Michael Harty (Clare, Independent) | Oireachtas source

I wish to raise the state of the psychiatric services in west Clare but these problems are reflected nationally throughout the psychiatric services. In west Clare, we have not had a psychologist in the community psychiatric service for the past six years and this is putting huge pressure on other aspects of the health services. We only have a half-time equivalent social worker and for the past six weeks, we have not had a consultant psychiatrist. Recruitment of experienced psychiatric nurses is an issue but because of the deficiencies in the membership of the community psychiatric team, clinics regularly have to be cancelled. Emergency cover is often only provided from other sectors.

Junior staff are prevented from practicing fully in an unsupervised role. As the staff left behind are just burning out, we have a huge deficiency in the membership of our community psychiatric teams. This situation is not unique to Clare. In the Oireachtas Joint Committee on the Future of Mental Health Care recently, we heard from Dr. Kieran Moore from County Wexford. He and two of his colleagues are resigning from the psychiatric services in the Wexford area because they find that what they are being asked to do is unsafe and unfair to their patients. Rather than continue to work in an unsafe and unfair manner, they have decided to resign. This a poor reflection on our psychiatric services and we do know that recruitment and retention is a huge issue right across the health service but particularly in the psychiatric services.

Again, at the Oireachtas Joint Committee on the Future of Mental Health Care two weeks ago, we discovered there are 25 different hoops that must be gone through before a member of staff can be recruited. That is before looking for a member of the medical profession to actually take up a post. There must be huge deficiencies in how we are managing recruitment and retention issues. The most common requirement for people in the front-line staff, particularly general practitioners, GPs, is access to counselling and to psychologists. Not every patient with a mental health issue has a biochemical abnormality, yet because talk therapies and counselling are not available and because psychological services to deliver non-medical therapies such as cognitive behaviour therapy, occupational therapy and all the other therapies that go to help people who have mental health issues are not available, there is an overreliance on medication.

We heard, again at the Oireachtas Joint Committee on the Future of Mental Health Care, that €400 million is spent on medication in the mental health services and only €10 million is spent on talk therapy, psychological therapy and counselling. Medication obviously has an important part to play but the disparity and imbalance between what we are spending on medication and what we are spending on counselling is unacceptable. Talk therapy and access to psychology and counselling is extremely important yet many of our community psychiatric teams are lacking in those disciplines.

We need to have one-to-one therapy with patients. The issue is that there must be continuity of care, there must be one-to-one therapy with people and they must know that they have a person they can contact when they have a problem. What is happening at present is that our services are disjointed, there is no continuity of care and there is no consistency in providing staff. Some areas have excellent recruitment and retention and others have not. I ask the Minister of State how consistency can be brought across the board.

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