Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

I apologise because I will have to leave after my contribution. I have a meeting at 12 noon. I very much welcome the discussion. I also commend the Ceann Comhairle on his proposal that we would have the symposium in September. I commend Deputy James Browne on legislation that essentially takes us further towards removing the stigma regarding mental health and recognising the legitimacy of people having mental health problems and not dealing with them in the sort of cruel and inhumane way that was the case once upon a time. Today, notwithstanding that the reasons are often slightly different, the wrong approaches to dealing with mental health issues are still taken. I do not doubt the bona fides of people who spoke. I think all of us have been touched by this. I certainly have been touched, losing some very close friends to suicide. I believe all of us have an interest in resolving this issue.

I want to input something. I am a big fan of Sigmund Freud, having been a student of psychology in university, although not of everything he said. He was a revolutionary in that he was the first to move away from the schools of psychology that imagined that, if there was a mental illness, there was something fundamentally wrong with that person. There were schools of thought at the time that Freud was developing his theories that believed that nails should be hammered into certain parts of the heads of people with mental health issues. That was how barbaric it was. That went along with the schools of incarceration and dehumanisation and simply locking people away or categorising them as beyond the pale of mental normality. We have moved a long way from that, but there were a couple of absolutely critical things about Freud's revolutionary understanding of mental health without which we will not grasp how to deal with this issue.

He understood the absolutely critical importance of children and babies being nurtured and of their early relations. He understood that the essential character of the human mind was a conflict between two things. Those are the basic needs of a human being - what he called the instinctual drives or the id - and the superego, which were the conventions of society, the rules, the norms and the pressures. In the middle was the ego, that is, you or me, in between those two things. How that balance was reconciled between the basic needs of human beings and the pressures of society would determine the mental health or otherwise of a human being. He identified the basic instinctual drives that had to be met but were often frustrated by the pressures of society, including the need to eat, to drink, to have a roof over one's head, to reproduce and have sexual relations - basic things - and to interact with other human beings. This was absolutely essential to what we were. There was also the creative impulse, which was absolutely central to Freud's understanding of human psychology and health. He pointed out that when these drives were frustrated, and pressure was denied or negated, it caused problems.

It is not difficult to see how all of this applies today. I do not think it is just about a fleeting technological change, because mental health issues far predate any of these technological things, although there is no doubt that they can exacerbate them. They can produce higher levels of alienation and pressures. These pressures come from everywhere, such as the pressure to put a roof over one's head but not being able to, the pressure to pass exams, the pressure to get a job that pays well, the denial of basic human relations and the alienation of human sexuality. All of these things have intensified and can do tremendous damage to our mental health, and in particular to young people in their development. Critically, Freud was the first to understand that the starting point of good mental health was first to ensure that those basic needs were satisfied and, in so far as people had mental health issues, he was the first to understand the talking cure. That is basic interaction between human beings, not pills or drugs - I am not saying they do not have some role - not nails in the head, not incarceration but to talk, one human being to another or a few human beings together, in order that there is real human engagement, a thing our society often denies us or puts pressure on us to deny, to become alienated from one another.

Where this comes down to real practicality is when one considers what is the biggest problem with the mental health services or indeed what is the problem with many of the services that would help to enhance health. There are not enough people to talk to other people. That is the big gap. In child and adolescent mental health services, CAMHS, we do not have enough human beings. That is why we do not have the beds open. We do not have enough human beings in the classrooms with our children, so their relationships are alienated. There are not enough teachers or special needs assistants. We need human beings. We even want to remove human beings from train stations, where the guy at the window talks to a person in the morning, and replace them with machines. We have to remember that if economic efficiency and all that are important as some people might say and if that begins to replace human beings or not make human beings available to do those jobs, we will be on a road to nowhere and we will not be able to solve these problems. That follows right through to the 24-hour services, dual diagnosis - recognising the difference between somebody who has certain types of mental health problems and others - having people in schools to talk to our young people or not having children in adult wards. All that requires human beings to provide for all these specific needs, interactions, human relations and engagement, that can allow us to really get through to people, talk to them and deal with the issues that they are facing.

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