Ms Brigid Quirke:

I will recap to ensure that we have them all. There was a question on the ethnic identifier. It is true that there was a national Traveller health strategy for 2002 to 2005. The inclusion of the ethnic identifier was recommended and we piloted it at that stage. From 2002 to 2018, it has been 16 years. Following a successful pilot with a 100% response rate, it was to be mainstreamed but we are still waiting for it to be mainstreamed. With the arrival of new communities, the ethnic identifiers are really more urgent. The Deputy is correct that we cannot disaggregate data or identify where are the gaps, particularly on quality of access, participation and outcome. It is clear that minority communities need additional inputs in terms of positive duty and ensuring the same outcomes to services. We are not all born equal, starting at an equal point, so we need that affirmative action. Subgroups have been established and it has been reinforced in the national Traveller and Roma strategy. We have been involved ourselves. The NGOs have taken on its piloting and the rolling out because the State was not doing it. We now work with Pobal, the prison service and some of the hospitals. We go out and do the training and the identification. We encourage them that it is possible and can be done. The NGOs have been driving it and we are now hoping that it will be mainstreamed.

In its absence, we have the all-Ireland Traveller health study which is an extensive study done over three years. A total of €1.5 million was spent by the Department of Health to find out the exact needs of Travellers. It has very specific detail and there are four reports and five volumes of data which still have not been accessed or utilised. We were given to understand that it would be turned into a Traveller health strategy. The previous one was not implemented because there was no data. Now we have data and they tell us there are no resources. It is, therefore, a very frustrating experience on the ground.

On infrastructure, the 30 Traveller primary health care projects are really good. We set out our own health data collection system. We try to document where there are barriers to services. In lieu of official data being collected, we collect data at local level to try to ensure that we maintain that knowledge. It is urgent and critical because only then can we see the barriers. We can see if there has been an improvement in the effectiveness and efficiency of services. In terms of resources, we can also see whether money is being spent in the right places, having an impact and creating the outcomes that would benefit everyone.

The Deputy asked about youth in terms of speaking to our colleagues in Southside Travellers Action Group. The youth programme at Pavee Point has been closed down. The funding was cut back. During the recession, as the committee will be aware, a lot of Traveller organisations, NGOs and community organisations disproportionately lost a lot more resources. For example, education was a priority. I was part of the study team in UCD and the study stated that, if there was only one recommendation to address Travellers' health, it would be to invest all our money in education because improving opportunities for people is the key to creating change. The study was launched in September but 85% of the Traveller budget was cut in the budget and we have yet to get it back. Therefore, the home work clubs, visiting teachers and all the things that were helping to retain Travellers in school in terms of progression to secondary school were gone. Again, that is critical. The Deputy is right that there are social determinants to mental health and health inequalities and we have to address those, including accommodation and education.

I do not have figures on the specific budget on mental health. It is done through the primary health care projects. Each of them would have mental health initiatives. There is one new initiative to be considered through the national Traveller and Roma inclusion strategy, which was employing nine Traveller-specific mental health workers. I think they are doing interviews this week. We are not too sure that that is the panacea. Our issue is that the projects on the ground are recognising people but the issue is the mapping. That has come up in a lot of services and was often raised during the committee's deliberations when I was reading over them. People do not know where to go and where are the services. In particular, suicide is falling between the two. The mental health services say it is nothing to do with them because it is not a mental health problem as the people are not diagnosed with a mental health problem and that it is the responsibility of primary care. Primary care does not have the capacity to deal with it, however. We have written case studies on this. We spent a whole weekend telephoning 30 NGOs and the National Office for Suicide Prevention but no one was available. I was with a person who was suicidal and, when I asked if we could go to accident and emergency, I was asked by the people there if she had cut her wrists. I was told that she needs to have done something. I asked if we could go in if I asked her to cut her wrists. It is a ridiculous system.

We have applied suicide intervention skills training, ASIST, and safeTALK and it is fine to train people but they have nowhere to refer people to. Mr. Reilly is chair of the mental health subgroup and we have been trying for the past eight years to do mapping and signposting so that we could find out. Even people within the service, however, do not know where one is supposed to go. To me, it is an urgent matter that the committee might consider further. I understand it was raised earlier.

We do not have a specific budget as part of others. Other work is about us going into a service telling it to be more Traveller-specific. In terms of training, we run culturally appropriate training such as workshops that are Traveller-specific on culture and how services can be proofed and made more appropriate. We offer this to services but we cannot make them take the training. We cannot go to psychologists or psychiatrists and say they need training. They come and say they need training. We can suggest that it is needed by all providers. That is one of our recommendations on training. We are prepared to deliver-----