Tom Neville (Limerick County, Fine Gael) | Oireachtas source

In 2019, €55 million was allocated to mental health services, bringing spending on those services to in excess of €1 billion. However, a reply to a parliamentary question I tabled on 22 October stated that €33 million had been drawn down, with €10 million to be sanctioned and €12 million not to be spent in 2019. I am seeking clarification as to why that €12 million will not be spent in 2019, given the report by the Joint Committee on the Future of Mental Health Care, the scale of deficiencies in the system, which we highlighted at the time, and the requirement for funding. It seems we are repeating now something that happened a number of years ago. Given what was highlighted through that report, I am looking for accountability and clarification from the HSE as to why this money is being left unspent. Is it a matter of systems or recruitment? If so, what changes have been made to the recruitment process or recruitment flow since the joint committee report was published? What changes have been made to the IT, business and reporting systems since then? There was a recommendation in the report that over three years the IT, business and reporting systems be changed in order that the HSE might highlight or be able to manage this and get out in front of any issues that would arise with funding or the lack of spending of funding. I am seeking clarification as to what the HSE has done on this. Like every other Member, I want that €12 million ring-fenced for mental health services. I want the necessary improvements to be made to allow us to keep spending that because the Government is supplying the money but it is not being spent. Where is the blockage, and what is happening? Are the reporting functions up to scratch to allow the HSE to report back to the Government as to what exactly is going on? My fear is that they are not. When I highlighted this in a meeting of the committee 18 months ago, I was unable to get straight answers on funding and specific subspecialties, hence my point about the reporting systems. A total of 60% of funding was drawn down by October 2019. There are two months left in the year for another 40% that is in swing. I do not understand the mechanisms of accounting for this, but, again, I seek clarification on that as well. Why is the 60% not drawn down in June or July to front-load the funding and give the Department four or five months to draw down the remaining 40%? What is going on behind the scenes?

I have tabled a number of parliamentary questions on the pathfinder programme. On 25 May 2018, I was told that the Departments of Education and Skills and Health were "working with DPER to resolve some technical issues with the above proposals" and that "a timeline to full implementation can not yet be agreed as the participating departments have not received final approval from DPER". On 19 July 2019, I was told that at the end of May the Minister of State had a constructive meeting with the Minister for Public Expenditure and Reform, Deputy Donohoe, and his officials on the proposal. The Minister of State said they were very supportive of the proposal. Subject to resolving the outstanding matters, the Minister of State said, his officials were in regular contact with their counterparts in the Department of Public Expenditure and Reform. He said he hoped to make substantial progress on the matter in the coming months. I would like an up-to-date statement on the position regarding the pathfinder programme, of which I am a major supporter. I know that many groups are also pushing for that integration within the various Departments to bring all these ideas into the education sphere and into the schools and to use them to help the teachers themselves to try to work to bring these ideas forward. I refer in particular to the way technology and communications are moving. Yesterday the Joint Committee on Children and Youth Affairs, of which I am a member, discussed social media, communication, interaction and so on.

During the week I attended the launch of the My World Survey carried out by the UCD School of Psychology. One of the conclusions concerned social media use. The researchers' findings indicated a significant relationship between time spent online - specifically, more than three hours - and higher levels of depression and anxiety and lower levels of body esteem. These findings concern adolescents. The researchers found several explanations for the potential link between time spent on social media and mental health issues among adolescents and young adults. For example, they stated there is some evidence that time spent engaging on social media might displace other more important activities that protective of mental health such as sleep or face-to-face time with friends. Another explanation was that a major motivating factor for using social media in general involves escapism and diversion from everyday life. Indeed, they stated, the current research shows that young people who reported spending more than three hours online showed significantly higher levels of avoidance-based coping than their peers who reported spending less time online.

It is also important to note that the research does not suggest a causal relationship between time spent online and poor mental health. For instance, a young person who is feeling depressed may turn to social media to try to alleviate his or her negative mood or depressed symptoms, to connect virtually with others or to escape from his or her problems. Findings from current research suggest that many adolescents and young adults are using social media to build and extend their social connections in real life and that there may be some benefits to spending time online. Adolescents and young adults who reported spending less than two hours online per day had lower levels of support-focused coping and lower levels of perceived social support from friends than those who spent two to three hours online. Further research is needed to examine the context and content of social media use. The data provides evidence for both the potential risks and protective possibilities of social media engagement. We need to get ahead of this in terms of research on social media because the landscape is fast moving. As a society we need to get on top of this. This report suggest that we need more data and research on both the negative and positive aspects of social media.

I have tabled numerous parliamentary questions on CAMHS and I welcome the decrease in the waiting lists for the service, particularly in CHO 3. In July 2018, there were 294 people on the waiting list but by October 2018 the number had dropped to 245. Recent figures show that the waiting list stood at 124 in August 2019, which is welcome. In an ideal world there would be 124 fewer people on that waiting list. I acknowledge the initiatives being undertaken to provide a 24-7 access line and on referral pathways. I have spoken to the Minister of State at length on this issue and welcome her work in this area. I want early intervention to continue because, as outlined in the My World Survey report launched earlier this week, adolescents reported higher levels of depression while the number reporting severe anxiety has more than doubled. We do not know why that is the case and we need to do much more research on it. It may be related to social media. In adolescence, there is a decrease in the ability to cope well with problems and to talk about them, which is very worrying. Another finding of the survey was that young adults were increasingly self-harming without necessarily wanting to take their own lives. I have not read the report in full but had a quick look at it prior to this debate.

Deputies Mattie McGrath and Connolly mentioned suicide watch groups, of which there are two in Limerick, namely the Limerick Treaty Suicide Watch and Limerick Suicide Watch. I went out with members of the latter group one night for four hours and saw the great work being done. There is a need to develop a closer relationship between such groups and the Department of Health, the HSE, local authorities and gardaí. The knowledge and experience of people in such groups is invaluable. I volunteered with Limerick Suicide Watch and it was a very humbling experience. During the four hours, we came into contact with people who were down, rather than distressed. There was one intervention on the night that I was out but I was not involved in it. As a volunteer walking around, I was nervous. While I was talking to others in the group, I was on edge and had butterflies. I was watching and waiting and felt like I was on the front line. It put me, as a public representative, on the front line and gave me an insight into what emergency service staff, including gardaí and nurses, as well as volunteers have to deal with every day. I commend them on the work they do. It is special, vocation-like work and we need to attract more people into it. This brings me back to the argument around recruitment. We need to identify the bottlenecks and address them. I worked as a recruiter for eight years all around the world. We headhunted people for high-level positions globally and always found them. We proactively went out and found them. We need to get to the bottom of the problems with recruitment.

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