Holly Cairns (Cork South West, Social Democrats) | Oireachtas source

Speaking at the Joint Committee on Health, Ms Fiona Coyle, CEO of Mental Health Reform, outlined the stark reality of mental services in Ireland. She stated:

Our mental health system was and is not capable of coping with a surge. Our system was struggling and close to breaking point long before the pandemic hit.

[...]

Covid-19 [now] underlines the need to reconfigure mental health services. We ... [need to finally] put service users at the centre of design and delivery.

The World Health Organization recommends that each state spends 12% of its health budget on mental healthcare. In Ireland, however, it is less than 7%. Not only has the pandemic caused a whole range of mental health issues, it has revealed the inadequacies of our system. To be clear, I know that is a system inherited by the Minister of State and not one she created. In response, though, we need to not only put in place the necessary staffing and infrastructure over the long term, but we also need a temporary investment to deal with the current surge in mental health concerns.

The psychological impact of Covid-19 is intersectional. People with pre-existing mental health difficulties, healthcare workers, women, young people, people in precarious work or those who are experiencing homelessness are all more likely to have negative effects.

The Irish Youth Foundation’s report, Generation Pandemic: Futures Are on the Line, highlights that the pandemic will have a profound long-term impact on the mental health of the young people in disadvantaged communities. It also points out the knock-on effect that mental health takes on all other aspects of life, including education and employment.

Almost 9,000 children are currently waiting to get access to psychological services in the HSE and more than 2,700 young people are waiting to get access to child and adolescent mental health services, CAMHS, of whom 98% have been waiting for more than a year. The impacts of these delays are significant for young people and their families and they require immediate intervention.

Women, especially those in low-paid jobs, have been disproportionately affected. They have had increased home and childcare responsibilities throughout the pandemic, incidents of domestic violence have risen significantly and the distress of ongoing restrictions in maternity hospitals has taken its toll. Specific and targeted interventions are needed for the groups most affected. We need considerably more funding that goes into front-line services to offer targeted and preventative measures.

I really want to raise with the Minister of State the mental health of people with disabilities, which has been under-discussed during the pandemic and in general. The cessation of many services last year, and ongoing restrictions, have significant negative effects on people with disabilities. Research carried out by Inclusion Ireland last summer shows increases in loneliness and anxiety for people with intellectual disabilities, as well as an erosion of independence and developmental progress. In particular, young people with disabilities need structured and dedicated interventions, and studies to assess and respond to their mental health needs as a result of the pandemic.

People with intellectual disabilities often feel invisible and poorly treated by mental health services. A Vision for Change, which was launched in 2006, set out targets for mental health services. Almost 15 years later, however, services for people with intellectual disabilities remain at 33% for adults and 12% for children.

I am highlighting disability because the reality is that disabled people and their families are too often neglected by the State. Ireland was the last country in all of Europe to ratify the UN Convention on the Rights of Persons with Disabilities. Appallingly, we have yet to ratify the optional protocol, which would enable people to hold the State to account for its failure to realise these rights.

I sit on the Joint Committee on Disability Matters and the reports we have received from Departments have been beyond appalling. They were so disappointing and unsatisfactory that I barely have the words. They lacked basic sufficient detail to understand the issues on different scales and to provide accountability. One Department actually considered a single page response to the committee to be sufficient. This is indicative of the way the State views its obligations to people with disabilities. This requires a fundamental change in the way people with disabilities are treated, not only in terms of mental healthcare services but in all services across all Departments.

Our mental health services need sustained strategic development. We need to bring spending up to the levels required and to tackle the surge in issues raised by the pandemic. Simultaneously, the Government needs to address many of the underlying causes of mental distress.

Mr. Martin Rogan CEO Mental Health Ireland highlighted that the pandemic has revealed:

... underlying tensions and ... fragility that ... [many Irish people] live with ... strained social bonds, overstretched families ... insecure housing ... long commutes, inadequate childcare provision, drug and alcohol misuse and financial uncertainty.

To tackle the mental health crisis, we require proper State interventions that provide fully funded mental healthcare as well as sufficient housing, funded childcare and workers' rights. Only then can families and communities be assured the Government is taking mental health seriously.

Finally, I would appreciate if the Minister of State could give an update on the disgracefully low number of inpatient beds for people with eating disorders. There are currently only three HSE beds for such patients.

See this speech in context