Marcella Corcoran Kennedy (Offaly, Fine Gael) | Oireachtas source

I thank Dr. McDaid and Ms Mitchell for their contributions this afternoon and wish to ask a couple of questions.

Last week, the director of the Healthy Ireland policy appeared before this committee. She talked about how the Healthy Ireland agenda is embedded in all the Departments, that there is an interdepartmental and whole-of-society approach and that taking care of one's mental health is a significant part of the approach. Today, the witnesses mentioned the Healthy Ireland policy in their contribution and the economic cost of €11 billion per year. Of course that is only the economic cost and it does not include the cost to individuals and their families. It became very clear from other contributors who attended our meeting last week that substance misuse is causing enormous mental health problems in this country. Do the witnesses think we are doing enough to convey how substance misuse damages one's mental state? Do the witnesses believe that people are aware that cannabis or alcohol inflict damage on one's brain? As for conveying the message that exercise and eating well is important, I believe that a focus on preventative measures will be crucial to our report because we want to keep people well in order that they do not need to access services and we want to empower and enable them.

I would like to know whether sufficient use is being made of psychotherapists in the system. Earlier reference was made to the number of psychologists and psychiatrists and whether sufficient use is being made of psychotherapists. Again, a point that arose in some of our engagements is that there are approximately 1,500 psychotherapists here and many of them are available to deal with whatever cases come before them.

Do the witnesses think the HSE should ensure art therapy is given a therapeutic role? I know that art therapy is really important, particularly to young people as it helps them to express themselves when they cannot express themselves verbally. The witnesses undoubtedly will correct me if I am wrong but I do not know whether there is a recognised position or proper grade attached to it. Art therapy is really important to many people who are dealing with mental health issues. Is there a recognised position? Such a position would be beneficial. While artists visit facilities on a freelance basis or whatever, without a proper grade they are in a vulnerable position. If we want to provide art therapy then we must mainstream the service.

Do the witnesses believe the facilities available across the country are adequate for what we want to provide to people? Recently we all decided to visit our local child and adolescent mental health services, CAMHS. Yesterday, I visited St. Fintan's Hospital in Portlaoise, County Laois. As I travelled towards the main entrance I thought that were I a 14 year old who was being admitted there, I would be completely intimated by it because the entrance looked fairly forbidding. I would feel intimidated even if I was an adult seeking care. Should we not spend more of the capital spend on these facilities to ensure they look welcoming? An awful lot of work has been done inside of the building but an awful lot of work remains to be done. I ask the witnesses to outline what standard these facilities should reach to better help patients.

Deputy Brassil mentioned the number of people who are available to deal with the cases. Is there an argument to be made for upskilling additional clinical nurse specialists who could intervene at a very early stage? Such specialists could also refer people, rather than have them spend time on a list waiting to be seen by a psychologist, psychiatrist, psychotherapist or whoever. Is there scope for such a position?