James Browne (Wexford, Fianna Fail) | Oireachtas source

I thank the committee members who worked so hard on the first and second interim reports. It is very clear that party politics was very much left aside. Considerable work is ongoing. I thank, in particular, Senator Freeman, who chaired the committee and brought it as far as it has come. No doubt she will bring the proceedings to a very successful conclusion. With regard to what the committee can do and its fixed purpose, the key to a really successful conclusion would be the implementation of what is contained in the report.

We heard very substantial contributions today from the Deputies, including committee members and non-members. It shows the level of interest in and support for the objective of addressing mental health issues. Even in the term of this Dáil, over the past two years, the quality of the debate has increased from a level of tea and sympathy to one involving a detailed understanding of mental illness. There is a very fine debate now on the issue of mental health in this Chamber, the committee rooms and Seanad.

We heard some very detailed and fine contributions, including from Deputies Wallace, McGuinness and Neville. I never met the former Deputy, Mr. Dan Neville, but his name rings out throughout this building. He made a real contribution. It is fair to say we would not have come as far as we have, or even close to it, without the real groundwork done by Dan in his time. Deputy Tom Neville is following his noble footsteps. We heard a very strong and personal contribution from Deputy Penrose and the Minister of State, Deputy Catherine Byrne. When leaders in society open up about their experiences in this area – Deputy Buckley has done so in the past — they help to destigmatise and normalise mental difficulties.

When I speak to families experiencing issues connected to mental illness, I note that blame and fear almost envelop them. They experience considerable stress in deciding how to deal with that very difficult situation.

Deputy Calleary talked about increasing awareness of mental illness and the supports that exist. This absolutely needs to be done. Intervention is required at the earliest level. From talking to primary school teachers, we hear mental health issues are experienced by children as young as four, five and six. We need to intervene at the earliest stage to make the children aware of what is happening and to give them the coping skills with it. Young people today are being exposed to things at such a young age that it is having a dramatic effect on their mental well-being.

Deputy Gino Kenny talked about the profound crisis with regard to mental health. He also made the important point that there is some fine work being done in the mental health sector. We have fantastic staff in the sector and we must be careful not to terrify people such that they do not seek support to deal with mental illness. Help and support are available, but not enough.

Deputy Harty talked about GPs and the very difficult circumstances they are in. First, there are fewer of them, which in itself is becoming a serious issue. GPs, because they do not have clear pathways and cannot gain access to the supports they need, and in certain circumstances may not even have the training they need, very often have to fall back on medication for sending people to accident and emergency units. The point on medication feeds into what Deputy Wallace was talking about. We probably have an overly medicalised service. Medication certainly has its place but we do need to examine other approaches. Deputy Wallace referred to open dialogue that was very successful when tried in the NHS. We must consider a more holistic, community-based and patient-centred service.

Deputy Buckley talked about front-line staff and referred to the frustration they must be experiencing. We have seen evidence of the stress they are under because they do not have the necessary supports to help.

Very clearly, the dual-diagnosis issue is not resolved. Deputy Buckley has been very strong on this for a long time. He is absolutely correct that the dual-diagnosis misalignment in this country needs to be addressed. Yesterday, we were talking about gambling addiction, which involves an area of dual diagnosis that is probably not addressed. Gambling is dealt with through addiction services. Many mental health issues arise because of gambling.

Deputy Eugene Murphy made very strong points on mental health generally and on issues in Roscommon. He has been constantly raising the scandalous circumstances that arose in Roscommon.

The key will be implementation. I urge the House strongly to support the committee's request that a permanent committee be set up. A number of issues were highlighted that the committee is not dealing with. The committee is limited in both scope and time. A permanent committee will be required. As Deputy Neville stated, we are overturning the pebbles but we need to go deeper and go at it for longer. We are certainly highlighting very many issues. As Deputy Harty, Chairman of the Joint Committee on Health, pointed out, his committee simply would not have had the time to go into the detail. It is worth going into detail.

I thank the members of the Joint Committee on the Future of Mental Health Care. I thank its Chairman, Senator Freeman. I thank the secretariat, including Ms Gina Long and her team, who have been a great support to the committee. I thank everybody who has contributed today. As Deputy Buckley mentioned, the key is keeping mental health on the agenda. That is what we will all keep doing together.

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