Mr. Martin Rogan:

It is particularly important that we recognise that mental health services are a component of services provided to meet the needs of the entire population and that the profile of needs can vary. For example, CAMHS is designed to cater for 2% of the population who have an extreme level of need. The question is what comes before that. There is an increasing movement in the mental health space towards promoting positive mental health. A public health model is beginning to emerge in which consideration is given to urban planning and how and where people live their lives. Many lessons have been learned from the pandemic. We have seen an extraordinary community bond and solidarity. It has also shone a spotlight on the need to address certain dependencies with regard to terms and conditions of employment, particularly in the context of precarious work. We are at a reset moment. Before we repack the boot of the car, we must be sure that we are packing things that we really want in our communities. These are significant decisions that we have an opportunity to reflect on and revisit.

On how we invest in our mental health service, it is very important when it comes to, for example, promoting positive mental health that we do this in an evidence-based way. We have worked with Professor Margaret Barry of NUI Galway who is a world expert in this area and developed a new level 9 programme that will produce 25 graduates this year. Taking an evidence-based approach means that we are much better informed regarding what works, what is effective and what is acceptable to communities. It allows us to create strategies and life approaches that people can use to protect their mental health, that of their family members and that of those in their community.

The Deputy also mentioned unregulated residential settings. This is not quite something of a legacy from our past but one must remember that in 1950 Ireland held the world record for psychiatric hospitalisation. Almost 1% of the Irish population lived in what were then large mental hospitals. As people moved back to their communities, and were received well back there, often with the support of volunteers and staff members, large numbers of community houses were established. These were often quite congregated settings which were sometimes not ideally or purpose-built. Often convents, old nursing homes, or small hotels were taken on for this function. We can still see the last embers of that. Unfortunately, as we saw in the tragedy in the Maryborough Centre in Portlaoise where eight people who lived there passed away as a result of Covid-19, this has had a hugely traumatic effect on their families and for the staff members who have made valiant efforts to protect that group. The physical infrastructure did not lend itself to that. It is very difficult for a person to live a dignified independent life where they do not have their own accommodation or space and where they are sometimes even sharing bedrooms with an unrelated adult. We can do better in 2020. We have made big progress but we need to finish that task to ensure that everybody has good quality accommodation, can live in their own space and make their own decisions. That whole message around recovery and stepping back into a full life within the community is absolutely critical to what we do across the mental health sector.