Jan O'Sullivan (Limerick City, Labour) | Oireachtas source

I welcome the debate and I know we have had a number of debates on mental health issues. What is really important is not so much that we have a debate but that we ensure there is action and implementation with regard to A Vision for Change and specific and deliverable developments in the area. Funding is important and ring-fencing funding is particularly important. I refer to the work of former Deputy Kathleen Lynch when she was Minister of State with responsibility for mental health. She insisted on having a ring-fenced budget as there had been a tendency for money allocated for mental health to be taken back into the general health budget. It is important that money should be ring-fenced, with money allocated specifically to mental health being spent in the area. To suggest that money that was to go to the area in 2016 - with a similar amount for 2017 - would be cut sends a signal to services that they will not continue to develop in a similar way to when the ring-fenced money was used in recent years.

A Vision for Change set out much more focus on prevention and community services rather than the old idea that everything had to be done in acute services and through psychiatry rather than areas like counselling.

Many people felt they could not talk about mental health. They thought they could not say they had a mental health issue. The whole mindset needed to be changed. In particular, services needed to be rebalanced in favour of local community care and alternatives to the acute care-based model that was previously followed needed to be provided.

When the money was ring-fenced, it was used to support community organisations, to educate GPs on suicide prevention, to fund a primary care counselling service, to facilitate access to psychology and psychotherapy services, to make additional beds available for child and adolescent mental health services, to employ clinical nurse specialists to respond to those who present with self-harm in accident and emergency departments, to finance the national clinical programme for eating disorders, which is an area that had been neglected, to provide training in behavioural family therapy and to provide for the roll-out of Jigsaw, to which a number of previous speakers have referred. Jigsaw is a good example of a service that is welcoming and accessible to young people in particular. I think it is an example of the way we need to go. I welcome the fact that it is being rolled out. We need to continue to roll out this service. I know that the Limerick and Cork areas are targeted at present. I was really impressed by it when I had an opportunity to see it in action in Galway. When I speak to young people, they tell me they want to be able to access a service that is open to them. They do not necessarily need psychiatry. In many cases, they need other models like counselling. It strikes me, based on the research that has been done on young people who present to the mental health services, that they often require this kind of service rather than the traditional kind of service that was made available in the past.

I want to make the case for ensuring counselling services in primary care are made available to young people. I know that a service has been delivered for adults, but it should also be available to younger people. We need more community services like the Jigsaw example I have mentioned. Many community organisations throughout the country are doing great community support work to bring mental health services out to people in the community and to let people know what is available. I believe they need to be well supported. It is important that we are having a debate about funding this evening. If we do not ring-fence funding, it is inevitable that it will be spent in other areas. I wish the Minister of State well with that. I think she should get the support of her colleagues in government as she seeks to ensure funding is retained in the mental health budget. I know there have been issues with regard to recruitment, but I think many of them have been addressed. I think there is now a capacity to recruit that did not exist in 2011. The Government needs to ensure it continues its efforts to recruit staff and to broaden things out into the community.

As a number of Deputies have said, the education system now places a much greater emphasis on mental health and well-being. When we were reforming the junior cycle, we concentrated on making well-being a compulsory subject for the junior cycle. That is due to be introduced next year as a way of ensuring all young people get an opportunity to talk about mental health and well-being, to recognise there are places they can go for support when, as a part of life, they do not necessarily feel all that well at certain times and to understand that it is okay to talk about these matters. The cultural change that is needed must be accompanied by the practical measures that are set out in A Vision for Change. We need to ensure sufficient money is available to implement these programmes, particularly those that provide access in people's local communities, GP services and primary care services. This will ensure people can seek help and get it when they need it, rather than after they have been suffering for a period of time without knowing where to go forward or who to go forward to. This is a welcome debate. We need to continue to raise mental health issues. This area has been neglected in the past. I hope the emphasis that was brought about by the ring-fencing of funding by the previous Government is continuing in the current Government. We should continue to strengthen our mental health services, particularly by making them accessible.

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