Thursday, 29 April 2021
Covid-19, Mental Health and Older People: Statements
I join others in congratulating the Minister, Deputy McEntee.
I am seeking an update, albeit not on the funding that is to be allocated for the treatment of eating disorders. That has already been announced and is funding that was not spent previously. Rather, I am seeking an update on the number of beds for inpatient care. There are only three currently. Has there been any work on addressing this situation?
The challenge of Covid-19 has reminded us that personal health and well-being are no longer solo pursuits, but ones that require cohesion, collective effort and mutual respect across all life stages. In his submission to the health committee last October, Mr. Martin Rogan, CEO of Mental Health Ireland, highlighted that mental health issues affected people of all ages. I welcome this session focused on the mental well-being of older adults, who are often overlooked in these conversations. The elderly have been identified as a group especially impacted by the pandemic. Although necessary, cocooning and the closure of social outlets have increased isolation. A volunteer on ALONE's support line reported to RTÉ that "A lot of the issues that people would ring with, would stem from loneliness." The difficulty of bereavement at this time has taken its toll and the clusters of Covid in nursing homes was a major source of distress.
While the vaccine roll-out and safe reopening of society will make a significant difference, we cannot let the lessons of Covid slip away. First, we need to fund mental health. The World Health Organization recommends that countries dedicate 12% of health spending to mental health care. In Ireland, the figure is less than 7%. Not only must the Minister of State, Deputy Butler, ensure adequate resources are allocated, but she must also secure special interventions to treat the pandemic's legacies. For example, reduced activities for older adults living with dementia has caused distress and exacerbated behavioural and psychological symptoms, and nursing home residents have experienced relapses in their mental health due to restrictions on visitors and therapies. While these measures were necessary to save lives, we must act quickly to alleviate any regression.
Now that increasing numbers of older people and healthcare professionals are vaccinated, we need safe ways for them to interact as soon as possible. A multidisciplinary approach needs to be at the centre of this response. Increases in depression and anxiety are strongly related to declines in activity - this is a crucial factor in the well-being of older adults - as well as sleep quality and cognitive functioning. Geriatric psychiatrists, psychiatric nurses and psychologists can drive medical treatments, but we also need occupational therapists, physiotherapists and other therapists to help provide holistic care. I know from community hospitals in west Cork that music and art therapists have a positive effect. We need to ensure that these professionals are facilitated in getting into hospitals and nursing homes as soon as possible.
Second, who cares for the carers? The difficulties faced by our older cohort are also experienced by their carers and families. Carers are consistently undervalued by Governments. The amount of supports and payments offered to them compared to the work they do and care they give is disgraceful. They receive plaudits from Ministers, but they need much more. Family Carers Ireland's budget submission, entitled "Life After Lockdown", outlines the measures they need, such as an increase in the carer's support grant and increased home care hours. We need the Government to implement these proposals. An holistic response to the mental health of older people will recognise the vital role that carers play.
Third, the Mental Health Commission's report on services for older people, released in December, is sombre reading. It states:
Despite the increasing elderly population, we are currently not providing a nation-wide, comprehensive mental health service for older people. We have highly-trained and committed specialist clinicians, yet we have only 66% of the recommended number of specialist teams, which themselves are only staffed at an overall level of 54%.
The report's author, Dr. Susan Finnerty, highlighted an "alarming" underprovision of acute mental health beds for the elderly and "serious under-resourcing" of community mental health services for the same population. She also explained that "Older people's mental health is an increasingly important area of public policy that does not get the attention it deserves." This needs to change now. The Government must vigorously address the issues raised in that report.
The World Health Organization has stressed two interconnected elements to help improve the mental health of older people by alleviating feelings of anxiousness, anger, stress, agitation and withdrawal. The first element is practical and emotional support through connections with family and community and the second is the role of healthcare professionals in providing the expert help that individuals need. Over the past year, we have seen families, neighbours, volunteers and whole communities provide this first type of support. Now we need the State to deploy all of its resources to address the second.