Tom Neville (Limerick County, Fine Gael) | Oireachtas source

I thank our guests for appearing. My first question is to Mr. Ryan who spoke about A Vision for Change being updated. When will the full document be updated? Has a date been provided? What is the position regarding the implementation of a 24-7 telephone service? The Minister spoke previously about introducing such a service.

I am working on the path finder service behind the scenes with various Departments. I would like an update on that but that is more for the Government side.

Two weeks ago, I joined a Limerick Suicide Watch patrol for four or five hours. It was an extremely humbling experience. I cannot find another description for it. One intervention was made during that time but I did not witness it as it occurred on the other side of the city where a second team was on patrol. We met people who felt low and wanted to speak to somebody and did so before going about their business. These groups operate across the country and are doing unbelievable work. My experience was that there was a jovial atmosphere among the volunteers patrolling the bridges because that is how people deal with these types of issues. However, there is also a sense of nervousness at all times. For want of a better description, people have butterflies in their stomach for the four hours that they are on patrol. I was shadowing others as I am not a qualified patroller.

Does the HSE interact with these patrol groups to discuss their findings, the data they gather, the types of interventions they make and the tangible recommendations they may make on deterrence? They are doing all they can but is the HSE and the other agencies doing all they can to communicate with these groups. Anecdotally, I heard from the Limerick group that further interventions sometimes occur after people have been brought to hospital by the emergency services. They recommended having a qualified person on site immediately because the gap between the intervention and the involvement of the emergency services is where they believe the system needs to be improved.

Dr. Duffy spoke about being proactive in reaching out to these people as opposed to being reactive. I accept that this is difficult. From speaking to people, those who experience a mental health difficulty often find it difficult to make the call and seek help.

They need somebody to help them make that call and reach out, as opposed to reacting. It is all very fine to say to somebody that he or she should get help, but sometimes that person would need somebody else to take the lead and ask whether to make that call for help. I am trying to consider the system, particularly at this acute emergency level, when there are people in such distress and there is a link between the emergency service and where the cases are. This is an example but I am coming from an area where I do not have a huge amount of knowledge. I only spent four hours with these people.

Was all the new money coming from the Government to the Health Service Executive, HSE, spent in 2018 or was some of it handed back? We know there have been recruitment challenges in mental health services but has anything been done to overcome those recruitment challenges since the mental health committee sat? We identified a number of roadblocks in the recruitment process but have any changes or improvements been made? If there have been, what are those improvements?

I visited the Jigsaw service in Limerick and it is fantastic. It was mentioned that Jigsaw is seeking proactive community early intervention. What type of work, from the experience of the witnesses, has been done on stigma? Is there a push or move against stigma? I take comfort that in some people of the younger generation, stigma is not as prevalent as it would have been in the older generations, but we should not take our eye off the ball. Stigma is still there. What is Jigsaw's experience of this and what would be its advice for any future campaigns trying to combat stigma?