Cathal Berry (Kildare South, Independent) | Oireachtas source

I move:

“That Dáil Éireann:

recognises that: — positive mental health is fundamental to overall health and well-being;

— mental health is central in building a healthy, inclusive and productive society;

— people’s experience of well-being may vary, with some experiencing vulnerability at some stages in their life;

— the Government’s response to the Covid-19 pandemic should ensure that measures protect not only the population’s physical health, but its mental health also, as an equally important component of health and well-being;

— many people may be facing increased levels of alcohol and drug use, insomnia and anxiety during this pandemic;

— reporting of domestic abuse has increased during the pandemic;

— bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones;

— people with pre-existing mental, neurological or substance use disorders are also more vulnerable to Covid-19 infection;

— Covid-19 itself can lead to neurological and mental complications, such as delirium,agitation and stroke;

— the long-term socio-economic impact of the crisis is likely to exacerbate the financial inequalities that contribute to the increased prevalence and disproportionate distribution of mental health difficulties;

— Covid-19 has had a negative impact on access to mental health services and underscores the urgent need for increased funding;

— underfunding of mental health services prior to the pandemic emphasises that the health budget for mental health is struggling to meet the population’s needs; and

— the pandemic is increasing demand for mental health services; and calls on the Government to: — publish all data in relation to mental health and the effects of the Covid-19 pandemic;

— prioritise and build human resource capacity to deliver mental health and social care;

— ensure redeployment of mental health staff during the pandemic only occurs in extreme circumstances;

— ensure that mental health is a central part of the response to the pandemic;

— apply a whole-of-society approach to promote, protect and care for mental health, as mental health actions need to be considered essential components of the national response to Covid-19;

— include mental health and psychosocial considerations in national response plans across relevant sectors;

— respond proactively to reducing pandemic-related adversities that are known to harm mental health, for example, domestic violence and acute impoverishment;

— ensure mental health and psychosocial support are available in any emergency;

— support community actions that strengthen social cohesion and reduce loneliness, for example, supporting activities that help isolated older adults to stay connected;

— safeguard uninterrupted in-person care for severe mental health conditions;

— ensure that mental health services have the capacity to cope with the additional strain experienced due to Covid-19, which they will continue to be under into the future;

— develop strategies for more vulnerable groups in society as outlined by the World Health Organization and United Nations’ surveys;

— utilise digital platforms to provide psychosocial support and early detection and management of mental health conditions;

— invest in mental health interventions that can be delivered remotely, for example quality-assured tele-counselling for frontline health care workers and people at home with depression and anxiety;

— strengthen communication strategies to support a national campaign to highlight the mental health supports that are available;

— design all communications to be sensitive of their potential impact on people’s mental health, for example, by communicating empathy for people’s distress and including advice for their emotional well-being;

— provide access to information about positive coping methods;

— prioritise psychosocial support, including for grief and loss;

— ensure the Department of Health conducts a comparative study as to which countries perform well in the area of mental health and assess how Ireland compares;

— build support structures for mental health programme strategy across all Government Departments;

— re-establish a dedicated lead for mental health within the Health Service Executive that reports directly to the Chief Executive Officer;

— support recovery from Covid-19 by building mental health services for the future,recognising that all affected communities will need quality mental health services to support society’s recovery;

— develop and fund the implementation of national services, re-organisation strategies that shift care away from institutions to community services;

— ensure mental health is part of universal health coverage by including care for mental,neurological and substance use disorders; and

— involve people with lived experience in the design, implementation and monitoring of mental health services.”

I welcome the Minister of State at the Department of Health, Deputy Mary Butler.

I am very happy to move this motion, which is my first Dáil motion. I am doing so on my own behalf and on behalf of my very good colleagues in the Regional Independent Group.

As we have all lived through 2020, we can probably all appreciate that there is no more deserving, no more fitting and no more worthy topic of discussion than that of mental health resourcing in the State. Mental health is a vast area that requires absolute focus and absolute commitment to solve the issues we have.

From the get-go, I thank Deputy Denis Naughten and our group parliamentary assistant, Cáit Nic Amhlaoibh, who did a huge amount of research into this topic, and who also drafted the wording of the motion. I also commend the Opposition and the Government who have provided a lot of support for the motion over the past week. It is very heartening and encouraging to see that this is the case, and why would it not be the case, because mental health issues affect every party in the House, and indeed every house in the State?

I will raise three points with the Minister of State. I will first focus on the situation in hospital emergency departments from a mental health perspective. There is huge under-resourcing of infrastructure in emergency departments. We need a dedicated pathway or channel, similar to the paediatric channel. When a paediatric patient shows up at an emergency department, he or she is routed through a particular pathway. We need the same model for patients who present in psychiatric distress or with a psychiatric illness, with a separate waiting room. The current practice whereby acute psychotic patients are interacting with general medical patients is completely unacceptable and we really need to improve that set-up.

From a crisis team perspective it is not good enough to just have one clinical nurse specialist on a crisis team. We need to resource this properly so the teams can deal with multiple presentations simultaneously, and so they are not completely stressed out themselves.

I am very happy with the commitment in the programme for Government to appoint a national director for mental health, with a direct line to the director general of the HSE, currently Mr. Paul Reid. This is very important. Perhaps in her reply, the Minister of State could clarify where we are with that process and indicate if there is a likely date for the appointment of a national director.

My second focus is on mental health resourcing in the community, and especially from the point of view of the NGO sector. It is an issue nationwide. I will use as an example an excellent NGO agency in my constituency in Newbridge called HOPE(D), which has approximately 1,000 service users on its books. HOPE(D) gets no funding whatsoever from central government or through the HSE. The service relies on the charity of Kildare County Council to provide 20% of its funding and the other 80% is made up through fundraising or donations. I am sure we can all appreciate that relying on a GoFundMe page is not a sound basis on which to provide a very important service to the community. In such a case the agency is always distracted from providing that service because staff are focused on trying to keep the lights on and the doors open.

The third issue I wish to focus on is an area in which the Minister of State has a particular interest. It is assistance and the mental health of the elderly population. From my own medical practice, I am aware there has been a shift over the past 12 months in the demographics of people who present with mental illness. The shift is towards the elderly population and people who have had no history of mental illness in the past but who are now presenting. This is as a result of cocooning, isolation, bereavement and just loneliness. Again, I am very happy to see a commitment in the programme for Government that there will be a commission for care of the older person. Will the Minister of State, in her response, indicate the status of that process? When are we likely to see that commission in place? This would be hugely appreciated.

In summary, I believe that everyone in the Chamber can appreciate how precious and fragile our mental health is. It is incumbent on us all to ensure there is adequate resourcing nationwide, from a HSE perspective and from an NGO perspective, for the betterment of the public.

See this speech in context