Dr. Jennifer Doran:

That is a great question. There are 160 people on Clare Island, but it is an ageing population. I mentioned newborn babies but there are people in their 90s living there. As the Deputy rightly said, many people manage multiple chronic conditions. Earlier, Dr. Cashman talked about older people whose kids cannot get planning permission and then say they will have to leave. There are a lot of older people living alone whose families live on the mainland. While the community does gather around, it can be a real issue, for example, in older people going into care homes prematurely or having to stay in an acute bed in a hospital because there is nobody at home to look after them. They should be well enough to go home, but there are no services. Physios cannot get out to them, or it is much more difficult, and there is no home help. On Clare Island, we have one home help who is part time. This ties in a little bit with what Senator Garvey was saying earlier. She said she was going to speak to the Minister for Further and Higher Education, Research, Innovation and Science about islands becoming self-sustaining and self-sustainable, and training up people on the islands. The problem is that if people want to become a home help or a healthcare assistant but they live on the island, they are not going to be able to go to a FETAC level 5 course in Westport that takes six months to complete. How do we train people who live on the islands already to ensure that older people can remain on the islands? It is an absolutely heartbreaking situation to see a person who was born on the island and has lived on the island all their lives, but does not have anybody to look after them in their own home, having to leave for the last years of their life. It is no good for the community and it is really awful for the older person themselves.

The island has an ageing population. There is a great sense of community and people do look in on each other, but there are certain things that need doing that people need training and payment for. Obviously, everybody looks out for each other but if it is the case that a patient has been allocated X number of home help hours a day by the HSE, that is no good if there are no home helps there. Someone cannot be sent out from the mainland because that will take a whole day. That is one issue.

The Deputy also asked about mental health. My background is actually in psychiatry. There is a serious problem with mental health services across the country and shortages. Mental health is something that lends itself so well to being provided at a distance. On the islands, just like everywhere else, there are long waiting lists, in particular for adolescent mental health services. People deteriorate in the time they are waiting. Across the board, there is not enough being provided to the island in terms of mental health services. There are additional challenges such as loneliness and isolation. For young people who are being bullied in school, there is no escape. They are going home, living and growing up with these people all the time. There is a huge need there as well. I do not know if the others have anything to add.