovery, it is not clear that they want to die. There is an ambivalence. As we have heard from the College of Psychiatrists of Ireland, in some regions, there may not be all the right approaches to support or intensive treatment linked to the physical and mental health co-morbidities. I suspect a subgroup that may apply for assisted dying might come in there.

The other point the Senator made related to suicide prevention. Ireland has come a long way and is seen by the World Health Organization as leading in some areas of suicide prevention. The Connecting for Life strategy is still en route. A lot has been achieved but a lot more needs to be done. We in the NSRF would certainly say that, if the assisted dying legislation is further developed, progressed and implemented, this should go hand in hand with continuous efforts to support and sustain all the priorities for suicide prevention. I do not want to add in more complexity but some countries have gone so far as to legislate for suicide prevention, something that has had positive impacts in reducing suicide rates.