Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

I take seriously the calls by a number of Deputies when we discuss mental health and suicide not to be political and to humanise the topic. This must be the starting point. For those who suffer from mental illness and suicidality, particularly those who are lost through suicide, and their families and friends, no words we say here can fully do justice to the suffering, anguish and pain it involves. No political party can claim a monopoly of wisdom or experience on it. Sadly, the issue of mental health problems and suicide is widespread and increasing, and has touched all of us in one way or another. We must do justice to the human beings involved and those who suffer as a consequence.

Having said that, we must examine the facts and ask whether the State is doing its duty by discharging its obligations in terms of providing the supports, service and help people need for what is a very complex human problem influenced by many factors. While we cannot deal with all the problems, we must ask whether we are discharging our responsibility as best we can and with all the resources available to people who are suffering in this way and who need our support and help. By any honest assessment of the evidence and situation, we must acknowledge that we are not doing all we can.

People have alluded to the scale of the problem, which is very stark. Approximately 15% of young people between the ages of 11 and 13 years are suffering from mental health problems. This figure increases to 20% between the ages of 19 and 24 years. There is a shockingly high level of suicide among young people. Generally, Ireland has one of the highest levels of suicide in Europe. Particular groups are suffering disproportionately as a result of suicide and mental health problems. People in the LGBT community are three times more likely to commit suicide. The homeless are disproportionately represented at every level in terms of mental health problems and suicide, etc. People without jobs are disproportionately more likely to commit suicide or suffer from mental health problems.

Against that background it is frustrating to hear the Minister playing with figures. I have to be honest and say that is what I think he is doing. He says he has pushed the budget up. His argument that there has been an increase in the level of expenditure on health services generally and mental health services, in particular, depends on the benchmark against which these levels are being measured. When he said the mental health budget had increased from €711 million to €827 million, it sounded like a big improvement. Of course, the real benchmark is the mental health budget of €937 million in 2008. The truth is that since 2008, when the cuts began, there has been a decrease of more than €100 million in the amount of money being spent on mental health services. It is important to mention, based on the sheer demographics of an expanding population, that the number of people who need help is far greater than it was in 2008. At a time when we need more support, more help, more staff and more funding, the significant reductions in money and staff mean that we are way short of the mark. We have to be honest in saying this. It is true not only in the case of mental health services but also in the case of the budget.

The Minister said the health budget was pushing back up, but it is still €3 billion less than it was. I agree with him that we must not play one bit of the health budget off against another, or play one priority in mental health services off against another. The least we can do to ensure this does not happen is to return health spending in general to where it was before the crisis, provide for a twofold increase in the mental health budget, in order that it can reach some reasonable level, and recruit staff in line with A Vision for Change. Everybody agrees that the provisions of A Vision for Change, about which we have been talking for many years, represent a target at which we should aim. Equally, everybody acknowledges that we are falling far short in that regard. We are 25% short in adult mental health service staffing levels and a shocking 50% short in the level of staffing for young people. Somebody mentioned - it may have been the Minister - that there were 33 suicide prevention nurses. Given that there are 29 emergency departments, it seems that we have just a little more than one suicide prevention nurse per emergency department. How is one nurse supposed to cover for 168 hours, which is what 24/7 cover means? As one nurse cannot do this, it is clear that the number of suicide prevention nurses needs to be doubled, at least. We need twice as many, if not more, if we are to provide the 24/7 cover needed and prevent long waits in emergency departments. Beyond this, other services need to be targeted specifically at the homeless, intellectual disability services, primary care services, counselling services for young people in schools which have been cut and preventive programmes.

I want to make an important point about my local experience. The Minister says he has pushed the budgets up because the Government is taking this issue seriously and trying to improve the position. Just before Christmas, cuts were imposed on two tiny projects in my local area. I mentioned them during the leaders' debate before the recent general election. The first was the Oasis project, an outreach project that cost just €40,000. It reached out to young people in one of the most disadvantaged areas in the Dún Laoghaire borough. Even though it was costing virtually nothing, it was providing a vital service for vulnerable young people. When a former project worker in the service called to see me during the week, he reminded me that one of the young people who had been in that service when it disappeared had committed suicide on New Year's Eve. This project worker was distraught as he spoke about all of the other young people who needed help but who now had no service and nowhere to go. This small project was helping them, but it was cut. A similar cut has been made in the funding for the Southside Women’s Action Network, a small community-based project that costs virtually nothing and reaches out to families affected by addiction and mental health problems. How can that be? If, as the Minister says, we are increasing funding and improving the position, how can there be cuts in services that act as lifelines for some of the most vulnerable in some of the most disadvantaged communities? It is shocking. If I hear nothing else from the Minister, I would like him to say these two projects will be reinstated. It would cost €80,000 to reinstate them. I ask the Minister to do so. Such a move would be preferable to the excuses I get from the HSE which tries to justify these cuts when I submit parliamentary questions.

I have not had time to go into the issue of homelessness. Even though 58% of homeless people in Dublin have mental health difficulties and 98% of those in long-stay psychiatric care have accommodation problems, last week NAMA sold two more portfolios with hundreds of apartments that could have been used to house some of the people in question and help to solve the problem of homelessness which can have a detrimental effect on people's mental health and welfare. We could do these things.

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