Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

I move amendment No. 1:

To delete all words after “Dáil Éireann” and substitute the following:“notes:

— the commitment by Fine Gael in its post-election agreement with Fianna Fáil to increase funding annually for mental health services and fully implement A Vision for Change;

— that the July 2016 estimate from the Department of Health indicated that the required resources needed to fully implement A Vision For Change are €177.3 million or €35.4 million per annum over five years;

— the recommendation of the Oireachtas Group on Mental Health that an increase of €37.5 million should be made in spending for the service in 2017;

— that in 2017 the funding committed for new developments is just €15 million;

— that such an increase would represent only a 1.8 per cent investment in new developments for mental health compared to the 2016 Budget; and

— that even including the €9.7 million announced for increased pay rates in mental health services, this represents an increase of just 3 per cent in revenue funding for mental health, much less than the 7.4 per cent increase in revenue spending for the health budget as a whole;

commits once more to the complete implementation of A Vision for Change as soon as possible;

resolves to:

— increase the mental health budget for 2017 by a minimum of €37.5 million; and

— ring-fence all and any monies allocated to mental health, and that go unspent within a financial year, for use the following year and for such monies not to be returned to the exchequer and/or expended elsewhere; and demand that a multi-annual plan be published by Government, within three months, outlining how the full implementation of A Vision for Change will be realised including provision for required future funding increases.”

This Government was founded on an agreement between Fianna Fáil and Fine Gael which sought to lay down the basic objectives for the Thirty-second Dáil. The agreement stated that support would be given by Fianna Fáil to Fine Gael and its Government so that these objectives would be followed through on. It provided Fine Gael with the chance to remain in power and Fianna Fáil with the ability to keep one foot in either side of the Dáil, criticising what it did not like and claiming credit for policies with which it agreed. Much was made in the recent budget of Fianna Fáil's claims to have exerted positive influence on the Government to achieve certain initiatives. Tonight we debate one glaring failure of this Government to live up to its agreement and a glaring failure of Fianna Fáil to hold the Government to that up to this point.

I welcome this motion. It could be stronger but it is necessary, and the Sinn Féin amendment is in keeping with its spirit, which is to pressure this Government to adequately fund our mental health services and implement the necessary reforms laid out a decade ago by A Vision for Change, a document which promised much but went largely unimplemented by Fine Gael and Fianna Fáil while in government. Fine Gael may have felt it had a soft commitment in the agreement with Fianna Fáil. I ask the Government to fully implement A Vision for Change. However, anyone who knows much about A Vision for Change and the mental health services currently in place knows that while this objective is all too achievable, it requires significant commitment and political will, which has been absent in the last decade.

One crucial part of seeing A Vision for Change implemented is the issue of funding. Our mental health services have long been underfunded, with their share of the overall health budget shrinking again and again. At present mental health funding makes up just 6.4% of the health budget. In 2017, it looks like that will be closer to 5.7%. If we take the model in the UK and Canada - we should take a leaf out of their book - it is 13%. This does not sound like mental health being prioritised but it sounds like more of the same - a lot of talk about mental health but very little substance.

In 2015, we remember the then Minister for Health lauding a supposed increase of €124 million for mental health in 2016. When this year's plans were revealed to remove €12 million of this funding, this was only thwarted by the voices of mental health advocates and campaigners who simply refused to accept it and took to the streets and the airwaves to force this Government to back down. In the end, funding for 2016 was €45 million less than had been stated on budget day. A Department official in a freedom of information request said the Minister had "overstated" funding and was "not correct". This year we were told that €35 million would be added to the mental health budget for 2017. No further detail was provided. The figure being just short of that called for by groups such as Mental Health Reform and the Oireachtas group on mental health was welcomed. I welcomed it while stating that more details were needed. In the coming weeks it became apparent that once again the media, the public and the Opposition had been misled and given incorrect information. As soon as budget fever died down, the truth was revealed quietly in response to the questioning of Deputies. Instead of €35 million, just €15 million would be added to the budget for 2017, a pathetic increase of just 1.8% which would barely allow the services to stand still in a time of increasing demand. The Government knew that this was an unacceptable figure. It knew it was not good enough. This was clearly the reason it hid the figure as best it could.

In Fine Gael's election manifesto it promised €175 million in additional mental health spending over five years. This would have meant €35 million per year extra on average. The 14 promises included: to extend youth mental health services, such as Jigsaw, which is free to access and does not require general practitioner referral; to extend counselling in primary care services to more people; to ensure greater access to counselling and psychological services; to support mental health recovery by offering follow-up training and booster self-help courses; to expand the national educational psychological services; to ensure integration of psychotherapy, counselling and social care services with primary care teams; and to build on reduced waiting times for child and adolescent services. None of these were achievable in the context of such low spending on mental health, but those funding levels are achievable now. If the Government is claiming an additional €35 million over two years, are we to expect only €10 million in additional funding for 2018?

We cannot wait any longer for the political will and the funding needed to bring about the needed reforms underpinned in A Vision for Change. The Government can no longer talk out of both sides of its mouth on this issue. Members of the Government will surely deny this is the case, but how can they do so credibly when the figures are there in front of them? We have a lot of work to do and we need to start it now. Our services are overstretched in every sense and staff are underpaid, overworked and undersupported. Those who depend on these services are not being treated adequately, or at all in some cases, not due to the failures of the front-line staff but rather the political failures which have left the cupboard bare. In the past eight years, the number of staff in posts across the mental health service has decreased by almost 1,000. Child and adolescent mental health teams were at 50% of the recommended staffing levels at the end of 2015, while referrals increased by 50%. Staffing levels across the service are well below what is recommended.

Referrals to counselling in primary care services increased by almost 20% from 2014 to 2015. Just five mental health and intellectual disability consultants for children are in post throughout the country, which is 3% of the number of positions the expert group on A Vision for Change recommended. Ireland has the fourth-highest rate of suicide among young men and women aged 15 to 19 years across 31 European countries, with increasing levels of self-harm also being reported.

I am glad this motion has been taken today and I hope Fianna Fáil will follow through with the appropriate pressure needed to ensure Fine Gael lives up to its commitments. Sinn Féin will work with anyone to improve mental health funding and put it where its needed. The Minister of State and her Government must listen to the Dáil tonight and to the activists and the people who depend on these services. It is simply not good enough and they can and must do better. Tonight is an opportunity to do the right thing, which many of the people in the Government parties would like to see. The Government should stand by its commitments to the people, those made in the election and afterwards.

I will conclude by mentioning something posted recently by a friend on social media. It was her story, the story of a young woman who, having endured some hard knocks in life, found herself feeling utterly beyond hope. She attempted to take her own life but awoke a day later in hospital having done serious damage to her kidneys. Her life continued on a cycle of behaviour that only hurt her further because she could not see through the fog of her own mental ill health and value the brilliant young woman she is. Eventually she worked up the immense courage and strength to make a change and to seek help. Today I am sure her life is not perfect but she has put herself on the long road to recovery. If someone so young, dealing with all of that, can be so strong and so courageous then we too must match that example. We must not shy away from the challenge of building a mental health services for those who seek it in their darkest hour or just on the little bumps along the road; it is for every member of our society because we all have mental health. This is a service for all of us and its neglect fails us all.

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