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

I move:

“That Dáil Éireann: acknowledges that:

— a mental health crisis demands an emergency response;

— the World Health Organization recommends that a minimum of 14 per cent of a country’s overall health budget be allocated for mental health;

— SláinteCare recommends a minimum mental health budget of 10 per cent;

— the Government’s mental health spend in 2020 was reduced to 5.2 per cent of the overall health budget; and

— the €10 million in additional funding committed to in the Government’s Covid-19 Resilience and Recovery 2021 – The Path Ahead plan falls far short of what is needed to provide the emergency care adults and children desperately need;

further acknowledges that:

— 2,551 children and young people are waiting for Child and Adolescent Mental Health Services (CAMHS) and 8,893 children are waiting for primary care psychology treatment;

— 1,553 adults are waiting on primary care psychology treatment with the Health Service Executive;

— there remains no State-wide provision of 24/7 crisis mental health care at a community level;

— waiting lists for mental health care within the public system were at crisis levels before the Covid-19 pandemic and are now at emergency levels; and

— the Mental Health Commission told the Oireachtas Special Committee on Covid-19 Response that Ireland’s mental health system is not fit for purpose and is out of date and that investment in it and the community is needed;

recognises that:

— community and voluntary front-line services are experiencing an unprecedented demand for mental health care;

— increased numbers of adults, children and young people are presenting to services for the first time;

— clinical and public mental health specialists have advised that Ireland is facing into a tsunami of mental health need; and

— the private sector has the capacity to provide emergency talk therapy and acute care;

commends:

— the commitment of public health staff, and the community and voluntary sector in maintaining mental health services throughout the Covid-19 pandemic; and

— the commitment of non-traditional mental health community organisations who are providing mental health supports to meet the emerging needs in our communities; and

calls on the Government to:

— establish an emergency talk therapy fund, to provide an additional 128,000 sessions with an accredited counsellor or therapist in the private system for those in need of immediate support on referral from a general practitioner (GP);

— remove the GP visit card and medical card accessibility barriers to deliver universal access to the Counselling in Primary Care service;

— recruit 138 additional child/adolescent psychologists and 138 additional adult psychologists, to provide additional capacity in every primary care facility;

— assist community organisations to continue to provide mental health supports;

— create two one-off funding streams to support trainee Counselling Psychologists during the Covid-19 pandemic;

— establish a 24/7 care public crisis de-escalation, multi-agency triage team ambulance service in every Community Healthcare Organisation area; and

— maximise surge capacity within all private hospitals with acute mental health beds in accordance with the ‘surge capacity’ agreement currently in place.”

The State is in the grip of a mental health crisis. The crisis demands an emergency response. Over recent months, Sinn Féin Deputies have met representative bodies and front-line community and voluntary mental health services throughout the State. We met those on the front line who provide mental health supports such as family resource centres, addiction centres, youth services and suicide prevention organisations, among others. They are working over capacity and have had to adapt their services to meet the demand. They have done this with little support from the Government. This is not sustainable; they need and deserve support. We also met national mental health organisations that stated that the inability of people to access mental health supports when they need it was at a critical level.

In February, the Taoiseach announced €10 million in funding that will be made available to meet increased demand for mental health supports. Front-line mental health services we have met will see very little of this money, and based on previous announcements, I have no confidence the money will reach the groups that really need it. We have been here before with this Government: big announcements about mental health, with very little substance. We were in a crisis in mental health provision pre-Covid, but the impacts of Covid have put us in a mental health emergency. Mental health services are experiencing unprecedented demand for mental healthcare. Many people using mental health services are doing so for the first time, and too many of them are being left out in the cold as services are just not there to meet the demand. This is a really frightening place to be. This increase is set against excessive pre-pandemic waiting lists for care, and the result is the perfect storm we are now experiencing.

Our already under-resourced mental health services, which were struggling to cope pre-Covid, are now operating over capacity. This is also not sustainable. Speaking at a meeting of the Oireachtas Special Committee on Covid-19 Response, the CEO of the Mental Health Commission told members our mental health system is not fit for purpose and is out of date. Sinn Féin wants to change this. It is unacceptable that in a year of national crisis, the Government chose not to increase investment in mental health in proportion to the overall health budget. We need to tackle the issue of mental health in a real and sustainable way, with a roadmap for capacity-building in the system. Right now, what we need more than anything else is an emergency response to the crisis we are currently in. This is what the motion sets out to do through a series of commonsense and practical proposals that, if implemented now, will make a real difference in the lives of people who are struggling.

Sinn Féin proposes a significant emergency investment in mental health care for a six to 12-month period to allow for the provision of surge capacity by private practitioners who will provide urgent and immediate care. This emergency provision will address the issue of waiting lists and meet immediate demand through the provision of private care, thereby giving the public system the breathing space it needs to increase capacity for the long term.

Alongside this emergency provision, Sinn Féin recommends measures to be put in place which will have a positive long-term impact on mental health services. One of the measures specified in the motion is the provision of an emergency talk therapy fund. Such a fund would allow people access to an accredited counsellor or therapist on referral from a GP. The Irish College of General Practitioners has told us that many of its members would even be able to provide this service in their own practices. It would be a kind of one-stop shop. This is not aspirational. It is doable, achievable and realistic. With the right political will, it could be implemented very quickly.

We also call for an expansion of capacity in child and adolescent mental health services, CAMHS, and primary care mental health services to be meet the demands of the 10,000 children and adults who are waiting on public psychology appointments and the 2,500 children who are waiting for appointments with CAMHS. This will be achieved through the recruitment of additional psychologists to the public sector. The Psychological Society of Ireland, which has more than 3,500 members, has publicly endorsed this plan. It has said there is capacity within its ranks to provide these services. There would be no more long waiting lists and people would have the ability to access services when needed.

Sinn Féin would also remove the GP visit and medical card accessibility barriers to deliver universal access to counselling. We have been calling for this for a long time and have fully costed it in our alternative budget. As I said to the Minister of State before, one of the major gaps in the service relates to those who have a mental health emergency outside the hours of 9 a.m. to 5 p.m. At present, there is no State-wide provision of 24-7 crisis services at the community level. People must have access to mental health treatment as and when they need it. We aim to establish a 24-7 mental health crisis de-escalation team. Our proposal reflects a similar pilot scheme under way in the North. As we know, mental health issues do not occur only between 9 a.m. and 5 p.m., nor do they take a break at the weekend. This ambulance would include a mental health nurse who would call to the person who is having a mental health issue in the community. This nurse would then triage and treat the person before referring and bringing that person to an appropriate service. This would be a start in delivering 24-7 care.

From the outset of the latest lockdown, I have called on the Minister for Health to extend surge capacity in private hospitals to include acute care for mental health. The latest response I have was received last Friday and states that the HSE is currently in a tendering process with private mental health operators. We are more than a year into this pandemic and we are still in negotiations. This is not good enough and needs to change now. Mental health can no longer be the Cinderella of the health services.

One group of people who urgently need emergency treatment comprises those suffering from eating disorders. There are only three beds in the public sector for adults seeking treatment for eating disorders. This is not good enough. More beds could be provided as part of this surge capacity. Parents have told me that they are watching their adult children die before their eyes. I have spent all week on the phone talking to parents. In their words, community care is non-existent. We have heard the Government rhetoric that we are all in this together. Today is the Minister of State's chance to prove this. I ask that the Minister of State and all Deputies, regardless of party, get behind this motion and give it support so that people can get the care they need when and where they need it.

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