Dr. Shari McDaid:

Mental Health Reform, the national coalition of organisations which promotes improvement to mental health services, welcomes this opportunity to speak to the finance committee about its pre-budget submission.

There is a need for continued investment in the development of community-based mental health services. There is a need for the counselling and primary care service to be invested in, so the number of peoples who can avail of counselling services through their general practitioner is increased. There is a need that people with severe and long-term mental health difficulties can avail of a medical card.

Up to the end of last year, there has been no additional funding for mental health services. Instead, we have just had a designated amount of re-allocation of funding in mental health services to foster the development of health and social care staff. That has been effective in bringing about the real configuration of services towards having more psychologists, occupational therapists and social workers available in community-based mental health services. We are very far off still from the number of staff recommended in the Government’s policy with a quarter down on levels recommended in A Vision for Change. At the end of last year, there was less than half the staff required to provide child and adolescent mental health services. The services, accordingly, cannot provide the holistic range of supports needed that would help people recover. This means we have not been able to put in place the crisis intervention supports across the country that were set out in the policy. We do not have home treatment as the norm of services, crisis houses or effective liaison between primary care and mental health services.

Last year, the HSE, Health Service Executive, implemented a free counselling service of up to eight sessions for medical cardholders who were referred by their GP. This was a progressive step that we welcomed. We estimate, however, there are probably 690,000 people who experience anxiety and depression during the course of the year. This is based on a comparative analysis of the UK’s figures. In the first six months of this year, we had 5,000 referrals. One can see there is a significant gap between the availability of this service and the level of need. Only 0.5% of the total mental health budget is going to counselling in primary care. In the UK, it is 5%.

There is a need to ensure that people with long-term and severe mental health difficulties have the opportunity to have a medical card. This is a low-cost, cost-effective option and a way of providing security so people can take up work without fear of losing their mental health treatments.