Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

As this is my first time addressing Deputy Butler in her capacity as Minister of State responsible for mental health and older people, I congratulate her on her appointment. As Sinn Féin spokesperson on mental health, I look forward to working with her in a spirit of constructive, genuinely solution-focused, tangible opposition.

For too long, mental health has been the Cinderella of the health service. We need parity of esteem between mental health and physical health. In June of this year, the former Minister finally published Sharing the Vision - A Mental Health Policy for Everyone. There are 100 recommendations in the document, 41 of which are classed as short term and to be implemented within 18 months. These short-term recommendations comprise the foundations of the whole policy. They are the building blocks on which it is built. If these foundations are not secure, the policy itself will come tumbling down. It is almost three months since Sharing the Vision was published, yet there are still no costings or timescales for its implementation. As part of the Minister of State's discussions on the upcoming budget allocation for mental health services, she should ensure that the appropriate resources to implement the 41 short-term recommendations are made available if she is to give this policy document a fighting chance.

The first recommendation is for an independent national implementation and monitoring committee to oversee the process. With regard to the previous document, A Vision for Change, the Minister of State's predecessors chose the recommendations to examine without taking into account the overall vision of the document. This is not a game of Jenga whereby one can pick and pull the policies that look the most appealing but in which, ultimately, everything just collapses.

It is a shame that the Taoiseach did not believe mental health warranted a place at the Cabinet table. If he had, it would have given the Minister of State direct access to those who make the policies on housing, education, social protection and other matters right across the spectrum. The policy decisions made at that level have a direct impact on people's mental health.

As with the Minister of State, I have had several meetings right across the country with relevant stakeholders. One of their key asks - I am trying to help the Minister of State out on this - is the reappointment of the HSE director of mental health services, who would report directly to the Minister for Health.

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The decision of the HSE to remove the post of national director sent out a clear message that mental health is not a priority for the executive.

There are huge concerns in respect of all areas of mental health service provision, but most notably in that of child mental health. More than 8,100 children and teenagers were awaiting psychology appointments at the end of June in 2020. This figure represents an increase on last year's and shows that systematic underinvestment in and mismanagement of mental health services are coming home to roost. What worries me most is that 3,359 of these children were waiting over a year. This is unacceptable. Early intervention is key to a child's development and any delay in treatment can have an untold detrimental impact on children's future well-being. Sometimes we get lost in figures. We hear figures all the time in the context of Covid-19 and get lost in them, but behind each of those figures that make up the number of 3,359 waiting for appointments is a child with an individual story and an individual need. It is a vulnerable child who deserves a service.

I challenge Deputy Butler, during her tenure as Minister of State with responsibility for mental health, to get rid of the draconian practice which leads to some of our vulnerable children with acute mental health needs being admitted into adult psychiatric hospitals. It is frightening for any child to be admitted to a hospital for mental health reasons but this is exacerbated for those children who are placed in adult units. In 2019, 54 children were admitted to adult units. Child or adolescent mental health care should not be dealt with through a service that is not specifically equipped to deal with their needs.

As the Minister of State will be aware, two weeks ago I received a petition from Stacey Quinn who collected 45,000 signatures calling for 24-7 access to emergency mental health services. I commend Stacey on her activism and passion and the Minister of State on acknowledging the petition to me yesterday. What Stacey and the 45,000 signatories are calling for is not rocket science. All they are seeking is something simple, that is, 24-7 access to emergency mental health care. If I bang my head on the outside, I will be treated by a medical professional. If I have an issue going on inside my head, however, I will not receive the same level of care. Mental health issues do not occur just between the hours of 9 a.m. and 5 p.m. and they do not take the weekend off. As the Minister of State mentioned, mental health issues have not taken a break during the pandemic. In fact, we have heard from numerous stakeholders that mental health problems have been exacerbated because of Covid-19.

We can have no half measures when it comes to mental health. The onset of the Covid-19 pandemic has only increased pressures on an already under-resourced mental health service. We heard from the Covid-19 committee that there will be a huge demand for mental health supports post pandemic and that this demand has already been seen during the pandemic, right across the spectrum. Our community-based mental health services that were already bursting at the seams prior to Covid are now seeing unprecedented demand for their services. Despite modest Government investment in mental health services in recent years, we have seen little improvement in waiting lists. The figure of €1 billion allocated for mental health in 2019 was much lauded by the Minister of State's predecessor and thrown out by him at every opportunity. However, I remind the Minister of State there was also budget of €1 billion back in 2009 and there has been no substantial increase in funding in over ten years despite a much higher level of demand.

Tomorrow is World Suicide Prevention Day. Last year, 421 people lost their lives through suicide. That is 421 too many. I wish to send my condolences and solidarity to everyone who has lost a loved one through suicide.

Increasing the priority and spending on mental health services is not a cost, it is an investment and one the Minister of State cannot afford not to make.

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