Dr. Matthew Sadlier:

May I jump in on this? As I have said, I work as a psychiatrist within the public hospital system. The pandemic has exposed significant gaps in our mental health services. The percentage of our total budget we spend on psychiatry is one of the lowest in the world. I echo what Ms Ní Sheaghdha has said. By profession, I am an old-age psychiatrist. My day job involves me going in and out of nursing homes and visiting people at home. Isolation and loneliness has been a very significant issue during this pandemic, especially for the elderly. I welcome the introduction of the concept of the support bubble within the level 5 restrictions. It was a very good late addition and may help to offset some of the problems we saw during the first wave of the pandemic.

We need better integration of community psychiatry and acute hospital mental health care. The division of psychiatry out into the community comes with the side-effect of reducing the supports available to the general hospital system in places. This needs to be seriously thought about. Liaison psychiatry, the special type of psychiatry in hospitals, needs to be better resourced because not only does it provide care to patients within the hospital, but having a good and well-resourced liaison psychiatry department within a hospital provides a resource for the staff of the hospital. It is able to look at matters such as psychological first aid, a programme we ran in the Mater hospital in Dublin, and other such initiatives to support staff. If the staff's mental wellness can be supported, we can prevent mental health problems developing.

If we can stop it becoming a mental health problem then we can prevent it becoming a mental illness problem. There is a gradated system from wellness to illness that happens in all parts of the body but specifically with regard to mental health, we have look at the integration of community and acute hospital care.