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

Issues of mental health and well-being are some of the greatest challenges facing us as a society. The suicide rate stemming from mental health issues has reached epidemic proportions and has well overtaken the road death rate. As a society, we must ask why this is happening, what remedies are needed and where the shortfalls in our system lie.

It is very clear there has been a huge haemorrhage of nurses and front-line professionals. A report by the Psychiatric Nurses Association, PNA and the Royal College of Surgeons in Ireland, RCSI, found that there has been an overall reduction in mental health staff numbers since 2006. The HSE's report, Delivering Specialist Mental Health Services 2014-2015, identifies the fact that staffing in CAMHS was half the recommended level. The mental health service needs more staff, particularly psychiatric professionals, in virtually every area. The current staff do Trojan work, often on their own time and go way beyond the call of duty. Psychiatric care professionals aim to assist in the recovery of people experiencing mental health problems and to promote mental health and well-being. However, understaffing puts the whole system under pressure. It is imperative that service levels are increased and that more nurses and trained professionals are recruited. The availability of services locally, in our communities, also needs to be resourced properly. Were it not for voluntary groups and individuals, I shudder to think how bad things could be. We owe a huge debt of gratitude to all those who give their time, energy and commitment.

There is a huge deficit in our system whereby at weekends or after hours, services are not available. A failure to provide community-based mental health services to replace the institutions that have been closed has led to many falling through the cracks. This motion clearly highlights what is needed from the Government, namely, the provision of a 24-7 crisis intervention service. In terms of staffing, an additional €37.5 million would fund all the positions outlined in the recommendations of A Vision for Change. The provision of 24-7 care would alleviate some of these problems but the process of admission to services also needs to be considered. Presenting oneself to a GP to get a note or to the emergency department is not working; nor is reporting to a Garda station. We cannot treat mental health issues in the same way as other medical issues. Any response to mental health problems must be flexible and capable of providing professional care when people need it, particularly in extreme circumstances.

There is a persistent problem of people presenting at accident and emergency departments with mental health issues being turned away for various reasons. There are many such cases to which I could refer. Indeed, I had the recent experience of seeing my own son being refused admission even though he has had a history of admission to the psychiatric services. This is not the exception but is happening regularly all over the country. The problem of dual diagnosis, whereby people are taking alcohol or drugs on top of their illness is not taken into account and such people are also being refused access to services. This need to be urgently changed and dedicated staff must be provided and trained to deal with it. We need more outreach workers to deal with people in their homes and their communities. The stigma associated with mental health difficulties needs to be tackled. The message needs to go out that help is available and that those in distress must talk to someone - a friend, family member or service provider. People should not bottle it up. It is okay not to feel okay - that should be the message.

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