Una Mullally: If we can cut road deaths, we can tackle suicide

Political will and ‘joined-up thinking’ saved lives before, and could do so again

Random breathalysing. The reduction of road fatalities is an example of a multi-faceted approach to a tragic problem. Photograph: Dara Mac Dónaill/ Irish Times

Back in the early 2000s, reducing fatalities on Irish roads seemed to be an insurmountable task.

Road deaths declined from the highest number ever on record in 1972 (640), then stayed in the 500s in the early 1980s, and 400s in the late 1980s and early 1990s. But the figures were still all over the place. There were the same number of deaths in 2001 as in 1985, and throughout the 1990s, figures would decline one year and increase the next. There wasn’t a strong enough pattern emerging to suggest that this was really being tackled.

In 2005, 396 people were killed on Irish roads. Then things changed. In September 2006, the Road Safety Authority was established with Noel Brett at its head, a sort of ‘tsar’ for road safety. A new Road Traffic Act was introduced, four years after the penalty points system started. This gave gardaí powers to randomly breathalyse drivers at alcohol checkpoints.

That same year, The Ray D'Arcy Show on Today FM won a PPI award for its work in highlighting road safety and fatalities. A few years previously, the Irish Independent's campaigning reporting on road deaths with its 'It Happens Every Day' series had already started to gain traction. High profile and sometimes controversial advertising campaigns meant that advertising road safety became synonymous with the term "hard-hitting".

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Also, like lots of attitude changes in society, the efforts to reduce road deaths were driven by personal stories, shared on talk shows and radio ads and in newspaper articles and television reports. Cars got safer (compulsory car testing was introduced in 2000, thanks to an EU directive), better roads were built and drink-driving became socially unacceptable. All of these conspired to maybe not “fix” a problem that seemed unfixable, but at least improve things dramatically.

Dramatic effect

Road deaths didn’t just peter off, they plummeted. In 2006 they were at 368, in 2007: 338, in 2008: 279, in 2009: 238, in 2010: 212, in 2011: 186, in 2012, the lowest ever on record, 162. They began to rise again in 2013 to 188 and in 2014 to 193 and fell again in 2015 to 166. This year will be higher than 2015 (there have been over 20 more fatalities than this time last year), but it will still be one of the lowest on record. You might be forgiven for thinking that road deaths are as bad as they were 10 years ago, given the consistent and high profile reporting on them, a legacy from the early to mid-2000s.

Several things conspired to help solve Ireland’s road fatality crisis, but none of it would have happened without the political will that created funding, legislation, new policing powers, and a new agency to tackle the problem once and for all. What happened was an example – and unfortunately a rare one – of that illusive “joined-up thinking” we hear so much about. It wasn’t a coincidence.

Road deaths no longer happen every day, but suicides certainly do. In 2014, there were 459 suicides in Ireland. In 2013 there were 487. Suicides declined between 2003 and 2007, but rose during the worst years of the recession, with 552 cases in 2009 and 554 in 2011. However, the suicide rate actually peaked in 2001.

The conversation about mental health has moved on a lot, but it is still a circular one. When will we tackle this crisis from as many angles as we possibly can in order to really make an impact? There are, of course, far more complex problems in the area of mental health than in road safety. Road deaths are not mental health issues, and that is not my comparison. What can be used as a case study, however, is the reduction of road fatalities as an example of a multi-faceted approach to a tragic problem. So what can we learn from how we saved lives on our roads?

Broken system

Mental health services are to preventing suicide what engineering is to improving road safety. If you can’t account for the variables and unpredictability of human behaviour, you can at least change the systems and infrastructures people interact with.

Some €12 million allocated in last year’s budget for mental health services was diverted to other spending areas because the Department of Health and the HSE said relevant staff couldn’t be recruited and therefore they couldn’t spend the money. Even when funding is actually set aside, the HSE seems unable to cope. Minister for Health Simon Harris said during the summer that he would restore that funding, but how are we to know that the HSE will be able to spend it efficiently?

Emotional rhetoric and stigma-busting have been extraordinarily powerful in drawing attention to mental health issues. However, the key component to any large-scale progress that is dependent on funding, legislation and structural change, is political will. Grassroots organisations and awareness is fantastic, but unless it is being properly resourced by Government, and organised intelligently, it will only ever have a fragmented impact.

Like most people, I have lost friends to suicide and have seen others struggle with, and become frustrated by, mental health services which almost always seem archaic and inadequate.

Road safety may seem like a strange comparison to make to the complex, individual cases of those with mental health issues, but we did actually save lives before when Government and society really wanted to. It’s time to demand that rare “joined-up thinking” that saved lives before, and could save them again.