Ireland has a real problem with people who try to kill themselves, or harm themselves in ways that stop short of suicide.
The word parasuicide has been coined by medical researchers to describe such acts. But those who make the initial attempt are up to 110 times more likely to commit suicide than those who don't.
And official statistics show that suicides and parasuicides are responsible for many more fatalities and injuries than traffic accidents in motor vehicles, infectious diseases and diabetes.
According to the latest figures compiled by the National Parasuicide Registry and published in this newspaper yesterday, some 8,500 people attended hospital accident and emergency departments in 2002 with injuries they suffered when they tried to kill themselves. Many of them were very young - 45 males and 156 females between 10 and 14 years, another 413 males and 938 females between 15 and 19, and 666 males and 716 females between 20 and 24 years.
There is substantial regional variation, with Limerick city showing much the highest rates in this, the second such annual report.
These are disturbing figures indeed. They tell a story of disruptive social change which has clearly created great unhappiness. Parasuicide is probably best understood as a series of cries for help. The aggregate figures are stark. They dramatise a social trend that is possible to discern from individual cases and experience, but which has not got the public attention and action it clearly deserves.
More research and analysis is badly needed to make proper sense of these figures. Ireland appears to have travelled up the comparative international tables for suicide and parasuicide over the last ten or 15 years, which is not surprising given what we know about the relationship between them and rapid socio-cultural change. We urgently need to know more about why this should be so in order to understand what can best be done to reduce them.
The age and gender differences involved must also be analysed and acted upon. The incidence of parasuicide is most shocking among younger people, but the figures show clearly it is by no means confined to them, remaining a substantial problem for middle-aged people. In the same way men and women are differentially exposed to suicide and attempted suicide.
Social research can go a long way to illuminate and clarify why this should be so, even if it does not resolve ethical and cultural arguments about the issues involved.