Clare Daly (Dublin North, Socialist Party)

There are many issues about which we can make the criticism that there is a lot of talk and not enough action. Ironically, the area of mental health is one in which there is not enough talk, although that does not mean there is enough action. It is one important area in which talking is a positive thing as it allows issues to be aired. It is important that we are having this debate because of the points made about the stigma that still surrounds the issue of mental health. As a shop steward in a previous job for many years, I represented people who were out of work sick, and never once did a doctor write on the certificate that mental health issues were involved. There were always other reasons put forward for the person's absence because of the fear of stereotyping. One of the messages from this debate is that there is nothing embarrassing whatsoever about mental health problems; they are perfectly normal. At least one in four people will experience such problems at some stage, and they can be dealt with. We were laughing here at the number of Deputies who said they had friends with these problems; we were thinking that maybe they were not actually friends at all. I have no problem in saying that I myself have suffered from depression. I have taken medication for depression on occasion; I have dealt with it, and now I am grand. Many other people in Irish society are the same.

It is important that we talk about these issues, in the House and outside it, but this is not enough. The talking must be backed up with action. I do not think it is good enough that A Vision for Change has been lying on the shelf for five years even when it must be admitted it is not that visionary in its approach. It was a repeat of a policy that was already in place, Planning for the Future, which was not that radical. It was concerned with the provision of treatment and care for people primarily in the communities they come from so that they would not have to be locked up and institutionalised. However, the resources were not provided to back up that policy and make it a reality.

It is appalling that these policy changes were not implemented during the boom. It is important to stress the need to protect the funding - €35 million - for community health teams and so on but given the stresses being experienced by people due to the recession, there needs to be more to respond to the crisis. The current economic situation is putting major pressure on people mentally and emotionally and contributing to mental health problems.

We cannot see the issue in isolation. It is clear that more staff are needed to deal with it. We cannot divorce this issue from the public sector recruitment embargo, which needs to be addressed, because decisions are being made without taking into account the views of staff at the front line. They are concerned that the resources will not be available to adequately run the new units that are being promised but they are not being listened to. It is not just lip service that we need. We need action and investment. It is impossible to deal with this issue while the public sector recruitment embargo remains in place.

I would like to step back and consider how society as a whole deals with the issue of mental health and the role of psychiatric drugs. Serious issues are currently being debated, including whether psychiatric medications alter the long-term course of mental health disorders for the better or for the worse. Do they increase the possibility that a person will be able to function well, or that he or she will end up with a disability? Could it be the case that a person with a mild disorder has a bad reaction to an initial drug which puts him or her on the path to long-term disability?

We must be careful in this regard, because research from the United States shows that mental illness disability rates have doubled since 1987 and increased sixfold since 1955, while psychiatric drug use greatly increased in the 1950s and 1960s and has skyrocketed since 1987, when Prozac was introduced. These pharmaceutical companies make billions of dollars, and anti-psychotic drugs are far and away the biggest money-spinners. Evidence suggests they are useful for short-term treatment but in the long term they can increase problems. There are worrying trends, in particular of children being prescribed such medication and this is something we must attend to. We must determine who controls health and who decides on these things. Is this being done in the interests of the big multinational corporations to earn a profit or is it being done for the benefit of the individual and for society as a whole? We must examine the role of transparency in decision-making in this regard and we must seek to enable people to make decisions for themselves. People should be able to make an informed choice about all of the treatments available. There is a role for drugs, for counselling and for other supports. People should get the entire package and should be informed not only of the short-term impacts, but also of the long-term impacts.

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