Dessie Ellis (Dublin North West, Sinn Fein) | Oireachtas source

The mental health services of this State are in danger of "stagnating and moving backwards" claims the Mental Health Commission in its latest report. That stagnation has already taken place and mental health care is deteriorating. Like many of the vital services which cater for the most vulnerable in our society the mental health services were given a bit of a tidy up during the Celtic tiger period. Plans were laid out for reform and improvement but were not fully delivered and the necessary funding was never realised. Now that the economic climate is more difficult the mental health services have fallen victim to the austerity agenda and so too have the people who depend on these services. According to the most recent report of the Mental Health Commission, 56% of the services are operating under the standards for staffing laid down in regulations. There is a shortage of at least 3,000 staff across the service where a total of 9,000 are employed. This comes after long years of hard work by mental health professionals to reform the system and to bring it more in line with international best practice. Much has changed in the treatment of mental health problems and it has become easier for people to reach out and seek the care they need. Unfortunately, the ability of the service to respond in kind given its very limited resources is a major problem that needs to be addressed. This understaffing which has been a growing problem over the past few years of austerity has taken its toll not just on patient care but the morale of workers, their conditions and safety in their workplace. The work of mental health professionals, their ability to intervene and provide care can often be a matter of life and death. These professionals face challenges daily which, if handled incorrectly, can have far-reaching and tragic repercussions. Yet we refuse to ensure they have adequate support. A mental health service must ensure the best conditions for its workers in order to ensure the best treatment for those suffering health problems.

The recent spike in suicide rates and the fact that many of our acute mental health units operate at or above capacity certainly indicate that the best environment for treatment is not being provided. I know from my work with many constituents that there is a serious problem. The system is not adequately resourced to provide the care needed. I have dealt with many families who have been distraught when their loved ones have been discharged early without being admitted for treatment to a mental health service despite presenting at accident and emergency departments with self-inflicted injuries, either as a result of self-harm or a suicide attempt. This is due to the pressure on the system to provide care to so many with so little. The consequences of this situation are dire. It has undoubtedly led to people who should have been in care engaging in further self-harm and ending their lives.

Recently a young man from Finglas was discharged in a clearly unfit state having made a number of attempts on his life in the recent past. He was admitted in a very serious condition to the Mater Hospital and was placed on a ventilator for three days. When he had physically recovered he was discharged. His mother pleaded with the doctor and staff to have him admitted to the mental health services as he was a danger to himself. He was allowed to sign out and was seen on CCTV leaving the hospital. He went missing for over a week and his body was found in the canal.

This man died because of a failure in the system. He was in the hospital. It was clear he was a danger to himself and that his mental state had not improved following his treatment for his injuries. There were not sufficient staff to ensure that his case was dealt with properly and that he was admitted for treatment under the Mental Health Act 2001, as would seem to have been the necessary step. This is one case but it does seem that in similar situations doctors have been slow to act on admitting people involuntarily who are a threat to themselves.

The Psychiatric Nurses Association at its recent conference said that it was aware of several cases in which people had been discharged or turned away. These people went on to end their lives by suicide. The clinical director of Beaumont Hospital, Professor Shane O'Neill, resigned recently because of the serious state of the service. He said he could not stand over significant clinical risks. He was referring to the treatment or failure to treat many severely unwell people at grave risk of suicide or self harm.

In response to his resignation, Mental Health Reform stated that acutely psychotic patients were being left in emergency departments for hours on end. They do not receive appropriate care there nor are they in an appropriate environment given their mental state. The distress that is being caused for sufferers who have attempted suicide and their families being turned away from accident and emergency departments is hard to fathom. They can see that their loved one needs immediate care but because of understaffing and a lack of beds they are being left to their own devices and in too many cases this has led to a tragic ending. Families I have spoken to have tried all avenues to have their loved ones admitted but the obstacles due to lack of resources block their way. Some have gone to the gardaí but have had to wait hours for the doctor on call, who may or may not sign an order.

Their families had made numerous requests for them not to be discharged. They wanted them to be readmitted immediately. This is the tip of the iceberg. There is no family in our small country that has not been touched by suicide and mental illness. Every sector of society, particularly those in vulnerable and disadvantaged positions, has been affected by this problem. These people are victims of the inequality which is so tightly wound into this State's DNA. They have been failed by the State. They have been wronged by austerity throughout their lives. When they are on the brink, they are far too often failed again by a system that does not want to resource services that could save their lives.

My family is not very different from many other families that have had to deal with the challenges that arise when a loved one is plagued by mental health problems. I know the details of the cases I have mentioned all too well. I have been in an accident and emergency department with a loved one, pleading for them to be admitted. I have seen at first hand the obstacles that are placed in the way of those who seek to have a family member cared for properly in life or death circumstances. I know what I have said about the struggles of these families to be true because I have lived with it for the past three years. Times were very dark at one stage, but our family banded together. With the help of the work of the excellent staff of Connolly Hospital, we have come out of those times and there is hope again. The nurses and doctors succeeded in this case in spite of the obstacles and challenges they faced in their vocations. Their dedication was second to none, but they had an uphill struggle due to the understaffing and inadequate resources with which they had to deal.

We have fantastic mental health professionals and good strategies, but we need the right focus. We need to resource our mental health services and prioritise suicide prevention. We can turn back the tide which has undermined the progress of A Vision for Change. We must begin now by helping our excellent mental health professionals to do their jobs. In the past, citizens were put into mental health institutions by their families, their friends and State bodies. Many people spent long numbers of years - in some cases, their whole lives - in these institutions. Some people did not see the light of day even after the family members who had put them into these institutions had died. This is another example of a scandal in this State that needs to be investigated. I urge the Government to examine the scandalous manner in which people were put away in some of our mental institutions over the years. It should be hitting the radar because it has huge implications for many families. I commend this motion and ask the Government to support it.

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