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

I thank Deputy McGuinness for his remarks. I agree with what he said about how we approach the subject of mental health and how we speak openly about it. Unfortunately, we have to contend with the fact there is still a stigma attached to it and it is quite prevalent. It is different among different generations or age groups. I am heartened by the response I get from younger age groups, particularly teenagers, when I speak to them about mental health, and I have spoken about that previously in the House. They are much more open about it. The next step is for people who are facing a challenge in terms of their mental health to be able to open up about it. As Deputy McGuinness said, that is what fosters an environment, culturally, where people will feel more comfortable in being able to do that. It is easy enough to talk about mental health, particularly in the third person, but it is still very difficult when it is personalised. That needs to be recognised.

I thank the Government for appointing me to serve on the joint committee. I commend Deputy Browne on the work he has done on this committee and echo his sentiments that the committee should be established as a permanent Oireachtas committee. We have shone a light on this issue in the six months or so that the committee has been in situ. We have turned over many pebbles and uncovered much of what has been going on, brought it into the open and put it in this interim report format.

Deputy Wallace mentioned a number of factors. I do not discount what he said but a more balanced approach is needed, depending on the person's clinical requirements and the type of therapy or mixture of therapies he or she may require. The interim report recommends that a permanent committee be established, which could approach all these issues as it would develop.

Issues highlighted by the committee in its work included management systems, including management information systems particularly around information technology and the way budgets and sub-specialty budgets are reported to those in government who are the budget-holders and give the money over every month. We could not be told about particular sub-specialties. I would refer to a response I got to a parliamentary question on 24 January last, which states:

The HSE's financial reporting systems do not provide for sub-specialty reporting and on that basis we cannot isolate specific spending on children's mental health services. The mental health division is working on a resource allocation/costing model that will allow more detailed reporting on service type when the project is completed.

That is a vague answer from HSE management on that issue. There are no timelines or any indication of when it will happen or where it is in the process. We, as committee members, are trying to get the answer to those questions.

Many of these systems were built ad hocin recent years and are used as financial reporting systems. They will fulfil audits as they come up but regarding front-end budgetary terms, it is very difficult to see where this money is being spent, particularly where there are needs. We, as decision-makers, need to be able to get that type of reporting structure in place. That was very much highlighted by the committee. It was something of which I was not aware beforehand or in such detail.

Another point concerns recruitment. At our last meeting I proposed we would see an end-to-end recruitment process, in a diagrammatic form, in mental health services and how the stakeholders from all sides come into that. There are anomalies and delays in that process that are not helping with the recruitment of staff. I am not discounting that these are challenging times in terms of recruiting staff. We are in competition with other jurisdictions in terms of our very well educated and strong staff here in Ireland. However, to be able to compete we need to streamline our processes, particularly the recruitment process. We need to see that end-to-end process to determine how we can work more efficiently in that respect.

I have been told that the recruitment process can take more than 12 months. Posts are not advertised or flagged in terms of people who are coming towards retirement age and the end of their career. Those are the tangible solutions that can be put in place straight away as opposed to the longer-term solutions in terms of IT in which a vanilla-type or homogenous-type system would be in place which all the services could look up and which would be electronically integrated. Some of the staff still use paper trails. In terms of systems, it is like driving on a 1980s road when a highway or motorway is needed. Again, that can be achieved as that system is implemented, but we need a long-term plan. Such a plan could be integrated into the Sláintecare report on the future of healthcare and there can be synergy and integration in that respect.

At the outset, it was difficult for us as committee members to see how we would approach this task. There are 21 members from across all parties and the tack we took was to get behind the nuts and bolts of the implementation of A Vision for Change. That is the reason we are seeing the anomalies in recruitment and issues concerning IT systems arise again as well as the other issues outlined in the report.

The Government has made some moves on the issue of mental health. Spending has increased: the mental health budget will increase by €55 million next year. Schools are being resourced with a 300 hour emotional well-being module. I welcome the fact the Minister is working on a single dedicated phoneline and a digital and text service he hopes to roll out. The introduction of regulation for counsellors and psychotherapists will begin soon, which is to be welcomed. Jigsaw has opened in Limerick and Cork, which is a free service for people between the ages of 12 and 25. We are seeing a marginal reduction in suicide figures as well, which I welcome. Obviously the figures are still too high and I have the greatest of respect and sympathy for those who are affected by the issue. I am mindful of that while speaking. We want to move towards a 24-7 service based on that line. Some 112 assistant psychologists and 20 psychologists have been recruited at primary care level. We need to target that area. There is a problem at acute level in terms of waiting lists. The referral pathway has to be tackled, and the Minister has looked at tackling the manner of referral for people who have been left on waiting lists for a very long time. We have to improve at primary care level. We also have to improve mental health awareness and well-being. This issue is similar to the old scenario of the vitamin pill versus the painkiller. It is very difficult for people to engage with vitamin pills to stop the pain in the first place, whereas people will take a painkiller because it works straight away.

We need to start focusing on mental health awareness as a society. It should be promoted through the arts, through sport and community initiatives. We can do small things and make subtle changes which will have a huge, lasting effect for people. In my county there was a drive against suicide a couple of weeks back. The initiative is in its second year. It really connected with young men in their 20s, rural people whose pride and joy is their car. They connected with that drive against suicide, which was phenomenal. It created a sense of community and brought people together. It allowed people to address the issue and to meet people from different backgrounds and communities. These people then formed their own sub-communities. There are subliminal, knock-on effects that result from initiatives such as this. People are able to open up and move forward. These are the challenges we face as a result of the change in Irish society that has occurred over the past ten to 20 years.

I look forward to working with all the Deputies on this committee. We are scratching at the surface at the moment: we need to get into the issue in more depth. I look forward to the next report. The committee will address more issues as we go along, but this report contains the main issues that the committee began with. The committee itself has started to find its own feet. It had a shaky start because we did not really know how to approach the issues. I very much hope that this will become a permanent committee to send a message that this area has been neglected down through the years, that it has not been spoken about enough, but that we will give it that profile, shine the light on it and hold people to account in front of an Oireachtas committee.

I am very mindful of the front-line staff who work in this area and thank them for their work. They work in very challenging environments at times, which I have learned from my time in the committee. While I have criticised management information systems and management organisation systems, I do not want to deflect from the fact that those working in the front-line service who actually deliver the service and work on a day to day basis, interacting with the patients, are doing a great job, and I want to pay tribute to them.

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