Séamus Healy (Tipperary, Workers and Unemployed Action Group) | Oireachtas source

I commend Deputy Browne on bringing forward this important motion. I confirm my support for it and for the amendments tabled by Sinn Féin. It is important to state we have come a long way. Both of my parents were psychiatric nurses who started in the service in the early 1930s at St. Luke's Hospital, Clonmel, which was then known as a lunatic asylum. At its height, that institution had more than 1,200 patients. It was a very different place in those days than it is today. My dad joined the service as a warder. There were no nurses in those days. He qualified as a nurse afterwards, as did my mother. Restraint was then the treatment method employed at the time. Indeed, my father often said that he regretted the restraint methods they had to use in those early days.

That generation, however, was also the one that started challenging the whole idea of stigma surrounding mental health. That was the generation that removed the huge walls around psychiatric hospitals. They took down the gates, welcomed in the community and invited it into the hospital. I remember well that there was a local pitch and putt club on the grounds of St. Luke's' Hospital. Members of the public were invited in and patients in turn began to go out into the community. They went on day trips to the cinema and to the circus. Eventually, some patients came to live independent lives in houses in the community.

That was the beginning of community-based services. Staff in mental health services, both past and present, have been exceptional, but current staff are under immense pressure due to underfunding and a lack of personnel. As a result, it is difficult to recruit and retain staff.

It is important to refer to the various volunteers whose work in this area is considerable and valuable. Our area has organisations such as Community Suicide Awareness Workers, C-SAW, the River Suir suicide patrol and Taxi Watch, and there are many others around the country. We should recognise the essential work that they do. They should be supported.

I acknowledge the involvement of the Minister of State, Deputy Jim Daly, his engagement with local issues on the ground, and, in particular, his approval of the Jigsaw project for Tipperary. I spoke to those involved in the project recently. We will shortly meet them to discuss the programme's implementation on the ground.

It is a case of a lot done but an awful lot more to do. The report of the Mental Health Commission as well as the reports on individual acute units are very disturbing, in particular against the background of increasing mental health issues in the community generally, especially among young people where self-harm and suicide are increasing at an alarming rate. The reports are also disturbing in light of the fact that there is a plan for a seamless mental health service. That plan, A Vision for Change, has been there since 2006. Unfortunately, that document is still not implemented 13 years later. It was a far-seeing policy and might have been before its time. It addressed all of the various areas, for example, early intervention, 24-7 services, community care, talk therapies, day care, crisis services, emergency services and acute beds. It is a pity that A Vision for Change has not been implemented. That policy is the key to putting in place good quality health services for the community.

The Minister of State is well aware of it, but I must refer to a particularly difficult situation in Clonmel in Tipperary where services were devastated in 2012 following the closure of the St. Michael's acute unit. When it closed, south Tipperary patients were sent to Kilkenny and north Tipperary patients were sent to Ennis, but those units were overcrowded and not fit for purpose. The Kilkenny unit has been prosecuted and convicted in recent times following a Mental Health Commission report. It is also difficult for south Tipperary patients to be admitted to that unit. Even when they are, they are discharged early. Due to the need to travel, family support is almost non-existent, despite the fact that it is key to helping patients improve and recover. At the time, we were promised a Rolls-Royce community service, but that did not happen either. We now have community teams that are significantly understaffed. For instance, 19 nursing posts and a number of other healthcare professional posts are vacant. We were promised a new crisis house. Seven years later, we appear to be no nearer to it. As other Members have stated, there are particular difficulties in respect of patients with mental health issues attending emergency departments of our general hospitals. Young people are being admitted to adult wards. At one point not so long ago in Tipperary, one third of our paediatric beds were taken up by young people with mental health issues.

These are some of the issues affecting Tipperary. They need to be addressed urgently. The bigger national picture needs to be addressed as well. A Vision for Change should be the foundation for that.

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