James Reilly (Dublin North, Fine Gael)

I am delighted to have an opportunity to address the important issue of mental health provision in the State. I thank Deputy Maureen O'Sullivan and the Technical Group for putting forward the motion on Private Members' business. This subject is obviously close to the hearts of many Members and the contributions last night and again this evening have been both extensive and impressive. Another feature of the debate which cheers me is the strong cross-party support for A Vision for Change and the many efforts of this Government to put renewed impetus into the implementation of that policy.

Our counter-motion and the Minister of State, Deputy Kathleen Lynch's, contribution last night summarise the Government position on this issue. As the Minister of State pointed out, A Vision for Changewas widely welcomed on its publication in 2006 as a progressive, evidence-based and realistic document which offered a new model of service delivery for mental health that was patient-centred, flexible and community-based. Since then, a great deal of progress has been made in closing many of the old psychiatric hospitals and providing modern acute inpatient as well as community-based facilities and services.

We must ensure that we fast-track the remainder of the strategy set out in A Vision for Change. To do this we will have to provide more and better mental health services via primary care and in the community. There must be a cultural shift away from the overly medical model of the past to an all-embracing therapeutic and person-centred service that is focused on recovery. This will include an increased focus on the provision of counselling services. In this regard, it is my intention to introduce a system for regulating the provision of counselling.

A point that has been made numerous times but bears repeating is that one in four of us will experience some mental health problem in our lifetime. The message is clear; we must mind our mental health every bit as much, if not more than, our physical well-being. The Government has demonstrated its commitment to mental health from the start, with the programme for Government including several commitments in this regard. These include the ring fencing of €35 million annually from within the health budget to develop community mental health teams and services. We are also committed to ensuring patients can access mental health services such as psychologists and counsellors in the primary care setting. Early, appropriate and effective intervention is our key message.

My Department and the Health Service Executive are locked into a process of identifying specific aspects of A Vision for Change and Reach Out which we can target in order to apply resources in a planned, proactive fashion in the next three years. I have asked for timelines, detailed costs, structures and identifiable responsible persons in order to prioritise and drive the necessary change. I will not accept "cannot" or "will not" as an answer. This is too important. It is my intention that the issue of a directorate of mental health services, as referred to in the debate last night, will be dealt with in this context. I am also anticipating recommendations in the area of clinical care programmes across the spectrum of care pathways, including dedicated services to deal with complex psychological conditions such as eating disorders which are all too common and have devastating effects on individuals and their families.

The Minister of State, Deputy Kathleen Lynch, set out our position on the staffing of the child and adult community mental health teams. These teams must include expertise from all the core disciplines of psychiatry, psychology, social work, occupational and other therapies as well as mental health nursing. It must be primarily a people-based, multidisciplinary provision.

Many mental health issues surface first in our early years. We must ensure such difficulties do not catch hold of and destroy the lives and potential of young people. The HSE provides a range of services across primary care, specialist child and adolescent mental health services, health promotion and suicide prevention services which support young people's mental health. I am particularly pleased with specific initiatives in this area such as the Jigsaw programme, which was designed by Headstrong and its panel of youth advisers and is an evidence-based, integrated model designed to strengthen a community's capacity to support young people's mental health. The most powerful comment I can make on the project is that it works. Jigsawis up and running in five counties and an additional €1 million in innovation funding was allocated to Headstrong in 2011 to support the expansion of Jigsaw to a further six areas. Further initiatives aimed at addressing young people's mental health include the National Office for Suicide Prevention's public education campaign, centred around the platforms of "Your mental health" and "Let someone know", which is specifically targeted at a younger audience. Both of these campaigns are critically important in getting the right messages out there.

The Government's commitment to mental health is reflected in our capital plan, which includes approval for funding to build a new central mental hospital. One of the Members opposite mentioned the vulnerable in society. Our commitment to the national paediatric hospital addresses the needs of children, who comprise a particularly vulnerable group.

Under the primary care strategy, primary care teams in each of the primary care centres will include specialist personnel to deal with mental health issues. By offering these services in a primary care team setting, we can help to remove the stigma associated with mental health problems. People with mental health concerns will be dealt with in the same way as anybody with any other health issue. They will walk in the same door and share the same services. That has already happened in some locations, such as Mallow.

Another aspect of the Government's work in this area is the ongoing review of the Mental Health Act 2001. We recently established a steering group, with representatives from my Department, the HSE and the Mental Health Commission, to oversee the review. The terms of reference for the review include examination of the general operation of the Act since commencement. Importantly, the group is also tasked with reviewing whether A Vision for Change could or should be underpinned by legislation. The group must also consider the provisions of the UN Convention on the Rights of Persons with Disabilities. The public consultation phase of the review has been completed. More than 90 submissions were received, with some 25 or more of those coming from individual service users or their carers. The steering group is now conducting a series of meetings with key stakeholder groups. I look forward to an interim report on all of these matters by the end of this year. We hope to have the review completed by mid-2012.

I thank all Members who contributed to this important debate. I assure the House again of this Government's firm commitment to the reform and modernisation of our services in line with A Vision for Change.

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