Ms Fiona Coyle:

I thank the Chair for inviting MHR members to this important meeting on the mental health of migrants and ethnic minorities.

MHR is Ireland’s leading national coalition on mental health, with more than 80 member organisations working for progressive reform of mental health services and supports in Ireland. Many of our member organisations are actively involved in supporting and delivering services to migrant and ethnic minority communities and have actively contributed to this statement. To provide a deeper insight into the lived realities of some of these communities, I am joined by representatives of three of our member organisations, who the Cathaoirleach has already introduced.

Ethnic minority communities have been integral to Ireland for centuries. Today, they constitute a growing part of the population. The term "ethnic minority" encapsulates a broad spectrum, including a wide range of people with diverse nationalities, ethnic backgrounds and legal statuses in Ireland.

The term also includes the Irish Traveller community, which was officially recognised as a distinct ethnic community by the Government in March 2017. It is important to note that ethnic minority communities are not homogenous. Where mental health is concerned, the barriers for these diverse communities may differ significantly from one community to the next and from individual to individual.

Research, including an important new report launched by the WHO last month, shows that there is a higher incidence of mental health challenges among people from ethnic minority communities. The reasons for this disparity are multifaceted and include racism, disparities in health access, inadequate support structures and, in some cultures, a profound stigma associated with mental health issues. Our colleagues from Doras will speak more to the policy considerations stemming from this report and will also examine the specific mental health needs of those seeking international protection, which can be complex and multifaceted.

It is broadly acknowledged that services are designed and developed in a way that reflects the majority culture. There are a number of barriers for individuals from ethnic minority communities in accessing mental health services in Ireland, resulting in inequalities of access and outcome. Our mental health policy, Sharing the Vision, stresses the importance of providing culturally appropriate health care to meet the needs of service users from diverse cultural and ethnic minority communities. Recommendation 61 of Sharing the Vision reads: "The HSE should maximise delivery of diverse and culturally competent mental health supports throughout all services." There are also three recommendations that specifically mention migrants, asylum seekers and refugees. It important to acknowledge that this policy was written in 2020 and that, since then, we have witnessed evolving circumstances, including the war in Ukraine.

Ireland is in urgent need of a mental health service that can truly serve the entire population, with a particular focus on those identified as being at higher risk, including ethnic minority communities. MHR, along with our members, calls upon the Government to ensure the development of mental health services that respect the diverse beliefs and values of people from ethnic minority communities and deliver care and treatment in a manner that takes account of such beliefs.

I will set out our recommendations. First, we need accessible and culturally sensitive mental health supports and services. To achieve this, we need to provide all staff working with people with mental health difficulties training in the areas of anti-racism, cultural competency and unconscious bias. This training should be developed in consultation with ethnic minority service users. Services must provide assurances that disrespect or discrimination of any kind by staff should not be tolerated. Specific measures for reducing discrimination in mental health services should be implemented. This could include actions such as employing individuals from ethnic minority communities and educating local communities to target stigma and discrimination. Mental health services should undertake systematic evaluation and self-assessment to ensure that the mental health needs of people from ethnic minority communities are being adequately met. We must also enhance our data quality through ethnic equality monitoring, which includes the incorporation of a standardised ethnic identifier in line with the national census. This identifier should be integrated into all routine data administrative systems within mental health services, including the National Self-Harm Registry Ireland, to facilitate the monitoring of access, participation and, importantly, outcomes in suicide prevention and mental health services for priority groups such as Travellers, members of the Roma community and other ethnic minority communities. It is crucial that the implementation of an ethnic identifier is carried out within a human rights framework.

Second, we must deal with the needs of those seeking international protection and Ukrainian beneficiaries of temporary protection. It is imperative to act upon recommendation 63 of Sharing the Vision and ensure that persons in direct provision services and refugees arriving under the Irish refugee protection programme have access to appropriate tiered mental health services through primary care and specialist mental health services.

We must scale up and promote community-based interventions and peer support initiatives. We must provide family-centred support and child-specific interventions. Mental health and other services being provided must be trauma-informed in their approach.

The third area where we are making recommendations is in meeting the mental health needs of the Traveller and Roma communities. It is important that the Government implements the commitment in the programme for Government and the committee's recommendation to develop a national Traveller and Roma mental health action plan. This plan would be developed in collaboration with key stakeholders, including the Traveller and Roma communities, under the guidance of a national steering group to ensure effective oversight during its development and implementation. There is a need for a sustainable and ring-fenced budget to be allocated specifically for Traveller and Roma mental health to ensure the successful implementation of the national Traveller and Roma mental health strategy. We must ensure that evidence-based and culturally appropriate resources and supports are prioritised for the Traveller community due to the level of the mental health crisis. We must implement a cross-departmental approach through the new national Traveller and Roma inclusion strategy to rectify inequalities and inequities experienced by the Traveller community, especially in areas like early school leaving, low educational attainment, unemployment, poverty and inadequate accommodation.

In conclusion, addressing mental health disparities among ethnic minority communities in Ireland is a multifaceted endeavour that necessitates a cross-government and cross-agency approach. This is a really important point that I want to reiterate. By responding to the needs of these communities, we can pave the way for a brighter, more inclusive society, where every individual's mental health is treated with the care and respect they deserve, regardless of their cultural or ethnic background.