Mr. Bernard Joyce:

I thank the Chairman, Deputies and Senators for the invitation. As the director of the Irish Traveller movement, a national membership-based, Traveller-led organisation, I very much welcome the committee's examination on the matter of Traveller mental health and the opportunity to present to the committee.

Traveller experience of mental health is long-established and reflected in Government policy as far back as the Traveller health status study from 1986. Traveller health was a national Traveller strategy from 2000 to 2005 that led to the Traveller health advisory committee being set up and recommendations which delivered the most comprehensive audit of Traveller health, referred to as the all-Ireland health study, in 2010.

Despite the Government strategy of 2002 and the benchmark and pathway all-Ireland study, no dedicated budget was made available to resource the critical actions within it. Since then, there has been no prioritising towards resourcing Travellers' distinct mental health outcomes with a dedicated framework. Since the 2010 study, there has been an ongoing increase in the level of suicide in the community and poor health outcomes broadly. The national Travellers sample survey in 2017 found that 90% of all Travellers said that mental health was a problem in the community. Some 82% of Travellers reported having been affected by suicide, four in ten of these being affected by suicide in the wider family, 49% among local Travellers or neighbours, and 38% among friends or colleagues, creating a multi-level effect on the family.

There are particular concerns regarding the rise of suicide among young women. Suicide represented 11% of all Traveller deaths in 2010, most commonly in Traveller men aged 15 to 26 years. This rate is six times higher than in the settled population. There has been a steep rise in the incidence of suicide in the past five years, with a distinct emergence among Traveller women. The past two years in particular have been a cause of great concern to us, where female deaths have included children as young as 14 years. Reports suggest an increase of suicide among young women in their teens and early 20s. Based on deaths reported to the Irish Traveller Movement by our members and networks, there were at least 30 deaths by suicide in the period January to August 2019 in Dublin, Cork, Tipperary, Limerick, Wexford, Clare and Kerry. From our figures, though, this is an underestimate.

The incidence of suicide in the community is outrunning the very low progress to date of limited strategies such as Connecting for Life, the National Strategy to Reduce Suicide 2015-2020, where Travellers are included in only one of 39 actions. The lack of data by way of a national study or an assessment of need worsens the problem. The Central Statistics Office, CSO, and National Suicide Research Foundation have a role to play when recording and monitoring. However, the CSO does not collect statistics on Travellers. There is no specific inclusion of Travellers as a high-risk group in the HSE national service plan 2019.

Of grave concern to the community is that, in the nine years since the all-island health study, which demonstrated a disproportionate level of suicide and poor mental health outcomes, there has been little intervention. In 2017, seven years after the study, 13 actions towards Traveller and Roma mental health were identified as part of a national Traveller and Roma inclusion strategy. The latest progress shows that one of these has been achieved, namely, the recruitment of nine mental health service co-ordinators to support access to and delivery of mental health services for Travellers in each community area. Progress on other actions has either not been initiated or is at an early stage of development. A budget to deliver on these actions has not been ring-fenced.

The policies and strategies to address Traveller mental health are disconnected and, given the scale of the programme, lack a priority focus. There is no ring-fenced budget to provide resources. There is additional complexity, as the actions are dispersed across Departments. There is no advisory group overseeing the implementation and progress, and supporting data collection is inadequate.

In our submission, we have made a number of key recommendations. I can refer to them later in my reply.