Dr. Liz Brosnan:

The Senator asked a great question and I am glad she did so because it is core to part of the fundamental difficulties we have with mental health services as they are constituted in Ireland. We know from experience that when a doctor does not have time to listen to people even in general practice and to explore the issue bringing the person to seek help, the easy solution is used because of the weight of medical education, theory and all of the funding from the pharmaceutical industry in terms of research.

This powerful lobby makes it far easier for people to give drugs than to spend time listening to people. This is not to say that on some occasions, although very rarely, with somebody presenting in a state of extreme distress, some medication could be used to alleviate that. In effect, the drugs are called antipsychotics, which are usually given to people with long-term conditions. They have a lot of metabolic side effects that are very often not spoken about and they have consequences for physical bodies so people end up more likely to die younger. They often put that down to the fact that many people smoke and they attribute increased mortality rates of people who use mental health services to that. They rarely look at the effect of the drugs on people's bodies because they are very powerful drugs and are used far more than they need to be. Joanna Moncrieff, a psychiatrist in the UK, would speak very strongly to the fact that these are very powerful medicines that are overused and often used in combination so there is polypharmacy. To be fair, I have come across some concerns about this discussion among professionals in mental health services.

There is a push to develop more access to talking therapies within mental health services. That is what people want. They want access to a safe space to talk about the underlying issues. It could not have been clearer from what Ms Hough said earlier about what she felt her sister did not get. Doctors are under too much pressure with too little time, too many people to see and too few resources. Community mental health teams need to be fully resourced and they need to be multidisciplinary because each and every discipline in mental health has a unique and important aspect to offer people who use the services. Owing to the dominance of psychiatry, quite often the first position that is filled is that of psychiatrist and it then trickles down so it is very hard to rebalance the power of psychiatry. Often when psychiatrists do not know what to do or do not have the time, falling back on overmedication is a human response to the pressure they may be under because of lack of resources for mental health services. Services are so underfunded. I know that during Covid, the first aspect of services to falter involved the community teams that had been developed because staff working in teams were pulled back into trying to cope with the acute units as these are the services that are currently legislated for under mental health legislation.