Oireachtas Joint and Select Committees

Thursday, 21 January 2016

Joint Oireachtas Committee on Health and Children

Wellness, Well-being and Mental Health: Discussion

9:30 am

Mr. Niall Breslin:

Why not? I am up for it. I will try to answer briefly as many questions as I can. We spoke about the health budget and how much of it is spent on the physical rather than mental side. We have to stop putting health into two different categories. It is the same thing. The prioritised health issues include obesity, which arises from a predominantly emotional response. It is not just that people want to eat lots of food and some people have underlying problems such as low self-esteem or confidence issues. These are mental health matters, so the problems are linked. Heart disease and related illnesses could be limited or prevented through effective education. We are spending all this money on priority issues, such as beds in hospitals, in trying to fix a massive problem. Politics, by its nature, does not deal with long-term strategy but this must be a long-term strategy issue. It will take 20, 30 or 40 years to resolve. To really normalise the conversation, we must stop putting these elements in different places. Physical and mental health must be treated holistically; they are part of our bodies. My mental health state had major implications for my physical health. My hair fell out and I had no energy. It manifests itself physically and panic attacks, by their nature, are as physical as they are mental. They are a terrifying experience for any teenager.

Deputy Troy mentioned the conversation about suicide. We must understand there is much more to mental health than suicide. We keep using it because it is a shocking statistic and people say we must do something about it. The reality is that we must consider mental health in a much broader way. We must examine how we can prevent many of these issues arising. We can reduce the numbers affected by implementing preventative primary measures and access to talk therapy. A very strong and powerful relationship with my GP was intrinsically important to my recovery. The GP put all the options on the table, outlined them and monitored them every step of the way. The first port of call was talk therapy, cognitive behavioural therapy, which was the most effective therapy I had. My biggest enemy were my thoughts and, for example, if I was going on holiday and checking into a hotel, people might be saying, "It's great to get away for a couple of days" but if the girl told me my room was on the fifth floor, my immediate response was thinking I would burn in a fire. That is how my anxiety would work. I would go upstairs and look out the window to see if I could jump out of it if there was a fire or if there was a place where I could climb down. I would leave the room and look for the best way out. Before I knew it, those thoughts would be going a million miles per hour in my head. They would manifest physically when my heart rate would increase and I would start sweating. Bang, I would have a panic attack.

Cognitive behavioural therapy allowed me to address those thoughts and label them as helpful or unhelpful. That was a major step. We must also address another point about these therapies. I would not ask anybody in the room to run a marathon with two days training and, equally, mental fitness takes a long time to achieve. It requires habit. I am more mentally fit than most people I know but, God, I have to work for it every single day. I hated mindfulness as every time I tried to meditate, I hyperventilated. I had to look at other ways. I am answering a few questions at once here. The other aspect of the mindfulness is that I knew I could get better and I dedicated my life to it. I looked at other outlets, such as exercise and diet. I was on medication for quite a few years but that was under careful supervision from a very good GP. That was absolutely critical.

Anybody like Dr. D'Alton or I coming here and pretending we have the answers would not be telling the truth. The only way we are going to get sustainable answers is by parking egos. People need to stop thinking they know what to do. This is about working together. There are some amazing people involved in this. I work very closely with Mr. Tomás O'Ruairc, the head of Féilte and the Teaching Council, and Mr. Ruairí McKiernan. They are amazing because they look at life differently; they do not look at GDP as an economic factor but they look at prosperity as human. It is very liberating to talk to people like that. I cannot even tell the committee what some schools are doing in this country. It would take one's breath away. These people are changing the entire environments of schools, breaking down stigma. They are not worrying about the town, the country or anything else but rather what is going on in a single school, as they control that environment.

Stigma is slowly eroding. I have learned in my recovery to control what I control and if I try to go beyond this, I will be knocked down. What do we control? We control how we can look at our education system. We need to look at children and teenagers who have not been absolutely sabotaged by that stigma like we have. The running joke in my town when I was growing up was that one's mother was in St. Loman's Hospital or I would be there. It was a joke. There is no doubt that the stigma is slowly eroding and people understand this is an illness affecting every man and woman across all demographics and careers. It does not pick specific victims. I am very passionate about what we can do in education because I know how different my life would have been if it had been noticed that I had anxiety disorder that grew into depression purely from the frustration because I had no control.

I would love to go to every school in the country but, unfortunately, I must work. I have a job and must make a living. That is why two or three friends and I built a website called www.alustforlife.comas a platform for information. It is about real information rather than Oprah Winfrey quotes or saying everything will be okay, as that is not relevant to mental illness. It is not easy and there is no point pretending by telling teenagers that everything is okay. It is tough but the issues can be dealt with. That is what excites me. Online platforms are really important because that is where teenagers are communicating. If we want to reach teenagers, we should not spend big money on ad campaigns on television because teenagers only use the Internet. We can talk about the issues that Internet use brings for teenagers but for every issue there are 50 solutions. We could build something in a strategic or systemic way that would be safe for teenager interaction. There is no reason that cannot happen because the biggest Internet companies in the world are in Dublin. We can do it but the will must be there.

The members asked what I have done. No psychologist or psychiatrist can provide a definitive answer for recovery as it is about trial and error. That is what I had to do. Before I made the leap, I did a simple thing; I named my mental health illness and called him Jeffrey. I put on a piece of payer everything I think Jeffrey loves and hates, along with everything that could help him. It was that simple. I promised that I would dedicate the rest of my life to doing whatever it would take to do this. I have done that. More importantly, everybody around me had to know about the illness, as disguising it was the most difficult part of the journey. I could be out having a drink with a mate but if I disappeared, he would think I was being an ignorant git. I would have to make an excuse that I was sick, for example, and try to climb out a toilet window in a pub. Seeing me trying to climb out a window is interesting. These actions arose when I tried to find a constant excuse for my illness. That took its toll.

One starts to have other issues. One's relationships with people disappear. There are many other external problems, including intimacy issues. There is loads to it. It was unbelievably liberating for me to shout it out and absolutely say it. Part of that involved saying it publicly because I was on a very well-known TV show. Every single day of the first year of that really exciting part of my life, I completely believed I was going to have a panic attack on live television. I worried about what would happen if 500,000 or 600,000 people saw me having a panic attack. I wondered how they would react to me and my family. That scared me every single day. It was all I thought about for months. Of course, I had a panic attack before a live show. It was probably the worst panic attack I have ever had. I could not get up. My ears were ringing. It can take people weeks to get over a severe panic attack but I had just eight minutes. That is why I know I have an inner resilience. People perceive mental illness as a weakness. I do not know many people across all the different areas with which I am familiar - sport, music, etc. - who could have picked themselves up at that point. People perceive it as a weakness but it is actually a strength. If one can face life in the way people in such circumstances do, that will show one how strong one is. The key for us here is to bring out that resilience in some of our youth and let them understand and recognise it. We need to help them understand that there will be days when they will be in trouble and they will struggle. The Soar movement uses a brilliant saying, "Teenagers should not survive - they should triumph". That is a brilliant way to put it.

I read somewhere that wealth should not be there to blindly produce more wealth; it should be there to produce more well-being. That sums up everything that Dr. D'Alton and I have been saying. We need to look at a new prosperity in Ireland. It should not be based around economics, business and politics, it should be based around people. I know that is a big romantic thing to say but if the will exists, there is no reason it should not happen. As I have said, we have influence over everyone who is listening to this debate. We cannot allow this to be parked now. In a year's time, the media are going to be absolutely bored of me talking about it. They are going to park me and say "We cannot be talking to that fellow anymore". I understand that. I am well aware of how the media works. That is why we have built a website and a model we can use as we go forward. The Members of the Oireachtas are going to pull the strings when it comes to policy and stuff like that. The exciting thing is that current policy is not good enough. We can say what we want but we all know it is not good enough and I will not hear that it is. Equally, I will not hear that I am talking about the HSE. I have to say I have met incredible people - psychologists, psychiatrists and counsellors - within the HSE system. They are amazing. I work closely with them. They are just not resourced adequately. The priority is not mental health. We should really be looking at all the serious issues we are seeing in Irish society and asking why we think they are happening. I suggest that mental health is at the foundation of many of those issues and needs to be part of a long-term strategy,

There will always be people in the public eye who are willing to speak. Far more people are about to start talking. It might be suggested that we do not have more expertise in this area just because we are in the public eye. Although that is obviously the case, it does not mean we should not avail of the willingness of the media to engage and communicate with us. We know how to communicate, and we want to use that ability to try to change the stigma that exists in this regard. Those who are asking us to start slowly reducing that stigma by speaking out need to make damn sure that services are available for the people who are brave enough to look for help. It is great for me to be a mental health ambassador. However, it is heartbreaking to receive e-mails from people telling me they looked for help but could not get it. Such people ask me what they should do next but I cannot give them advice because I am not a health care professional.

In conclusion, I ask those who want us to make a big song and dance about this problem by shouting about it and trying to do something about it to make sure the services that are needed are made available and prioritised. This is a transitional time, but it is an exciting one. I ask the members of the committee to think about the position 15 or 20 years from now and to think about their kids. I think about my nephew and my friends' kids. I do not want them going through an education system where creativity or individuality are not promoted, where they have to repress their identities and where they have to struggle with mental illness. I want them to know exactly what they are facing. We all absolutely agree on that. It is now a matter of how we can work together and get the right people at the table to do this. I am willing to do anything.