Madam, - Your Editorial on suicide (September 1st), which followed the international conference held recently in Killarney, correctly highlighted that our response to suicide and para-suicide in Ireland has implications for the future of our mental health services.
There is a school of thought that the suicide rate can be connected, at least in part, to undiagnosed mental illness. This view was put forward strongly at the conference by Prof David Shaffer of Columbia University. Columbia's "Teenscreen" programme, which is in use in 30 states, advocates the screening of all teenagers in the population for mental illness and suicide risk. The "Teenscreen" literature argues, for example, that the recent tragic events at Virginia Tech is proof of the need for such screening.
In practice, medication (such as Prozac) tends to be the treatment of choice in the case of "Teenscreen". Not surprisingly, the past decade has seen a dramatic increase in the prescription of psycho-active drugs to teenagers and younger children in the US, particularly to those from less affluent areas.
Irish society and our mental health services will have to come to grips in the coming years with previously neglected issues of mental illness, adult and teenage suicide. The issue of mental health "screening" may well appear on the policy radar, as it has in other countries.
Arguably we already have an effective infrastructure in place for the prescription of medication via GPs in primary care, psychiatrists, hospitals etc. By contrast, there is relatively little provision in place for individual and group psychotherapy and family therapy as an alternative to medication. In many parts of the country today there is no realistic alternative to medication at primary care level at all.
In 15 years' time the quality of our response and the rate of prescription of psycho-active drugs to our children and teenagers will depend on the policy decisions on service provision that we make now. The blueprint document "A Vision for Change" has already been published. It is therefore time to debate these issues in a serious way. - Yours, etc,
EDWARD BOYNE, Director, Irish Association for Psychotherapy and Primary Care, Clarinda Park, Dun Laoghaire,
Co Dublin.