Ruairi Ó Murchú (Louth, Sinn Fein) | Oireachtas source

I commend Deputy Ward on bringing forward this Bill. I agree with a lot of what has been said about the parity of esteem required in respect of mental health services and dealing with mental illness. I also accept that the issue is not necessarily straightforward. It involves some of the difficulties we deal with every day. There is the question of whether someone has an actual diagnosis. Some people are told they do not have a mental illness but rather a behavioural difficulty. We need clarity. Certain terminology is used quite often. We need the policy to be that there is no wrong door. This means we also need a proper system for dual diagnoses. Given the services and resources we have at the minute, if some of these situations are not clarified and if resources are not brought to bear, all we are doing is putting further pressure on services that are not sufficient to deal with what they are already dealing with.

It is as simple as that. Across the board we have a bad history in this State in respect. We had a history of putting people in institutions and locking them up. We are all aware of the reality of what happened.

At this point, we are not operating best practice with acute beds. I accept not everyone with a mental illness necessarily needs hospitalisation but there are cases where it is required. Excuse me if I am wrong on the exact figure but I am told we operate in and around 20 beds per 100,000 whereas in parts of Europe the figure is between 50 and 70 per 100,000 or higher. This needs to be rectified. I am also told that within Louth and Meath and my local HSE community healthcare organisation the level of bed provision is less again. These things need to be rectified.

We have a situation with regard to mental illness behaviours. These may seem to many people like a mental illness but we are told that, without a diagnosis, what is at issue is no more than behaviour etc. We end up with the Garda dealing with this. Deputy Ward has already spoken this week on the situation. Sometimes our jails are full of people who need acute services but end up in that situation. All this needs to be rectified. We need a holistic approach across the board and we need all stakeholders to be included.

I imagine every constituency office is similar to mine. People appear or we are given issues. The issue may fall somewhere between mental illness, mental health, added disability or other situations and a lack of competence. Sometimes it falls somewhere between mental health services and social care. Really what happens is that the issue falls between the stools. Sometimes we deal with parents who are trying to deal with a child of theirs who is 30 or 40 years of age with many issues. The parents may be in their 70s and may not be fit to cope. We need to look at some element of diagnosis and treatment. We also possibly need to look at assisted living. Where this is not addressed, the pressure goes back on these people. Occasionally, this situation also puts pressure on either the Garda or mental health services. It absolutely fails.

I brought up another fact earlier when I talked to the Minister of State, Deputy Rabbitte, on institutions or congregated settings dealing with disabilities. I believe this happened in the Crosslanes unit in Drogheda recently. I do not believe we have proper screening or testing to ensure staff do not have Covid-19. We had an outbreak and we have difficulty sometimes with this. The public health advice may say people are not close contacts because they are operating certain procedures with masks etc. The fact is that many of our health settings were already under pressure without screening. They will come apart at the seams. I appeal to the Minister of State, Deputy Butler, to look at this situation. I understand that in September or October that was what happened in Crosslanes in Drogheda. I urge the Minister of State to come back to me on that. We need to look at the public health protocols as well as testing and screening at these facilities.

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