Mick Wallace (Wexford, Independent) | Oireachtas source

I welcome the introduction this Deputy James Browne's Private Members' Bill. An increase in the provision of mental health care in this country is urgent to say the least. We should be very careful about how this parity between physical and mental health proceeds and we should be especially careful about how we frame the discussion. It is important to be conscious of the fact that the term “mental illness” is a highly loaded and ideological one that takes away agency and certain types of possible treatment from a person. When one says someone is ill, one presumes to understand what a healthy person would look like. This is well and good for physical problems like diseases, and degenerative diseases, but if one applies this to the mind, then we are in very different territory. No one in the history of humankind has ever seen a mind, or been able to study one in anything resembling what we call the scientific method, and anyone who pretends to know what a healthy one looks like is not telling the truth.

I do not have time to go into how over time the brain has become the realm of science and consciousness has been left to the philosophers but a number of major problems result from that ideology. One of them is drugs. Pharmaceutical drugs that are used to treat so-called mental illnesses are physical things and that means that they can only have a physical effect. If the mind of a distressed person is a purely physical thing and our mental distress is purely the result of a malfunctioning of a person’s material brain, then there is a possibility that these may work. That is, presuming that the manufacturers of these drugs understand the human brain and how all the different parts of it relate to all the different diagnosed illnesses. However, any neuroscientist who is honest would tell you that we do not have a clue how the brain works. Any one of us here knows from our life experience that the circumstances in our lives and in the lives of those who are routinely diagnosed with so-called mental illnesses are a major factor in people presenting with distress and mental health issues. These life experiences and how we react to them are not physical things. The drugs are only designed to alter how people perceive their lives, not change them. The problems that lead to someone having a breakdown are not solved by taking the drugs: the problems remain. The issues that are at the root of the breakdown are not dealt with by taking the drugs, the issues remain. People can bury immense trauma deep in their consciousness in order to survive and it can be triggered years, even decades, later in the form of what a psychologist would diagnose as a severe mental illness. The drugs will not help these people build the tools to cope in a world where that world has violated them in an unimaginable way - the grief will remain.

A second problem is related to the first in a profound way. Talking therapies are rarely used by the HSE. One reason for this is that psychologists are running the show and they do not see any scientific value in talking to people they diagnose as mentally ill, the problem being scientifically, a materially, brain located one. Another is that there is no regulation of psychotherapy, a problem the Minister has said he is working on, but people should not hold their breath. The lack of regulation leads to an issue of insurance for the HSE, and only those educated in the art of denying the existence of human consciousness, with their PhDs from the highest institutes in the land, are a bankable proposition in this regard.

A third problem is that it is costly and time consuming to talk to people, and if one listened to what they are saying it would undermine the dominant medicalised model of mental health care, which is so cosy with the pharmaceutical industry. If one presents to a general practitioner, GP, he or she has the power to prescribe very powerful drugs. Usually this prescription is based on a few questions about one's behaviour - is one anxious, has one trouble sleeping, has one negative thoughts and so on. The GP will not ask, nor is he or she qualified to ask, what has been going on in a person's life and how he or she might deal with that. What is more, a GP will commonly not tell a person about the side effects of these powerful drugs. The number of people committing suicide because of the reckless prescription of these drugs is a scary reality in Ireland and nothing is being done about it.

At a meeting in New Ross just over a year ago, at which Independents 4 Change was presenting a submission on how to improve mental health provision, the executive clinical director for mental health services in community healthcare organisation area 5, CHO5, responding to a query as to why there were not more talking therapies provided by the HSE, told one of my staff that the mentally ill were not to be trusted, so there was no point, scientifically, in talking to them.

If we are to increase funding to the mental health services in Ireland, powerful people in the HSE who hold such positions should not be part of the process. We need to wake up to the reality that many people who are in charge in the HSE mental health services would not last long if we stopped talking about mental illness and started to talk to people about what is going on in their lives.

I have spoken in this Chamber on a number of occasions in the past while about five children who have presented with suicidal ideation in Wexford in the past year and a half. These are children, as young as seven years old and ten years old, and up to 14 years old, who want to kill themselves. Every one of these children has had to wait for over two years to access child psychiatry services. As I stated the last time I spoke here about suicide prevention services, I appreciate that not everyone presents with suicidal ideation and that it is, of course, not always possible to identify signs that someone might be suicidal, but from speaking to those trying to avail of mental health services in Wexford there seems to be an incredible lack of an emergency response to those who present with suicidal ideation. It is unforgivable. We have to take these threats seriously. We already know of very young children in Ireland who have committed suicide.

I was contacted this week by yet another mother, the mother of an eight year old boy who also presented with suicidal ideation. It is not easy reading about her son. For parents who are experiencing this for the first time, the lack of services and the length of time they will have to wait for these services comes as a shock. Having had experience of dealing with other parents in the same situation previously, I know what the waiting times are like. I dread breaking the news to the parents who are dealing with this for the first time. This poor mother has only just realised that the waiting time for her son who has presented with suicidal ideation is two and a half years. What must it be like? What is even more infuriating is that in Wexford we have someone who many people believe to be one of the best child psychiatrists in the country, Dr. Kieran Moore, but children cannot get access to him because the waiting lists are so long. I have never met or spoken to Dr. Moore but I have spoken to a number of parents who speak incredibly highly of him, not just as a psychiatrist but as a human being who cares deeply about his patients and, I have been told, goes above and beyond for these children and parents.

I recently received a letter from a woman in Wexford who said the recent suicides of two of her friends had spurred her to write to me. Suicide is an epidemic in Wexford. It is a remarkable letter. I would not mind showing it to the Minister, if I got the woman's permission. It is handwritten, and she lists 20 different individual significant problems with mental health services in Wexford. I have raised a number of these issues over time in here, but not all of them. The letter is a remarkably comprehensive and insightful list. In isolation, each problem she lists causes massive problems for people in Wexford but by listing all 20 problems together in her letter, she shows the overwhelming extent of the lack of mental health services in Wexford. As well as the list, she makes a perceptive observation, one that explains to some extent why parents in Wexford have not revolted. She states that many parents cannot advocate publicly because they are worn out just getting through each day keeping the children safe.

We have an awful lot to answer for in this place. What is going on is too bad and I am sorry but it is not changing. It is getting worse in Wexford, not better, and all the talk in the world will not sort it. Our approach is wrong, there is not enough funding and one cannot blame the parents for feeling that the organisations and apparatuses that run this country just do not care enough because that is how they feel.

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