Catherine Connolly (Galway West, Independent) | Oireachtas source

I welcome the opportunity to take part in the debate, although I feel I have been repeating myself in the short time I have been in the House. While I welcome the Private Members' Bill put forward by Fianna Fáil and I have no difficulty supporting it, I want to put it in the context that we are here once again. This is perhaps the sixth time since February that we have discussed mental health in the Dáil as a result of a constant campaign of emails, pressure and letters which make us fully aware of how unsatisfactory mental health services are in Ireland.

I have had the privilege in a different life of working in that area and I used my contribution on Leaders' Questions a few weeks ago to highlight the fact that we do not need to reinvent the wheel. A document called Planning for the Future was published in 1984 because mental services at the time were completely unsatisfactory. Fast forward to 2006 and A Vision for Change was published. I just left the Chamber to get the briefing document on A Vision for Change, which was the report of the expert group on mental health. The briefing document indicated that A Vision for Change was person-centred, recovery-oriented, holistic, community-based, multi-disciplinary and population based. All of this has been set out. I repeat the fact that it was a visionary document and everything was included in it, including the very high suicide rates in 2006 which unfortunately have worsened. Not only were the difficulties highlighted, but the solution was set out. In addition, the expert group said that it did not trust governments and it recommended the establishment of an implementation body. This body was set up for two different three-year periods. I have highlighted this aspect repeatedly and I am not taking particular issue with this Government because it relates to every Government. That is why an independent body, entirely separate from the Mental Health Commission, was set up to monitor it. Every time the body reported during those two three-year periods, it praised the progress that had been made and highlighted the tardy implementation of A Vision for Change between 2006 and 2016. What did the Government do with that information? It disbanded the implementation body because it was telling the truth and stating that the Government was simply not implementing A Vision for Change.

Since I have come to the House, I have heard people speak with the best intentions about a system that needs to be changed, but I take a different view. The vision and the policy are there. Of course, they need to be updated to take account of the complexities of what Deputy Browne proposes in his Bill, but the vision, documentation and solutions are all before the Minister of State. We were told we would get the review practically every month but we still have not got it. The Minister of State has given me a written reply and a timescale, but it has taken constant pressure. I do not know where the fault lies and I am not interested in that at this point. My real point is that it is there to be implemented and, therefore, we must ask why that is not happening. If we are told it is because of cost, that is not accurate because the report of the expert group points out in page 5 the cost of not implementing A Vision for Change. This is something I have highlighted repeatedly. As in the case of domestic violence, there is a cost involved in not doing something.

While I do not want to look at mental illness or services in terms of economic costs, it is important to note the estimated economic cost of not implementing the policy to balance the argument that it costs too much and we do not have the money. In fact, one cannot afford to fail to implement it because it costs the taxpayer more in the long run, not to mention the upset to the people who are not getting proper treatment. The report stated that the estimated economic costs of mental health problems were considerable and amounted to at least 3% to 4% of the GNP across the member states of the EU. The report stated that the total financial cost of mental health issues in Northern Ireland had been estimated at £2.8 billion. Translated to the Republic of Ireland on a pro ratapopulation basis, the economic cost of mental health problems in Northern Ireland suggested a total annual cost here of €11 billion. I ask Members to listen to those figures, which are not mine. We simply cannot afford to fail to deal with the treatment of mental health.

Not only have we failed to reinstate the implementation body, but we are also now aware that of the 165 recommendations made by the other body that looked at this area, only one has been implemented. I know it is difficult for the Minister of State to come to the House to take criticism, as it is for any Minister, but I would have expected her to come to the House tonight to tell us why the other 164 recommendations have not been implemented. She has suggested that some of them are complex and need more study and examination, but not, presumably, the whole 164. Why have they not been implemented? The major additional problem cited in relation to the implementation of change was the lack of staff. Another difficulty has been the interpretation of the document, in particular and to be parochial for a moment, in relation to Galway and Ballinasloe. It was misinterpreted and led to the closure of a brand new unit in Ballinasloe, an issue with which the Minister of State is familiar on foot of representations made to her by Deputies from east Galway. We had to go through the misinterpretation of this wonderful document, A Vision for Change, to justify the non-opening of a modern, state-of-the-art facility in Ballinasloe, leading to extraordinary pressure being put on services in Galway. I welcome what I understand is a review and attempt at least to undo that decision but I do not know how far that has progressed. I mention it in terms of decisions being made for short-term reasons which are costly in the long term. The pressure on the Galway facility is impossible for me to describe. I do not wish to add hysteria or fear, and I have a difficulty with the concept of suicide patrols in Galway city, but people felt so frustrated that they actually resorted to such patrols in order to feel that they were doing something to prevent the high rates of suicide.

All of this was predictable. We need to stop talking and to get answers from the Minister of State as to why the implementation body was disbanded, why the 164 recommendations were not implemented, when the implementation body will be re-established and whether it will have comprehensive powers to monitor A Vision for Change, which remains in place notwithstanding the fact that in theory it ran out in January last year. Presumably it is the same guiding document until a new policy is put in place. Those are the answers I would have expected to hear replies to a year and a half later after having been elected to the House. There should be no more debates on this issue. We should be told what the problems are and then see a cost analysis of not implementing this. The figures have been extrapolated from Northern Ireland, but it is time for a cost analysis here of the failure to implement the wonderful policy that has been there since 2006.

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