Tom Neville (Limerick County, Fine Gael) | Oireachtas source

I commend Deputy Browne on bringing the Bill forward. I believe stigma is starting to break down but we still have a long way to go. It is probably different in different generations and I am very heartened by the fact that teenagers and the younger generation are much more open in the area of mental health. My own age group is not so open and older people are probably less open again. That is not the fault of anyone but is a culturally entrenched belief and we must continue to break it down as best we can. Discussing it in the Dáil is very welcome, as has been said many times tonight, particularly for the people who are watching. I want to be mindful of the sensitivities of people who have been affected by the issue.

This is an all-Ireland challenge. I do not want to be political but the suicide rate in Northern Ireland is the highest in the UK, at 16.5 per 100,000, though that does not take away from the challenges we have in the Republic. There are different complexities in the North but we have to be mindful of it and we have to try to be as apolitical on mental health as we possibly can be, even though politics will creep in at times, as this is in the best interests of our country.

I welcome the development of Jigsaw in Limerick and the mid-west region. We must be mindful that stigma leads others to avoid living, socialising, working and renting and getting employment. People with mental disorders, especially severe disorders such as schizophrenia, have low self-esteem and suffer isolation, while hopelessness deters the public from seeking and wanting to pay for care. On the matter of stigma, people with mental health problems internalise public attitudes and become so embarrassed or ashamed that they often conceal symptoms and fail to seek treatment. This is the kernel of stigma and we need to keep combatting it. There is a lack of knowledge, negative attitudes and hostile behaviour.

Why do individuals stigmatise? The website of Aware contains the following:

Sadly, stigmatisation is actually a natural part of the human condition. When one is faced with something unknown, the natural reaction is ‘fight or flight’. In such a scenario, we make decisions rapidly, making general assumptions about what’s going on and filling in any blanks in our knowledge with other information which we do not actually know to be true. We sometimes tend to fill in these blanks based on previous stereotypes.

We must really get behind stigma and understand it if we are to articulate the issue and combat it. The effects are shame, blame, secrecy, isolation, social exclusion and discrimination and we need to focus on that. We need to find the pillars in this area and eradicate stigma. We are starting to eradicate stigma in how we discuss mental health, and particularly in how we discuss it in front of others, and that is welcome, but we now have to eradicate self-stigma so that people are comfortable opening up and approaching the services to speak about their challenges. That is the next phase, something which some commentators have stated in the past six or eight months, but it is a long process.

There are other models which operate in conjunction with the medicinal models. One of these is the creative arts and I am a great believer in what the creative arts can do for mental health. They focus on relationships, meanings and values. Art is therapeutic and art, drama and poetry offer space where meaning can be generated and confidence encouraged. It is open-ended and ambiguous, which helps. How many times have we heard of artists finding inspiration from their own mental health challenges and using them in their art? Creative people bring a different perspective, open-endedness and comfortable ambiguity and these should be used in conjunction with therapy. I am open to correction by people with backgrounds and qualifications in medicine but, following my own research into the subject, I am a great believer in using the two approaches in conjunction.

We have to examine, and keep examining, dual diagnosis, such as of addiction and mental health, and we have to attack it. We need to take advantage of the integration between both and to use the pilot projects which have been done.

Deputy Browne and I are members of the cross-party mental health committee and have seen how these pilot projects are using dual diagnosis in combating addiction and mental health issues. That integrated approach is something that really needs to be addressed.

There is huge complexity regarding the use of alcohol. Those affected may be the loved ones, offspring or partners of those with alcohol or drugs problems. Recreational drug use has increased dramatically in the past 20 years. As a society, we are seeing greater use of synthetic drugs and this must be combatted. I welcome this debate but I must ask that we continue to try to combat stigma in a big way.

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