Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

I congratulate Deputy Ward on bringing forward the Bill. I acknowledge his vision and understanding of an area of well-being that, as this Bill suggests, has been left behind in terms of policy decisions and access to care and treatment.

In talking about parity of esteem, it may be worth talking about what represents a lack of parity of esteem. We see this with young people ending up in emergency departments or general hospitals when what they need is tailored mental health supports. In 2019, the Mental Health Commission spoke of how children in need of mental health supports are ending up in general hospitals. The commission said the reason for this was due to an immediate risk to the young person or due to the lack of a bed in a specialist child and adolescent mental health services unit. The report went on to say that children and young people in crisis are left with the unacceptable choice between an emergency department, general hospital, children's hospital or adult inpatient unit. This is one example of how a lack of investment in mental health services results in children having to present at overcrowded emergency departments or general hospitals which are not equipped to deal with their needs.

In 2012, St Michael's inpatient psychiatric unit in Clonmel was closed. The services were transferred to St Luke's General Hospital in Kilkenny, leaving County Tipperary without any inpatient beds. This means that many people in south Tipperary have to travel far from their homes, while those in north Tipperary have to go all the way to Ennis. As well as the distance issue, St Luke's in Kilkenny has a record of overcrowding. That decision denied us a key service. It was a cruel blow to County Tipperary.

Before his departure from office, the former Minister of State, Mr. Jim Daly, admitted that the wrong decision was made to remove the beds from Clonmel. We have been unable to get a similar sentiment out of the current Minister of State. This year I found out that €2 million is being spent on upgrading beds at the same unit, but not for mental health. It seems as though the money is available but only if it is not for the purposes of mental health services. Since St Michael's unit was closed, all we have seen are delays with Jigsaw as well as a delay and a total lack of clarity in the development of a new crisis house in Clonmel. The list of problems goes on for Tipperary. At the same time, while a room has been put aside at South Tipperary General Hospital for people presenting with mental health issues, they still have to go through the emergency department process. All of this shows how mental health services always take the back seat in overall healthcare.

A similar lack of priority has been shown with regard to dual diagnosis for people with mental health and addiction issues. It is widely held that if both issues are not treated together, then it is difficult to get the desired outcome. The HSE has spent €124,586 over a 14-month period and this resulted in the draft model of care.

It went nowhere and the only resource available from that study is a link to the website drugs.ie. This shows how, as Deputy Ward put it, mental health is the Cinderella of health services. Organisations such as CARMHA in Nenagh are doing great work in this regard, and I again appeal to the Minister of State to hear what such organisations have to say and see what they do. I appeal to everyone here to support this Bill.

I will finish with a question put to me by a 19-year-old girl from Carrick-on-Suir, and a community work student, who wrote to me about a rising mental health crisis in the south east and the difficulties young people encounter when seeking help. She said:

Deputy in our constitution it states that every child should be treated equally. Yet here we are in 2020 with a multiple-tier health system in relation to mental health. I say multiple because it's not as black and white as it may seem. As a young person struggling, you are asked various questions, depending on your social status and your address. There could be many or no services available in your area. Now please explain to me how we are treating all children equally?

We have a tsunami of mental health issues coming after the Covid-19 pandemic and that must be tackled urgently. I encourage every Deputy to consider this question and to support this Bill.

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