Mr. Ian Power:

I would like to express my thanks to the Deputies, Senators and Chairperson, on behalf of the SpunOut.ie team, for the invitation to address the committee today. As Ireland’s youth information website, run by young people for young people, SpunOut.ie meets the information needs of over 140,000 young people each month.

One of our largest and most pressing areas of concern is youth mental health, where for over a decade we have acted as a trusted signpost to specialist services and as a non-judgmental provider of essential information services. In this role, we have developed a clear understanding not only of the general needs of our national mental health services, but crucially of where those gaps in the system have hurt young people the most. It is welcome that the committee has chosen to seek specialist information from the youth work sector. I hope our contribution today can go a way towards improving the future of mental healthcare, in particular for those whose futures are placed most at risk both by chronic underfunding and a lack of early intervention.

The fact that prevention is better than any cure is more than old cliché. It should be at heart of everything we do when it comes to mental health. Three quarters of all serious mental health difficulties start to present when a person is aged between 15 and 25.

It is at those ages that properly funded mental health interventions are not just crucial but, in actual fact, irreplaceable for ensuring long-term mental wellness.

There is enormous demand for accessible early intervention services for young people that charities, NGOs and acute services simply cannot satisfy on the basis of current levels of investment. I was encouraged to see the committee consider a recommendation that mental health spending be increased to 12% of the health budget. However, we have to bear in mind that even the 8.2 % figure set out in A Vision for Change has yet to be met. For all the talk of mental health as a political priority in 21st century Ireland, we remain far below the 13%, or even 23%, figure we managed in the 1980s, as mentioned by my colleague.

I say this to underline a simple truth, namely, that while we may advocate specific policy changes or reallocation of resources in isolation, without a meaningful and sustained increase in overall levels of funding, we will not be able to tackle the mental health crisis in our society. We should make no mistake; there is a crisis. The most recent EUROSTAT figures released last month put our youth suicide rate of males and females at seventh worst in the EU. Meanwhile, we continue to spend less than half of the percentage of our nearest neighbours in the UK. We need to build a consensus around funding services that work and can make early effective interventions that can have enormous positive impacts on individuals and communities.

There is a wide acceptance, informed by the work of the WHO and others, that the overwhelming majority of mental health interventions should take place in primary care. Therefore, any plan for the future of mental health services must have quicker, easier access to psychology in primary care at its core. The recent decision to appoint 100 new assistant psychologists makes for a welcome start. However, the apparent global shortage of mental health clinicians makes it more challenging than ever to attract the skilled professionals we need, especially in the context of services in rural areas.

The Seanad Public Consultation Committee has pointed out how, even as international competition for trained mental health professionals intensifies, we have not seen any steps taken to improve pay and conditions in the sector. This has been true not just within primary care but also for acute services, such as child and adolescent mental health services, CAMHS. In mentioning CAMHS, I am reminded of the ongoing work in which we at SpunOutare engaged in helping to build public awareness and understanding of that service. In choosing to partner with us, those involved in CAMHS have recognised the indispensable role of clear and engaging information provision in ensuring appropriate and effective mental health interventions. Moving forward, we would hope that CAMHS will receive the resources they need to create a truly accessible service.

Also of note and to be welcomed is the mental health digital and telephone support project, which is wisely exploring the possibilities of publicly provided, evidence-based ICT mental health supports so young people can potentially Facebook message a trained helpline volunteer in moments of crisis or use a digital signposting tool that helps them find the right service as opposed to needing to know the service for which they are looking. They could, potentially, even Skype with a therapist. I am sure the members of this committee who represent rural areas will intuitively understand the value and potential of remote services, particularly as rural isolation and distance from bricks-and-mortar services continue to hamper preventative and emergency mental healthcare.

The possibility of a genuine round-the-clock public service is one that would repay any required investment many times over. In that spirit of investment in long-term worthwhile projects, I wish to emphasise the excellent on-the-ground work carried out by the 13 current Jigsaw services, representatives from which are here with us today. Extending the reach of Jigsaw to more parts of the country or increasing its reach generally would be an extremely positive step for the future of Ireland’s youth mental health. The service meets an essential need for brief interventions and has a notable 98% satisfaction rating for those who have been able to access its services. Jigsaw will talk in much more detail about its service, but it is important that we see the impact it is having in local communities around Ireland and to state that as an independent organisation.

As the committee continues its work, I hope the need for more of these services will be front and centre, especially in light of Jigsaw's unstated role in supporting the case management of young people with mental health difficulties in many areas of the country, something that is absolutely pivotal in ensuring a joined-up and responsive national service. If we are to do that and do it well, I am absolutely convinced from my own time as a member of the youth mental health task force that the recommendations identified by that group will need to be addressed in full. The task force’s report highlighted, for example, the need for an independent advocacy service for children and young people and for new leadership structures in the area of youth mental health, including dedicated leads on national and community levels to enhance service co-ordination and accountability. The report also pointed out the need for legislative change that would allow 16 and 17 year olds to consent to their own mental health treatment and called for funds to be ring-fenced in order to satisfy the ever-growing need for counselling support services in third-level institutions. Each of these recommendations, if fully implemented, would remove barriers to proper treatment and strongly enhance youth mental health provision in key areas. I ask that the committee strongly consider the value of each of these proposals.

Crucially, I would like to point to the recommendations of another initiative, namely, the youth mental health pathfinder. Its proposals in this area would be transformative. However, a year after its approval by the Civil Service Management Board, implementation of the actions in its report has been delayed by the Department of Public Expenditure and Reform. The pathfinder report contains many innovative solutions to the challenge of co-ordinating cross-governmental action and of the existing accountability gap in regard to Government policy on youth mental health, while also making it clearer and simpler for young people to access appropriate services and receive standardised reliable treatment. I would again strongly encourage the committee to recommend swift action on these proposals within a clear and accountable timeframe.

I want to speak about the work of SpunOut in respect of health promotion. We have published the Survival Guide to Lifefor young people aged between 16 and 19, which aims to provide information across many of the issues and challenges faced by young people within that cohort. Over 10,000 copies of the book have been ordered by young people and sent to them for free. It has been availed of by many different statutory services, including HSE services, Garda diversion projects and other youth work projects throughout the country. We also produced "Ditch the Monkey", a five-part animation series about the five ways to well-being. Multimedia is becoming more important in getting across health promotion messages for young people. It is the way in which they consume information online. If a service does not have a video with subtitles that they can watch without sound on the bus, Facebook or their phone it is much harder to engage with young people.

On social media, the move from Facebook to Instagram is presenting us with challenges internally in the context of ensuring that we are where young people are today. In terms of the traffic on our website, some of the top issues young people have mentioned and come to us for include anxiety and positive mental health. Getting a good night's sleep, which is so important for physical and mental health, is a significant issue. We recently launched a campaign on problem gambling, which, we note, is a significant issue for young men and women. Being LGBTI+ in Ireland is still difficult and is presenting many problems and challenges for young people's mental health. Employment is the number one area visited on the website. We know that for young people being in employment or education is the number one protective factor in the context of their mental health.

While there is much more that could be said about the future needs of mental healthcare from a youth work perspective, I know that time is limited. Therefore, I will restate the need for genuine, sustained funding increases for mental health services which build on and support the best practice and innovation in care we see from certain service providers. I thank the Chair and members and would welcome any questions, either during this session or at a later time.