Mr. Ian Power:

On behalf of SpunOut.ie, I thank the committee for the invitation to address members. As Ireland's youth information digital platform, run by young people for young people,SpunOut.iemeets the information needs of more than 150,000 young people each month. SpunOut.ieis run by Community Creations CLG, which also operates the new Crisis Text Line digital active listening service. Crisis Text Line is Ireland's first free 24-7 text service for anyone in crisis at any time. It is a place to go if one is struggling to cope and in need of immediate help. The Crisis Text Line platform connects texters with a volunteer who is most likely at home and who has been trained to listen, reassure and guide people from a hot moment to a cool calm. Both services receive the majority of their funding from the HSE on an annual basis.

It is welcome that the committee has chosen to hold meetings on the important issue of youth mental health. I hope our contribution can support this committee in its endeavours. Given that time is limited and a number of colleagues from different organisations are present, I will focus on two of the 13 areas highlighted in our submission to the committee. The first is Pathfinder, the youth mental health project, which is an initiative of the Civil Service management board. Pathfinder aims to enhance the cross-departmental collaboration between the Departments of Health, Education and Skills, and Children and Youth Affairs in the co-ordination of youth mental health policy, funding and accountability. The Pathfinder report was finalised two years ago and approved by the Secretaries General of all three Departments for implementation. The report recommends a number of transformative actions for youth mental health in Ireland, including the establishment of a team of dedicated officials from the three Departments on a time limited basis.

The creation of the Pathfinder team and the implementation of the report's recommendations was viewed by the members of the national task force on youth mental health as potentially transformative in addressing the crisis in youth mental health in Ireland. The Ombudsman for Children is also enthusiastically supportive of the proposal.

While the Pathfinder proposal has the support of all three sponsoring Departments, it has yet to receive sanction from the Department of Public Expenditure and Reform and the Attorney General to proceed almost two years after it was first proposed. Every day the Pathfinder report gathers dust, we delay the opportunity to radically reform how we approach youth mental health in Ireland. Pathfinder has the potential to demonstrate an effective model for cross-departmental co-operation and working, which could be replicated in other policy areas. The Department of Public Expenditure and Reform should resolve promptly the administrative issues holding the sponsoring Departments back from establishing the Pathfinder team. This must happen without delay and, as lead Department for the project, the Department of Health must continue to drive this initiative forward with urgency.

The second issue we wish to highlight is primary care. Prevention and early intervention should be at the heart of everything the State does when it comes to mental health care. Almost three quarters of all serious mental health difficulties first emerge between the ages of 15 and 25. It is, therefore, vital that properly-funded mental health interventions are available to young people in this age range to prevent problems from becoming acute, sometimes irreversibly so, and to promote recovery and long-term mental wellness. There is significant demand for accessible early intervention services for young people that charities, NGOs and acute services simply cannot satisfy on current levels of investment. We need to build a consensus on funding services that work and make the early, effective interventions that can have significant 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 settings. Any plan to improve mental health services must, therefore, have quicker, easier access to psychology in primary care at its core. While the decision last year to appoint more than 100 new assistant psychologists posts is a welcome start, we encourage the Department and the HSE to engage with the Psychological Society of Ireland, PSI, to establish an evidence-based training programme for those recruited to ensure they make the contribution we want and need to primary care.

The apparent global shortage of mental health clinicians makes it more challenging than ever to attract the skilled professionals we need, especially for services in rural areas. I point to our submission and the need to continue to expand the number of places in psychiatry, mental health nursing, clinical, counselling and education psychology to begin to address the skills shortage. In addition, we encourage the committee to examine the need for mental health teams to regain autonomy over whom they hire into their teams. While headcount can be managed or controlled centrally by the relevant business unit corporately in the HSE, HSE mental health services at local level must have a say in who joins their teams for a proper people strategy to take effect and to build effective teams.

I emphasise the excellent on-the-ground work carried out by the 13 current Jigsaw services, soon to be 15 with the expansion to Wicklow and Tipperary. Extending the reach of Jigsaw to more parts of the country would be an extremely positive step for the future of Ireland's mental health. The service meets an essential need for brief interventions and has a notable 98% satisfaction rating among those who have been able to access its services. As the committee continues its work, I hope the need for more of these services is front and centre, especially given Jigsaw's unstated role in supporting the case management of young people with mental health difficulties in many areas of the country. This role is pivotal to ensure there is a joined-up, responsive national service. In fact, a no-wrong door approach is exactly what is needed to ensure young people get access to the help they need early, instead of having to undergo what can often be a very frustrating search for the right help at the right time.

As a former member of the task force on youth mental health, I encourage the full and speedy implementation of the Pathfinder report's recommendations, including an independent advocacy service for children and young people, legislative change to allow 16 and 17 year olds to consent to their own mental health treatment, and a ring-fenced fund with the HEA to provide resources to higher education institutions to help satisfy the ever-growing need for counselling support services in third level education. Each of these recommendations, if fully implemented, would remove barriers to proper treatment and strongly enhance youth mental health provision in key areas. I thank the Chair and committee and welcome questions from members.