Mr. Martin Rogan:

In regard to the historical reference, in the past we had a very large institutional base in Ireland and I do not think any of us are nostalgic for that. These hospitals were often over-inclusive and included people with learning disabilities, people with mental health needs, people who were socially different and people who were graduates of orphanages and Magdalen laundries. We had a great fondness for institutional care. The pendulum has now swung in the opposite direction and we have gone from having the world's highest bed to population ratio to one of Europe's lowest. It is a kind of Celtic thing to do, in that we go from one extreme to the other. Even at that, the challenge is finding sufficient staff to serve that small number of beds, which is now lower than recommended norms. Ireland operates some 22 acute beds per 100,000 of population whereas the European norm is closer to 70, so we can see the pinch point when someone needs hospitalisation. Admission should be, if not a last, then a late resort, but there is really no substitute for it when that is the person's need.

We are very conscious that we simply will not be able to treat our way out of this demand. This is why we need prevention, promotion, early intervention, engagement with people and upskilling of people to survive in the world. As Mr. Power clearly said, smartphones exist and that technology is not going to go away, but while there is a certain level of "new toy" about them at the moment and they are probably over-intrusive in our world, they will fall back into the landscape over time. Nonetheless, we need to be very mindful that it is not a passive relationship and is a much more motivated relationship to which we need to be alert.

What is very important in this forum is that we do not continually restate the diagnosis. Restating the diagnosis is not treatment. Saying things are terrible, shocking and awful leaves a very unhealthy and unhelpful impression in the public mind. There are services and those services are far better than they have ever been in terms of the calibre and quality of both the services and the staff who are available. While there are capacity issues, they can be addressed. In the Victorian era there was an extraordinary investment in mental health and that continued up to the 1960s. I am not sure our generation will be judged well by history in this regard. We have the technology and the understanding, but the question is whether we have the willingness to invest in our mental health. That is a very simple question. One of the important roles for this committee is to sample public opinion and ask the public what they want and expect and whether they are willing to pay for that. If the answer is "No", then let us stop pretending, but if the answer is "Yes", then let us get on and do the work. This forum is really important and, as public representatives, committee members are immediately in touch with the pulse of the public and their attitudes and needs. If we want these services, we need to invest.