Maureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

Progress has been made on mental health issues. I refer to correspondence from Mental Health Reform in which it acknowledges that the Minister of State will send a draft update of the mental health legislation to it in July.

It outlines the work it has been doing on guidelines relating to ethnic minorities and improvements in building a culture of transparency. I feel, having been here for ten years now, that we are saying the same things and going around in circles when it comes to mental health.

The outstanding issue is A Vision for Change and its full implementation. It was so lauded when it was introduced but we are still waiting on implementation. There has been very slow progress on implementing every aspect. There was an independent review mechanism that worked for two terms. We are looking at all this but it has now gone. Where is the independent review?

It is the survivor groups from the institutions who have the phrase, "Nothing about us without us." That could also be applied to those with mental health issues so they can be part of whatever services are being provided.

Yesterday I attended a seminar addressing substance use and misuse in the north-east inner city. The HSE was outlining the improvements planned for health services, covering factors such as a new case management tool and a new inclusion hub where a range of services will be provided. It was using terms such as "outcomes-based accountability" and "ensuring the service is making a difference". This represents a positive way forward but the theory must be applied to individual cases and to the reality. It is as if we know what to do but that doing it is problematic.

An area of need I wish to refer to is dual diagnosis. This is a very real issue for those with both an addiction and mental health issue. When a person presents with an addiction to an addiction service, the service is not provided once it is realised there is a mental health issue. Likewise, when a person presents with a mental health issue to a mental health service and it is realised that an addiction is involved, that is the end of the service. The mental health issue could range from psychosis or bipolar disorder to depression or an anxiety disorder. The difficulty is that mental health and addiction services are not treating people holistically because they are treating the condition instead of the person. I acknowledge there is work and research taking place in DCU, but in the meantime, people with both a mental health issue and an addiction are just not receiving the service they need. The reality is that two thirds of those who have died by suicide had both an addiction and mental health issues.

The last point I wish to make is about child and adult mental health services. The staffing level is 57% of that recommended in A Vision for Change. I once mentioned talking to some teaching friends about their experience of the child and adult mental health services. One said the experience is positive once the child is assessed and is in the service. Another asked what a child has to do to be guaranteed access to the service in a swift manner. That teacher said the service is more reactive than preventive. Of course, the communication leaves schools at a distance because the referral is made by a general practitioner, yet the child is probably attending school and the school is left out of it. As others have said, it is about joining the dots on this.

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