Maire Devine (Sinn Fein) | Oireachtas source

We know about the loss of nursing staff and this is probably due to the austerity cuts. There are other factors but those cuts happened ten years ago and that is when we started haemorrhaging staff. They were severe cuts which went to the core of the service. There was no foresight and the service shot itself in the foot. We and in particular the kids with mental health issues are living with that today.

Previous witnesses said that if there are applicants the recruitment process takes too long. It is too cumbersome and wrapped up with a lot of red tape. They ask if the community health organisation, CHO, areas, did the recruitment directly would that significantly improve and speed up the process. I am not sure whether the present witnesses can comment on that.

The observation was made that in 1984 there were 14% entering the mental health area but now it is 6% yet the statistics here show a rise of 21%, at least in those younger than 18 years, since A Vision for Change came into being. Mental health disorder in children and adolescents is growing with a prevalence of diagnosable mental disorders in our young people aged between one and six. That scares the living bejesus out of me. I do not believe our teenagers have such a high incidence.

Dr. Sadlier described the serious need for wraparound services which are important for the enduring, chronic mental illnesses, schizophrenia, bipolar, and that sort of stuff. The Chairman touched on well-being and how we deal with that as opposed to putting the teenagers on this train that takes years to get them to a treatment they do not need but will need by the time they get there. The idea is to have well-being ambassadors in communities. Our well-being has to be community-led and owned. How do we do that? Dr. Sadlier asked who falls through the gaps, who is responsible and accountable when a person in serious need is missed. There has to be a way to figure this out because we cannot continue to label one in six of our teenagers as mentally unwell. They have issues with well-being and some have issues with mental health. That will develop into difficulties.

I am cynical about the influence of the Diagnostic and Statistical Manual of Mental Disorders, DSM. How often is it referred to? It has grown since 1957 from 106 diagnosable mental health problems or illnesses to over 300 in its last publication. On the back of it there is what I believe is disease-mongering. It is in the interests of big pharmaceutical companies to have more diagnoses available so that they come up with a pill that will hopefully deal with some of the symptoms. We have got so far in diagnosing to death all our foibles, all our sense of spontaneity and human traits that we need to separate them. They are not problems unless they are causing the person who is living with them, or those around them, problems. There has to be a much easier and more compassionate way to consider everyday difficulties that we all encounter as human beings, and to mind our children and make sure they get the well-being service wrapped around them, not necessarily the medication, the diagnoses and the waiting on the train for the wraparound mental health services. We need to have much more community ownership of this. Society needs to say it and not the DSM or big pharma guys. That is my soapbox speech.