Dan Neville (Limerick, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to this debate and welcome the Minister of State to the House. We come from a very low base, historically, in terms of our mental health services and how we have dealt with people who suffer from mental illness. My mother was a psychiatric nurse in the 1940s. The institution she worked in was known in her time as the mental hospital but 20 years before that it was known as the lunatic asylum. We are coming from that low base which goes back decades and centuries.

Even in recent decades we have neglected the opportunity to improve the area. Things have moved on and when A Vision for Change was published there was an increased concentration on the issue and the opening up of debate. Society had a greater awareness of the need to have a modern approach to dealing with mental health services. I welcome the Minister of State's statement that there will be a nine or ten year review of A Vision for Change next year. It will be interesting to see the analysis of its implementation.

Child and adolescent mental health services and the 89 admissions to adult hospitals last year were already mentioned.

There is a difficulty with this situation. In Limerick, for example, 20 beds were promised for the mid-west, but that was shelved some years ago. Now, somebody in Limerick must go to Cork, Dublin or Galway and somebody in Donegal must go to Galway. That creates a difficulty for parents in continuing to visit their families, which is very important for young people.

I welcome the review of the 2001 Act. This has been sought for some time so I welcome the fact that legislation will be brought forward in December. The €35 million allocation has been mentioned in previous discussions. There is an issue with the rolling out of improvement in the mental health services following the commitment by the Government. There is a full commitment of €155 million to the development of mental health services - €35 million each year, except for one year when the allocation was €25 million. There appeared to be no plan in place to respond to that. It was part of the programme for Government so the HSE should have anticipated it, but it appears that the plans for recruitment commence on 1 January rather than having everything ready to go. As a result the people are not recruited until the end of the year. That is an issue we have raised over a number of years in respect of the roll-out of the improvement in the mental health services.

Stigma has been mentioned. It is a key issue in educating people with regard to understanding mental health services. One in four people will suffer from a mental illness at some stage in their life. Mental illness does not exclude anybody: anybody can suffer from a mental illness. Stigma is a crucial issue in seeking assistance and in the demand for services by people in difficulty. There is still a sense of hiding it, unlike with other illnesses, when there should be an opening up and a demand for the services. I hope to deal with this in a letter.

Another issue in mental health is the coverage of mental health by Voluntary Health Insurance, VHI, and other bodies. There is discrimination in the coverage of mental health services. The VHI covers 180 days for general health issues and hospitalisation while the psychiatric policies vary from 100 days to 180. Likewise, GloHealth Insurance has no time limit on physical health whereas there is a time limit of 100 days for mental health services. Laya Healthcare has coverage for hospitals of 180 days, but it is 100 days for psychiatric inpatients. It is difficult to understand why there is discrimination in this area.

We have heard the figures for suicide. Suicide is a particular problem among young people. The suicide rate for young people is particularly worrying. The suicide rate among teenage girls in Ireland is the highest of any EU state, while the rate for young Irish males is the second highest. Ireland has the fourth highest rate of youth suicide in Europe, that is, of people under 25 years of age. While our suicide rate is generally just below the European average, our youth suicide rate is one of the highest in Europe. That is of extreme concern.

I welcome Connecting for Life, and I wish I had more time to discuss it. The World Health Organisation warmly welcomed and praised its publication, content and objectives. We have targets of 10%. Reach Out had targets as well. In fact, the Reach Out ten year programme from 2005 to 2015 recommended that there would be overall targets for the reduction of suicide rates, which should have been set by the then Government to advise the then Minister for Health and Children, when the Minister was satisfied that the suicide rates had been reasonably accurately determined. However, that did not take place. There was a strategy for action which was discussed and introduced in 2008 and 2009. A reply to a recent parliamentary question I tabled informed me that in 2009 there was a strategy to reduce it by 10% from the 2005 figures. However, when one analyses the figures one finds that the average for the five years up to 2005 was 494 while the average for the five years up to and including 2014 was 497.

Did Reach Out attain any of its objectives? The main objective was to reduce suicide rates and that did not happen. We must ensure that when we set targets the programme that is applied will meet those targets. The content and implementation of Reach Out did not reduce the suicide level, as the figures suggest. We will be given all types of explanations for that situation, but they are not good enough. Extensive resources were provided to achieve the objectives of Reach Out but the facts show that it did not happen.

Finally, I wish to raise an issue which I have been raising for the past ten years. I have encountered serious examples of this. It relates to the regulation of psychotherapists and counselling. I was given two serious examples recently by people who have suffered extreme difficulties with people who are not qualified and not members of professional associations. After ten years of examining this issue since the Health and Social Care Professionals Act was passed in 2005, I again urge the Minister that the regulation of counselling and psychotherapy is vital to ensure that people who access those services are dealing with competent people. I have heard examples of absolute exploitation and abuse of people who accessed psychotherapy and counselling which did not have the expertise available, as well as the abuse of using psychotherapy and counselling to damage people rather than assist them.

See this speech in context