Thomas Pringle (Donegal South West, Independent)

I welcome the opportunity to speak on this important Technical Group motion on mental health services. As we all are aware, one in four of us will experience problems with our mental health. It is part and parcel of being human and living our lives in today's climate. No one should ever be ashamed to seek help and no one should ever have to suffer in silence.

Too many lives have been lost in our country due to inadequate mental health services and the lack of out of hours cover for people who are in desperate need. People who are experiencing problems with their mental health need availability to services 24 hours a day, seven days a week. These people do not have a collective voice and are in a very vulnerable situation.

A Vision For Change was adopted as policy four years ago and given the slow pace of reform there is a risk that with any more significant delays as a policy it will be rendered out of date or unimplementable as the original end date of 2012 for its implementation draws closer. A Vision for Change is widely accepted by everybody involved in mental health services as being very positive, if only it was implemented. The lack of progress to date does not reflect the commitment or expectations of stakeholders, clinical staff or health service management who want to see the full implementation of A Vision for Change.

I take the opportunity to praise the staff of Donegal County Council who assisted me during the summer with a number of cases of people with severe mental health difficulties. They went above and beyond in that regard. They did not adopt a bureaucratic attitude but one of wanting to help and ensure those people could be safe and have accommodation that would ease some of their burden.

A Vision for Change proposes a holistic view of mental health and recommends an integrated, multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. It proposes a person-centred treatment approach which addresses each of these elements through an integrated care plan and reflecting best practice.

Special emphasis should be given to the need to involve service users and their families and carers at every level of service provision. Interventions should be aimed at maximising recovery and building on the resources available to service users and within their immediate social networks to allow them achieve meaningful integration and participation in community life.

The non-capital expenditure on mental health services in 2009 was €770 million. That was in comparison to €1.1 billion in 2008. Spending on mental health has dropped from 13% of the overall budget in 1986, as outlined by previous speakers, to 6.4% in 2009 and 5.3% in 2010. A Vision for Change recommends that the rate reach 8.4%, which is still a low level of commitment compared to international standards. The equivalent rate is 12% in England and 18% in Scotland, with other European countries allocating over 20% of their total health spend on mental health services and support.

The staff moratorium has disproportionately impacted on mental health services. Mental health represents just 9% of the health care workforce but accounted for 20% of the 1,500 posts lost due to the moratorium. That situation must be reversed if we are to have any meaningful progress in regard to assisting people with mental health difficulties.

In our society attitudes around mental health lead to stigmatisation, discrimination and social exclusion for those with mental health issues. Those attitudes and behaviour towards the issue of mental health have a direct impact on the experiences of those with difficulties. It impacts on their lives at home, at work and potentially in many social contexts. It is vitally important that we encourage people to seek help at an early stage and remove that stigma. The people who avail of counselling services should be able to say that with pride rather than try to keep it hidden from their neighbours so that they do not feel there is anything substantially wrong with them.

What has been lacking in mental health services also is advocacy and groups who support and advocate for change. I welcome the See Change campaign that has been taking place, which is very important. The Mental Health Commission and Amnesty International have also been campaigning for mental health reform. That is positive and should lead to real change because all of us who are politicians respond to pressure from groups. In many cases the crying baby gets fed first. It is important that we have strong advocates in the community who are monitoring everything being done and highlighting to us at all times that people are not getting the delivery of services they need.

If we compare it to the Disability Act and the disability strategy we can see how organised the disability groups are in that area. They are constantly lobbying and highlighting to us what is needed and we must get to that stage within mental health also. I welcome the move by any groups that will highlight the lack of progress and encourage us to keep working to ensure that progress is made on mental health priorities within society.

I hope this debate can contribute to highlighting the issues and encourage people to come together and work towards change by pushing the political groups and the health services to ensure we have real change and real implementation of A Vision for Change. I am aware the Minister of State is keen to ensure that happens and will work towards making it happen but we would all welcome having those groups pushing us along the road as well, which would make for a more inclusive programme.

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