Ms Fiona Coyle:

Covid has impacted on our personal networks and formal support systems have been wiped out. The ingrained thinking in Ireland is that mental health is hidden out of sight and it is fringed on the edges of our understanding of what health and well-being are. This binary thinking is long out of date. The pandemic has demonstrated how physical and mental health are inextricably linked to one other and to our well-being.

In late 2020, RTÉ commissioned important research, entitled The Next Normal, to better understand the effects of the pandemic. Mental health, which had previously not featured, emerged as the fourth most important issue facing Ireland. Research demonstrates decreased psychological well-being and increased anxiety, depression and stress as common psychological reactions. In an Irish context, a March 2021 Amárach poll carried out for the Department of Health reported 36% of people reporting stress, 36% reporting frustration, 29% reporting sadness and 24% reporting loneliness. These were the highest levels since the survey began.

Mental health is a dominant theme because it is a sharp reality. Research shows that different groups have different risk factors for Covid-19. People with pre-existing mental health difficulties, health care workers, women, young people, people in precarious work, those who are homeless and ethnic minority groups are more likely to be negatively impacted by Covid-19. When it comes to the effects of the pandemic on mental health, we are not all in this together.

Our member organisations, several of whom have appeared before the Oireachtas Sub-Committee on Mental Health, have witnessed an increase in those seeking support. Our mental health system was and is not capable of coping with a surge. It was struggling and close to breaking point long before the pandemic hit. When the tide went out on physical health, the inadequacies of our mental health services were brutally exposed. Deficits include inadequate staffing, ICT shortfalls and insufficient access to services. Covid-19 underlines the need to reconfigure mental health services. We must put service users at the centre of design and delivery.

The Emergency Measures in the Public Interest (Covid-19) Act 2020 has had an impact on those with mental health difficulties who are involuntarily detained under the Mental Health Act 2001, as Part 5 of the 2020 Act relates to the 2001 Act. Mental Health Reform notes that all efforts are and have been made by the Mental Health Commission to ensure the minimum impact on the procedural rights of service users. However, the legislation in itself continues to be problematic in its removal of safeguards for service users and its infringements of service users' rights, including rights under the UN Convention on the Rights of Persons with Disabilities, for example, the right to a tribunal. In particular, the legislation presents difficulties in some cases for individuals' ability to tell their stories and have their voices heard. Due to the considerable time these emergency measures have been in place and the progress made on vaccinations, we believe that the measures contained in Part 5 are no longer necessary. Ireland is in a different place to when this legislation was first enacted.

Ireland urgently requires a mental health service that can meet the challenges of the pandemic and its aftermath. The future of mental health services in Ireland will be shaped by the political action taken now. We urge the Government to resource, rebuild and reform our services. In particular, the Government must review and repeal Part 5 of the 2020 Act to strike a better balance between the need to protect people from Covid-19 and the protection of human rights for those under the Act. We must also address other human rights gaps by urgently reforming Ireland's Mental Health Act and publishing the draft legislation to update that Act in order to support planning for mental health services towards the future, reassure people and restore confidence that mental health services will protect their rights. We must substantially increase investment in our mental health services and supports to address the challenges of the pandemic and its aftermath and become resilient against future public health crises.

Covid-19 has laid bare the inadequacy of our mental health services and their peripheral position within the health system as a whole. The pandemic has offered a non-negotiable opportunity to resource, rebuild and resource our mental health services. We cannot go back to a broken system. Now more than ever, we need a fit-for-purpose, responsive and adequate mental health system in which people can access the care they need when they need it.