Tommy Broughan (Dublin Bay North, Independent) | Oireachtas source

Like many other Deputies, I was extremely disappointed and concerned to read reports last week of a planned cut of €12 million in funding for the mental health budget. I listened to the Minister’s speech referring to the size of the mental health budget and his reference to setting off one part of the health budget against another but the reality, as the previous speaker said, is that the outgoing Government presided over major cuts in this area, which it began to restore only a few years ago.

I understand the full HSE budget for mental health services is now €826 million. An additional €35 million was to be made available each year since 2011, as part of the programme for Government, to focus on services such as counselling for the under-18s. This is a critical area in respect of which the Government has failed hopelessly, as we have seen from reports and studies on mental health problems and suicide over recent days and weeks. The funding was also to be spent on clinical programmes for adults and children with ADHD, dual diagnosis, psychiatry and perinatal mental health services. It was reported that the €12 million our Minister for Health is deducting from the mental health budget was ring-fenced for the recruitment of critical staff in this area.

The administration of mental health services is not just about money. In 2014, we spent approximately 12% of gross national income, GNI, on health by comparison with an OECD average of 9.2%. This includes expenditure on our dual health system, whose failings are so clearly referenced in the report on the front of The Irish Timestoday on the huge waiting times for essential tests. Taking €12 million from the additional €35 million promised to the mental health sector seems to represent the general treatment of those experiencing mental health difficulties.

Historically, people with varying levels of mental illness and mental health difficulties were locked away in homes and asylums, excluded from society, and others suffered for long years in silence. Some still suffer in silence, and there is still a huge stigma surrounding mental illness. The optics of even considering taking back additional funding from the budget reinforces the historical sentiment that mental health is not a priority for the Government. Despite this, mental health is such a critical part of people's general health and well-being. Statistics show that one in four people will experience a mental health difficulty at some stage in his or her life, and his or her own coping mechanisms will determine how much this will affect him or her during those times. The 2014 OECD study Making Mental Health Count - the Social and Economic Costs of Neglecting Mental Health Care stated one in two will experience a mental health disorder or illness in his or her lifetime.

Often in this House, we do not live in the real world. We are some of the lucky ones who can afford to pay €50 to €100 per hour for counselling or therapy with a private practitioner, and for as many sessions as we would like. We are not at the mercy of the public system, in which one could be waiting for more than six months for a counselling or therapy session, after which one might be granted just six sessions.

Early last year, I requested information regarding the number on the waiting lists to gain access to counselling and the waiting times. I was informed by the HSE that at the end of February 2015, 478 people had to wait more than three months for counselling. As the Acting Chairman will agree, that is simply unacceptable because timing can be critical when acute mental health difficulties occur. The Minister seemed to be saying the number on the waiting list was reduced by 66 but there is still a considerable number of people, very often young people in difficulties, awaiting an essential service.

In August 2015, a "Prime Time Investigates" report published a comprehensive study of suicide in Ireland. According to the report, the worst year for suicides was 2001, when the rate was 13.5 suicides per 100,000 people. In 2004, the rate was 12.2 per 100,00 but this rate has not been exceeded since. Of course, these rates reflect population growth and translate into real, precious lives lost to their families, friends and communities. In 2011, there was a peak in the number of people taking their own lives, with 554 deaths by suicide that year. Of those who died in 2011, 83% were men between 45 and 64 years. Among women, the age group most likely to die by suicide comprised those between 24 and 44 years. Ireland has the fourth highest rate of suicide among those aged between 15 and 19 across 31 European countries. In 2015, there were just 54 operational child and adolescent acute inpatient beds available for 18-year-olds across the country. Twenty of them were in Galway, 12 were in Cork, 14 were in Linn Dara and eight were in Fairview in this city. The Minister said in his speech the number has now increased by approximately a dozen. Unfortunately, the resources are still very thin for dealing with a major issue in our health service.

The year 2014 saw 201 admissions to community child and adolescent mental health services, CAMHS, beds, while we know that under-18s were, and are, being treated in completely inappropriate adult mental health facilities. In a response to a parliamentary question provided to me this time last year, the HSE confirmed that the waiting list for the age-appropriate CAMHS comprised 3,000 children, of whom approximately 400 were waiting for in excess of 12 months. With research showing that 75% of mental health disorders emerge before a person reaches 25 years and given the high level of suicides among our youth, we can agree these waiting times are totally unacceptable. The outgoing Government has not addressed this whatsoever.

Where people live also has an impact on the suicide statistics. I note that the RTE "Prime Time Investigates" programme highlighted the fact that Limerick and Cork city had very high rates of suicide, at 16.7% per 100,000 people in Limerick and 18.5% in Cork city. As previous speakers stated, we know that there are strong indications that socioeconomic factors play a huge role in mental illness and the likelihood that a person will die by suicide. Recently Console reported that its free 24-hour helpline service had seen a huge increase in the number of calls from people experiencing homelessness, those in precarious housing circumstances and in mortgage arrears. Its helpline deals with approximately 3,400 calls each month. Unemployment and isolation have also been found to contribute to the likelihood that a person will die by suicide.

Recently I asked the acting Minister, by way of a parliamentary question, about his plans to increase resources to make free and affordable counselling available to those on low incomes in a timely manner. He replied that €7.5 million had been provided for the Counselling in Primary Care, CIPC, service, but in some areas there were difficulties in accessing accommodation in which to see clients which, in turn, impacts on waiting times. This also seems to be a major issue in rural areas. It beggars belief that these issues were not addressed during the past five years.

Katie Quinlan, the welfare officer at University College Cork, recently wrote an open letter to the acting Minister in which she succinctly stated: "Everyone is fighting their own fight. Some of us just need more help". Obviously, this refers to many of the gaps in services and the huge resources that it is necessary to provide and to which I have referred.

The executive summary of the Connecting for Life strategy document states that the national conversation on suicide and self-harm is improving and that "it is essential that we maintain the momentum". I am sure the Acting Chairman will agree that taking millions out of this area is like taking one step forward and three steps back and utterly disrespectful to those waiting for counselling, psychotherapy and other appropriate supports and clinging to hope. Like previous speakers and together with my colleagues in the Independents 4 Change grouping, I am strongly supportive of the Psychiatric Nurses Association which will be balloting its members on taking industrial action on 11 May as a direct result of the proposed reduction in funding. We know from it that "there are up to 700 vacant posts" and that "up to 1,000 nurses are needed to fill current and emerging vacancies". The answer to the crisis is certainly not to cut €12 million from the funding provided.

Like previous speakers, while I have painted a grim picture of the state of mental health services, we are fortunate that people in the public eye such as Bressie and the Rubberbandits and organisations such as Pieta House and Samaritians are keeping the public conversation going on the importance of talking about mental health. Mental Health Reform has been conducting a very powerful online campaign, #IAmAReason, in which people are outlining reasons the mental health budget should not be reduced. A demonstration in support of this objective will take place this coming Thursday. That shows the necessity to bring to an end this incredible interregnum. We are effectively coming up to three months without a Government. This is one of the urgent and critical areas of public policy that we should be addressing, but we are still talking about talking. At this stage Members on the Independent benches are becoming very frustrated and reflecting the views of their constituents, but the least that is needed is for the acting Minister to halt the cut.

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