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

There is a very broad consensus in this House and across the State that mental health is a very serious issue that requires immediate attention. It is our job to take that consensus and build a coherent and focused plan to ensure that the changes which need to happen are identified and tackled in the coming months. Mental health is an issue which affects nearly every family and people in every walk of life. It is particularly important that we discuss this issue now as no doubt budget preparations are already under way. Money is not a silver bullet that will solve all the problems in this area but it is clear that our mental health services and our mental health care professionals have been chronically underfunded for decades. The clearest evidence of this is that ten years on from the publication of A Vision for Change many of its recommendations are either completely unfulfilled or partially complete. Lip service has been paid to the delivery of true community-based care and institutions were closed or downsized but the replacement services have not met demand.

The Mental Health Reform group, made up of large number of bodies actively involved in care provision, advocacy and health promotion, estimates that a yearly budget of €973 million is required to properly deliver the services and care needed to meet the demand being place on the system. That is nearly €150 million more than what has been pledged for 2016 even before we consider the shameful proposal to reallocate €12 million earmarked for mental health for other purposes.

The list of crucial items yet to be delivered due to a lack of funding goes on and on. Staffing levels are 23% less than recommended. Only 2.8% of the recommended posts in mental health and intellectual disability adult services have been created. We do not have a 24-hour crisis support service in place, which leaves people in serious distress outside office hours with little access to care. In some cases people in crisis may have to travel hundreds of kilometres back and forth to different services in order to potentially get a bed in an acute unit. This is what is required of somebody who is already incredibly vulnerable and in such a hopeless state.

Accident and emergency departments, which are already packed to capacity with general medical emergencies, are having to deal with people in mental health crisis who have nowhere else to go. Many of these, after waiting for an extended period of time, have been told there is no place for them and to leave the accident and emergency department. Recently we have seen a spate of tragedies where people who left accident an emergency department in crisis subsequently took their lives. On the north side of Dublin two brothers in the space of weeks reported to an accident and emergency department with no resolution, and left vulnerable and in crisis. One brother took his life and the other brother was found having attempted to hang himself. The Minister has said that those who leave an accident and emergency department due a waiting times are gambling with their health but it is the State that is gambling with the lives of people who may be suicidal and are being forced to wait in this manner, in crowded, noisy and chaotic waiting rooms.

The full roll-out of suicide crisis assessment nurse would cost less than €400,000 but it has yet to be completed. These nurses need to be on hand to ensure no person in crisis leaves hospital without assessment and the appropriate care. We also need a focused response to the very common problem of what is called dual diagnosis, where someone with a mental health problem also has a substance abuse problem. Many people in desperate situations turn to substance abuse and our services must be able to address this without passing people from pillar to post looking for appropriate care.

I wish to praise the excellent work of voluntary and community bodies such as Finglas Suicide Network, Pieta House, the Mental Health Reform group and many others who have done so much to raise these issues and to provide crucial on the ground services. Initiatives such as the recent Walk of Hope in Tolka Valley in Finglas, organised by local people, is one many. It was a magnificent initiative to raise awareness of mental health problems.

It is the responsibility of the State and we must live up to that challenge. We cannot shirk responsibility by relying on the dedication of members of the public who pledge their time so generously. We also need to treat our nurses and junior doctors better. They are not volunteers but are professionals who deserve fair remuneration and decent conditions. We can provide a service which truly delivers care where it is needed but we need to recognise that this costs money and needs real dedication. If we are willing to prioritise mental health care, we will succeed. That is a political choice. Past Governments chose to ignore the issue and that cannot be allowed to happen again.

See this speech in context