Catherine Connolly (Galway West, Independent) | Oireachtas source

Yes, with five minutes each. I have checked back on speeches and I am looking at one I could read out again to the Minister of State. It is my own, from April 2017, over two and a half years ago. We do not need to reinvent the wheel and give personal anecdotes of all of our experience with mental illness and mental health services. I come from Galway where, unfortunately, there is a group of people who feel that they have to conduct suicide patrols of our waterways. I come from a city where a brand-new psychiatric department has at least four delayed discharges, that is, patients who are ready to be discharged but there is no money. I understand that there is a broken door. I have brought all of these matters to the attention of the Minister of State and want to move on to general matters. It is a symptom of what is happening in our mental health services, yet at the same time we seem to be returning €12 million. The Minister of State might tell me that I am totally wrong about that. I have a background in this area, so forgive me if I am a little impatient.

In 1984, we had the Planning for the Future report, which was a recognition that we needed to do something about our mental health services and we did. Such was the slow pace of change, however, that we brought in the A Vision for Change strategy in 2006. Everybody, including the Mental Health Commission, has said that it is a brilliant document that comprehensively set out exactly what was needed. It addressed every area, including the importance of carers of families and getting rid of the stigma associated with mental health and the high rates of suicide in 2006. Not only was the document excellent but those who were behind it stated that as they did not trust the Government of the day or any Government, an implementation body would be needed and an independent implementation body was set up. It did its job so well in two three-year periods that it was abolished. After it was abolished, we have played linguistic games with regard to A Vision for Change. It is appalling to use the word "refresh". The review should be about the appalling failure to implement A Vision for Change. Some progress was made and the Mental Health Commission acknowledges that but there has been an utter failure to implement it in total.

After 2016, when the allotted years ran out, we decided to set up an evidence-based, desktop review of the literature. That was done speedily when it sat and it reported in July 2017. The implementation of A Vision for Change was due for January 2016 but it took until July 2017 to get an evidence review that looked at literature. That literature told us that prioritisation of mental health is a major societal issue. Can the Minister of State imagine that we needed a review to tell us about primary prevention, positive mental health, social inclusion and recovery, mental health services and their importance, as well as governing and financing? If that was not insulting enough, we now need another refresh of A Vision for Change, when all we needed was for the independent monitoring mechanism to be set up again to implement A Vision for Change.

At the time, A Vision for Change talked about money and there is no parity of esteem. We cannot have health without mental health, yet we have absolutely no parity of esteem. I know the Minister of State agrees with this on a personal level but he is not here today on a personal level. He is here as a Minister of State. He has to tell us why A Vision for Change was not implemented. Will he put back in the independent monitoring system that was there? It worked very well. The proof in the pudding is that the Government abolished it because no Government, not just that of the Minister of State, wants to hear the truth. When the A Vision for Change strategy came in, it talked about a certain percentage of GDP going to mental health. It made that comment in the context of the mental health spending that had declined considerably in the 20-year period leading up to A Vision for Change.

There is no parity of esteem between mental health and general health, even though both are inextricably linked. There is no independent monitoring and money is returned when we have delayed discharges, among many other things. Most importantly, because this might get through to the Government, the economic costs are set out in the review. The economic costs of mental health issues are enormous, with figures suggesting that it may amount to as much as 4% of GDP in some countries. In Ireland, the most modest estimate of the GDP lost is 2%. This does not include the health costs. I will stop because my five minutes are up. I appeal to the Minister of State to answer as to whether the Government is putting back the independent monitoring system.

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