Mr. Martin Rogan:

I thank the Deputy for the question. It is a very important piece. We have received some very good advice from the WHO in recent weeks in regard to the management of Covid but it also gives advice on the level of resources we should invest in our mental health services. Its minimal recommendation is 12% of the entire health allocation. In Ireland, in the past we spent up to 23% of health spending on mental health and when I began my career in the mid-1980s, it was at 12%. We have drifted downwards and, unfortunately, we do not compare well with our European colleagues and we do not even compare well with ourselves in that regard.

To provide a mental health service in the best of times with 7% of health spending is difficult, and this clearly is not the best of times as there is an additional demand coming. We hear some unhelpful language about a tsunami of need coming.

That will present itself in a variety of ways in that people have been dislocated and unsettled by the experience. The lives of everyone, including individuals who have not been ill with Covid, who have not had an ill family member or who have not experienced a bereavement, have been changed. It would be very unusual and, in fact, quite unhealthy if this did not provoke some degree of anxiety and upset, or anger in some instances. It has been discovered that many families have bonded more when cocooned together in close proximity but some have found that very difficult. Covid has had an amplifying effect, therefore.

Some of conversations with international colleagues have been fascinating. Some of our US colleagues have teams who specialise in dealing with major adverse events, such as weather events or terrorist events. They have described not only the important need for additional investment but also the question of how it should be used. They have said that in the two years after Hurricane Katrina, for example, additional expenditure on just three conditions - anxiety, depression and post-traumatic stress - was $13 billion. That was the same as the amount needed to fix the levees that had flooded during the event.

It is important to remember that we need a series of tiered responses. Most communities will rally together and respond well. We have seen a huge upswing in volunteering and neighbourliness, and we have also seen a huge community bond. Many have never experienced it except in the past couple of months. That has been a real positive for us. We have demonstrated what we can achieve when Irish people pull together, with good leadership, support and information. People have used a range of techniques, particularly technology, to reach out.

Deputy O'Dowd mentioned older persons. Sometimes they are referred to as people who need care but our older persons are elders and they are very wise individuals. They have considerable life experience and want to contribute it. While they were cocooned away, we were at a loss for that expertise and wisdom, in addition to their gravity of experience, which is really useful at a time of crisis and difficulty.

We know loneliness is very impactful on a person's physical and mental health. It is said that loneliness is the equivalent of smoking 19 or 20 cigarettes per day. If one does not have a connection or a relationship, it is very difficult to mobilise, motivate oneself, self-regulate and share one's concerns. This is why we have been able to use various services through our volunteers and mental health associations right across the country. We have provided over 30 Zoom licences, for example, just to reach out so older people do not feel so isolated and can make an active contribution. That is what they wish to do.

Mental health services have adapted and they have demonstrated extraordinary innovation in recent months. Practices and behaviours that were considered science fiction four months ago are now routine. That has been remarkable. We must regain those learnings and advantages but we also need to make sure the capacity of the service is replaced.