Mr. Patrick Reilly:

First, we recommend the urgent publication and implementation of the national traveller health action plan without further delay. We understand this plan is being reviewed by the Department of Health. Travellers and Traveller organisations participated in consultations in 2018 and three years later, we are still waiting for this plan. We welcome the commitment in the programme for Government to implement the national traveller health action plan, but there have been major delays. We are concerned that our health is getting worse because of a blockage somewhere in the Department of Health and this plan not being prioritised. Is this fair? We need a health action plan and we need it now. Travellers cannot wait any longer. We are losing our people and we cannot wait any longer.

Second, we recommend that resources allocated to Traveller mental health must be spent on Traveller mental health work. In 2018, we presented to the Joint Committee on the Future of Mental Health Care. It recommended that more resources and funding be targeted at the areas of highest need, with particular attention being paid to Travellers and to addressing suicide. It would be good if this committee could see what has happened to this recommendation. With the exception of the appointment of nine HSE mental health service co-ordinators for Travellers and dormant accounts funding, we understand that there is no dedicated budget for Traveller mental health. Since the co-ordinator posts were funded in 2015 and recruitment for the roles was undertaken in 2017 and 2018, one such community healthcare organisation, CHO, post has never been filled, at an approximate loss of €300,000, in addition to the loss of resources and support for Traveller mental health. This is unacceptable, given the current Traveller mental health crisis, higher rates of suicide and poor mental health among Travellers. While we acknowledge dormant accounts funding from the Department of Health, it is imperative that this is mainstreamed and that ongoing Traveller mental health work receive sustainable and ring-fenced funding to respond to Traveller mental health inequalities, especially in the post-Covid-19 context. I hope we will get to that stage. Pavee Point, alongside other Traveller organisations, is ready, willing and able to undertake this work in partnership with the HSE and Department of Health.

Third, we recommend that Traveller mental health is prioritised within the Department of Health and the HSE. Traveller health structures at national and regional levels often lack high-level engagement from the Department of Health or the HSE and, as result, Traveller mental health remains marginalised. We recommend that there be representation of HSE mental health heads of service on national and regional Traveller health structures, given the documented mental health crisis our community is living with. Traveller representation on mental health structures at national and local levels must also be prioritised. We have seen evidence of this in our own area where we have engaged with the local structures and have witnessed the difference that such collaboration can make. Following our presentation to the Joint Committee on the Future of Mental Health Care in 2018, the development of a Traveller and Roma mental health action plan was recommended and we welcome the commitment in this regard in the programme for Government.

Fourth, we recommend the implementation of ethnic equality monitoring across all health data collection systems, including mental health. Without this, we are basically invisible in mental health policy and service provision because we are not being counted. Information on ethnicity is not being collected, despite this being Government policy. We recommend the implementation of ethnic equality monitoring, including a standardised ethnic identifier consistent with the national census and inclusive of Roma, across all routine data administrative systems in mental health services, and including the National Self-Harm Registry Ireland. The World Health Organization, WHO, supports our position on this aspect. As Dr. Mike Ryan said last week, "What gets measured gets done". If we do not measure things according to groups, then we are never going to have the data to identify the extent of the problem and make sharp improvements. This is straightforward: without those data, we will continue to be invisible and we will be having this conversation year in and year out.

We thank the Chair and the members of the committee again for their time this afternoon and we welcome comments and questions.