Ms Fiona Coyle:

Ba mhaith liom buíochas a ghlacadh leis an gCathaoirleach agus le baill an choiste as an gcuireadh teacht ina láthair inniu. Thank you, Chair, for inviting us here today. I am joined by Ms Bernadette Grogan, our policy and advocacy co-ordinator. Mental Health Reform is Ireland’s leading national coalition on mental health, with more than 75 member organisations working for progressive reform of mental health services and supports in Ireland. We welcome the opportunity to update members on the need for investment in mental health in the context of the increased need for services arising from Covid-19. There are three key areas regarding our mental health services that I would like to highlight this morning: resourcing, rebuilding and reforming.

Prior to the pandemic, mental health services in Ireland were already under pressure, with long waiting lists, staff shortages and a lack of therapeutic support in many areas. Investment has been long needed in primary care to improve access to psychology services, talk therapies, counselling, psychologists, social workers and social prescribing. Covid-19 laid bare the inadequacies of our mental health services. High quality services demand high levels of investment. As outlined in our pre-budget submission, the Government needs to increase spending on mental health to 10% of the total health budget. The World Health Organization recommends 12% while Sláintecare recommends 10%. The UK spends nearly 13% of its health budget on mental health. Currently, in Ireland, expenditure on mental health is approximately 5.1% of the total health budget.

Last week, before the Joint Sub-Committee on Mental Health, the Minister of State, Deputy Butler, said that this figure may not be fully reflective of the range of mental health supports which may be provided across other services and Departments. The figure was derived from available data and highlights our call for better data on mental health services and outcomes. For budget 2022, we are calling for an additional €85 million; €20 million to maintain existing levels of services and €65 million to be used exclusively for developing new services to drive change in the system and deal with the current challenges. The €10 million announced in February 2021 for mental health impacts of Covid-19 has not yet been spent. This funding must be ring-fenced and the proposed initiatives in place by the end of this year. All announcements in budget 2022 should be surplus to the €10 million.

Effective leadership will be key to driving rebuilding of mental health services. For that reason, we strongly believe that a dedicated lead for mental health needs to be created within the HSE. This lead should report directly to the CEO and drive forward the changes needed to realise the Sharing the Vision implementation plan. We need to build community mental health services to ensure needs are met. Due to Covid-19, many services provided by the community and voluntary sector moved online. The past 18 months have seen the growth of e-mental health initiatives and we call for these initiatives to be supported and expanded. Our Brave New Connections project is supporting capacity building for non-profit organisations, focusing on aspects of their activities and services where they have had to adapt or respond to the challenges of the pandemic.

However, we must equally be aware of the existence of a digital divide and that some of our most vulnerable and marginalised have been excluded from accessing online supports. While the additional €1.1 million in Covid-19 funding allocated to the sector was welcome, a significant digital divide remains. Mental health is not a matter for the health sector alone. Good mental health for the population of Ireland cannot be achieved without measures being taken by other Departments. We must reduce the risk factors for poor mental health in crucial areas such as income, employment and housing. Sharing the Vision includes recommendations for other Departments and we urge a collaborative approach to address all areas which affect mental health.

Mental Health Reform welcomed the publication of the heads of the Bill for the mental health (amendment) Bill. Ireland has an opportunity to introduce person-centred, progressive and non-coercive legislation, which is compliant with human rights and the UN Convention on the Rights of Persons with Disabilities, UNCRPD, and is adequately funded. We look forward to working with members during the legislative process. We believe that a draft Bill will be coming before committee imminently. We respectfully request confirmation of whether this joint Oireachtas committee or the sub-committee will undertake the pre-legislative scrutiny. We have an opportunity for the pre-legislative scrutiny to be as thorough as possible. We also have concerns around Part 5 of the emergency measures legislation. Mental Health Reform calls on the Government to review and repeal Part 5 of the Emergency Measures in the Public Interest (Covid-19) Act 2020 to strike a better balance between the need to protect people from Covid-19 and the protection of human rights.

Mental Health Reform looks forward to working with the committees, relevant Ministers and others to ensure that services are adequately resourced, are rebuilt and the legislation is reformed.