Éamon Ó Cuív (Galway West, Fianna Fail) | Oireachtas source

I congratulate the Ministers on their appointment. We all face a challenge with regard to mental health. Every day, Deputies meet people with varying levels of mental health problems and we have come across the ultimate situation where somebody commits suicide, leaving families devastated. The question is what we can do about this problem and how we can reduce the numbers. It is very important that we apply ourselves to this task as we applied ourselves in a previous time to reduce the number of people killed on the road, which we have done quite successfully.

We must look at every facet of this subject. One thing is certainly true, namely, that acute medicine has a much better ability to attract funding than continuous preventative medicine, which requires continuous investment without a very specific outcome. This House has to support the ring-fencing of budgets for mental health. We should also look at models of best practice. Suicide numbers have gone through the roof in the past 30 years but there may be good reasons for that. Some of it might be because of pressures in society but we must also take into account the much larger number of people who were locked up in psychiatric homes, although thankfully we do not treat these people in that way any more. We have to see whether there is a third way that does not go back to the totally unacceptable first way nor leaves us with the present situation. I have seen some examples of very good practice which are basically community based and very local. All of these require funding and there is a tendency in the system to prefer money to be spent on a certain number of procedures rather than on continuous care. The Minister has a major challenge in that regard but we also have a role to play. If we insist on all the funding going into acute care, we cannot complain when it does not go into continuous care.

I will touch on two other issues. One is that we seem to be living in a world where bureaucracy is becoming more and more codified and where people have to conform to the code, whether that is in housing or in something else. The code becomes more important than the personal or the individual circumstances. There is an inability on the part of people to deal with all sorts of things in life, such as farm forms or housing, health and social welfare issues, while the system always wants things to be done its way. Very little discretion is given to officials even when it is clear somebody has a health issue and this is something we have to look at. We need to get back humanity and have discretion, particularly when dealing with people who quite clearly have health issues which mean they cannot deal with things in the way other people can.

I believe in humanity and the benefits of dealing with people on their own terms. One of the great shocks I had was finding out that one cannot legally get a medical card if one has no income, which sometimes happen on account of mental health issues. Even when it is absolutely clear there is no cheating going on, people cannot get their card, which is bureaucracy gone mad. It is inflexibility gone mad. Students with problems who opt out of exams and want to go back to college are charged the full fees again. If they can prove by a certain deadline that they had a medical issue, they can avoid this but people with a mental illness often do not follow all the rubrics, instead getting themselves into a total mess. It is not just about the medical services but about society's attitude.

The third issue is our large prison population as compared to 1950. I raised this issue with somebody very senior in the Prison Service and he said the explanation is that we had a huge population in mental institutions at that time. If the Minister wants to test this theory, he should go down to the female prison, the Dóchas Centre in Mountjoy Prison, where he will find many people who should not be in prison because the issues that put them there are purely to do with mental health issues, in some cases allied to drug addiction. To criminalise what is basically a medical problem is totally cruel.

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