Thomas Pringle (Donegal, Independent) | Oireachtas source

Good mental health provides a fundamental basis for overall good physical health. The two are intrinsically linked and one cannot be delivered without the other. However, this Government has shown it feels differently, recently diverting €12 million of funding supposedly ring-fenced for mental health services over to its bigger sister in health.

Ten years ago A Vision for Change was published and yet unsurprisingly in all the time since then, it was never fully implemented. This Government and previous Governments claimed budgetary constraints as the reason for this failure but everyone knows it was complacency and a lack of political will that left this vision an unrealised ambition. For the second time this year, mental health funding has been unfairly targeted. While other areas of the health service received additional funds to deal with pressures, mental health did not. It is incredible that the Minister believes there was spare capacity within the mental health service to use its funds to take care of over-runs in other parts of the health service. Mental health reserves do not exist to prop up the bigger health sister. It should be seen as a stand-alone, independent entity within the Department of Health.

The extra €35 million was ring-fenced to improve prevention and early intervention counselling services for those under 18 years of age, dual diagnosis of mental health and substance abuse, services for psychiatry of later life and for those with mental illness and-or intellectual disability, and for the development of perinatal mental health services. The Government made a commitment in its 2011 programme for Government to dedicate the €35 million in ring-fenced funding towards the development of community mental health services. It has reneged on its promises on this too. How many times in the past five years have we seen that this funding was not ring-fenced but, in fact, was diverted to other parts of the health service?

The Mental Health Commission has recently expressed concerns about the staffing of community mental health teams, indicating there are still large gaps in teams especially in respect of social workers, occupational therapists, nurses and psychologists. We are still at only 75% of the required staffing recommended in the national mental health policy, A Vision for Change. Some areas of the mental health service have been largely ignored, including the mental health of homeless people, people with intellectual disability and maternal mental health. It is a sure sign of dysfunction when other areas of health such as primary care, disability and acute hospitals get funding for extra pressures, while mental health services do not.

I wish to focus on two areas of the mental health services, the services for children and for lesbian, gay, bisexual and transgender, LGBT, people. With regard to mental health services for children, the Children's Rights Alliance recently allocated a D grade in its 2016 report card for the Government's work in the area of children's mental health. According to its research, we are currently experiencing a crisis in operational beds for child and adolescent mental health services, CAMHS, and a crisis in staffing levels in CAMHS teams. The Children's Rights Alliance indicated that of the 129 specialist teams needed for CAMHS to operate effectively, only 63 teams are in operation and, as of November last year, the number of clinical staff in CAMHS posts was 505, which represents only half of the staffing level recommended. Without dedicated CAMHS beds, children end up in acute psychiatric units or in paediatric wards of general hospitals. The number of children and young people placed in adult inpatient units remains high.

We also must focus on particular communities vulnerable to mental health issues, such as LGBT young people. As indicated in a 2012 report on youth mental health by Headstrong, young LGBT individuals are twice as likely to self-harm and to suffer from mental health issues as other people. The report also found a strong correlation between bullying and mental health problems. In the report's recommendations, reducing mental health risks and building resilience are central ingredients to addressing mental health difficulties for people coming out. However, this means investing in youth work, which organisations such as BeLonGTo have been doing for the past decade. Youth work helps build resilience in LGBT people and, therefore, better mental health. Resilience can also be learned through our school system and through the Stand Up campaign carried out by BeLongTo, which is in 25% of post-primary schools. Such programmes require more investment to be able to address the full scale of homophobia and to reach more schools across the country. Funding must be secured within the HSE in the Department of Health and, most importantly, the political cycle must be taken out of funding allocation and planning.

To conclude, I remind the House that there remains no legislative entitlement to health care or mental health treatment in Ireland and that children and adolescents have a right to enjoy the highest attainable standard of physical and mental health under Article 24 of the UN Convention on the Rights of the Child and also under Article 12 of the International Covenant on Economic, Social and Cultural Rights. We should enshrine those rights in our Constitution to ensure that people can access the services they require.

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