Mick Wallace (Wexford, Independent) | Oireachtas source

Two weeks ago, I held a public meeting in Wexford to discuss the state of mental health services in the county. Ten groups were in attendance, namely, Good2Talk, the Collective Sensory Group, Cycle Against Suicide, New Me, New Ross, the campaign for Wexford's acute mental health service, Creacon Lodge wellness centre, Eolas Soiléir, Cura, See Change and the Cornmarket Project. These groups, among others, pick up the slack when the Health Service Executive is lacking but receive very little credit for doing so and next to nothing in the way of funding. The meeting heard from people who are going through or had been through the mental health system, others who could not access services and others who wanted to break free from HSE services.

There is a crisis surrounding mental health and mental health services, and nowhere is this crisis worse than in Wexford. Sadly, it is directly connected to neoliberal Government policy and the rise in inequality it has caused. Figures released last month by the charity, Mind, revealed that 46% of people with mental health problems in the United Kingdom had considered taking their lives or attempted to do so as a result of social factors such as debt and welfare difficulties. The austerity programme of the past seven years has taken its toll on the collective well-being, in particular in the area of mental health. One of the most maddening aspects of these years was observing cuts being made to mental health services just when support and resources were needed most.

Children and teenagers are being failed most. Even from a purely economic perspective, this is a disastrous position. Many studies, most recently a study carried out by the Centre for Mental Health in the United Kingdom, have shown that there is a serious economic case to be made for improving prevention and early intervention services. Money is much better spent reshaping services for children and young people and on community based alternatives than on inpatient crisis care in general. Sending patients far from home to access acute care when they are in crisis is expensive and bad for the patient, his or her family and his or her recovery. Despite this, only ten inpatient beds are available for those aged under 18 years in the entire south of the country. These are all located in the Eist Linn centre in Cork. Let us imagine the case of a teenager who survives an attempted suicide in Wexford and desperately needs around-the-clock supervision. If he or she is lucky enough to get a bed, it will mean travelling more than 200 km. That can hardly be described as humane.

The meeting the other week, which lasted for four and a half hours, was a very troubling experience. A number of issues stood out and were raised repeatedly during the discussion. Most important was the intense dissatisfaction with the complete absence of 24-hour acute mental health services in County Wexford. It is not a coincidence that the most recent figures from the Central Statistics Office show that Wexford has the highest suicide rate in the country. The rate doubled in 2011, one year after all acute beds in the mental health service were moved to Waterford.

People in Wexford are ending their lives because the Government has made the reckless and absurd decision that the best time to provide emergency mental health services is from 9 a.m. to 5 p.m. from Monday to Friday. The logic of that decision does not bear thinking about when we think about the times people are likely to come under pressure.

I was also struck at the meeting by the fact that nobody advocated or had anything positive to say about the medicalised model of mental health care that is promoted by the HSE. This brings us to the crux of the matter. We want better acute services but we do not approve of how these services tend to medicate rather than resolve issues and trauma. However, matters are so bad at this point that we are glossing over that concern while we call for just basic service provision. We got rid of a place that was not fit for purpose, St. Senan's, and were told that as planned under A Vision for Change, great care through community provisions would be made available. Sadly, that has not happened.

In a recent response from the HSE to a parliamentary question about the numbers of people currently prescribed anti-depressant medication by the health service, it revealed that as of 2015, there were 249,900 people on eight different versions of anti-depressant medication. This quarter of a million people comprises only those on State supported medication.

Some of the listed drugs are widely known in the scientific community to be dangerous. Seroxat was declared safe by a 2001 study and was marketed by GlaxoSmithKline as safe and effective for children and adolescents for the treatment of depression, although company executives were aware that studies had shown that the drug was no better than a placebo and caused thought disturbance and suicidal behaviour in a significant number of young people. After a ten year struggle by concerned scientists and researchers to get to the truth, the 2001 study was reanalysed and rebutted last September. However, GlaxoSmithKline refuses to retract it. Why are almost 10,000 people in Ireland still being prescribed this drug by the HSE, although we know it is unsafe? For ten years, GlaxoSmithKline intentionally deceived the public about its findings and made a killing while it knew it was killing children.

Sertraline, manufactured by Pfizer, is the second most widely prescribed anti-depressant in Ireland. It also has a woeful track record. The first study of the drug took place in Leeds University in 1983 and all the subjects who took it reported apprehension, insomnia, movement disorders and tremors. Pfizer pulled the study and yet here we are 33 years later handing it out to 42,585 people.

There are many alternatives to this top-down medicalised model of care, even for the most debilitating of mental health problems. For example, in western Lapland in Finland, there has been a state endorsed programme called Open Dialogue in place for the past 25 to 30 years. In the 1980s, western Lapland had the worst incidence of so-called schizophrenia in Europe. Now it has the best documented outcomes in the western world. Today, 75% of those experiencing psychosis have returned to work or study within two years and only approximately 20% are still taking anti-psychotic medication and a two year follow up.

The Open Dialogue approach ensures the person having the crisis is empowered and has the final word about how his or her care proceeds. Everyone involved in the crisis is invited to meet and discuss how to deal with the issue. The family, friends, care professionals, police, people who have been affected by the person and people who have affected the person are all invited to sit and discuss the best way to advance the well-being of the person in need. The Open Dialogue representative is only there to facilitate the discussion, not to judge or have an opinion about what should happen to the individual. At the centre of this process is a foundation built on respect for the individual and his or her autonomy. That alone marks a massive step forward for the person's sense of self worth and healing process.

It is frightening how much needs to change about how we provide care in this area. The Government's only solid plan so far is to remove ring-fenced funding from it. I already mentioned the group It's Good2Talk. Before the election, I saw a picture showing a huge cheque for €130,000 being awarded to that group. That was a political stroke for certain politicians. However, as of two week's ago, the group has not seen a penny of that money and has been led to believe that, for one reason or another, it will only get some of it. Will the Minister of State find out for me whether this group will get the money it was told it will get?

We are all very much aware of the problems all around the country in regard to mental health and I am sure anybody who knocked on doors during the election got it by the bucketful. Sadly, for a number of years now we have also got neoliberal government by the bucketful. This has led to significant difficulties and challenges for many people. It has also led to mental health issues for many people. Now, here we are taking funding, which was supposedly ring-fenced, from an area that is already under-funded. How in God's name can we proceed with that cut? The suggestion was made that professionals could not be found for jobs to be covered by that funding. If that is the case, the money should be put into some other mental health area. We all know there is a huge need for extra funding for mental health care all over the country, not just in Wexford. I am aware the fact we have more than 20% unemployment in Wexford is one of the reasons we now have the highest suicide rate in the country but that is not disconnected from the issue of the provision of services. The Government needs to put more money into mental health care.

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