Thursday, 3 June 2021
Mental Health During and Post Covid-19: Statements
Matt Shanahan (Waterford, Independent)
Covid-19 has wreaked havoc on the psychological well-being of many in our society. In many cases it has been indiscriminate to age, gender or financial standing. We have all had to accept the necessity of business restrictions and lockdowns at the early stages of the pandemic but the effects of constant isolation, financial pressures, sickness, and loss has taken a significant toll on many of our population. As we try to navigate our way out of this pandemic the resulting full psychological impacts are only starting to become apparent now.
Pre-Covid Ireland had an acknowledged deficit in many areas of psychological assessment. One of the most topical remains the psychological assessment of children with early learning disabilities. Sadly, that deficit is also extending to adult evaluations. We do not have, nor did we ever have, adequate psychological and counselling supports in the public system to cater for or meet that need. Where the services exist they do not have the capacity to cater for the more serious psychological problems that now exhibit far more frequently.
Parents are trying to access onward learning and disability services and they are waiting months and years for psychological assessments and for approvals to enter learning disability care pathways. The Department of Children, Equality, Disability, Integration and Youth continues to not recognise private psychological evaluations for learning spectrum disorders, which can be provided within weeks. Instead, we force patients to wait to access the public list even though waiting times can extend up to two years. This fundamental deficit must be challenged and changed radically in the State, given the extraordinary moneys we are currently spending in Covid support in other areas.
Psychiatric services are also at breaking point. In my city of Waterford, the Minister of State will be aware that there is no seven day psychiatric access and no on-call service at weekends in University Hospital Waterford, UHW, and the only possible admittance at weekends to the psychiatric department is via the emergency department with a referral. Even with this we have no child psychiatry services or beds available at UHW. This requires child patients to transfer to Cork, which adds to the trauma for many parents and children arriving into their local hospital after some psychological event.
Staff recruitment and retention in the psychiatric services has long been a problem, both in UHW and nationally. It is exacerbated by the increased clinical waiting lists, the extended workloads, the lack of available follow-on beds, and the recurring nature of psychiatric illness. We are also seeing significant amounts of anxiety and depression in our older age cohorts who have been forced to isolate away from family and friends for months on end. Those currently in hospital still suffer restrictions on family visiting times. This is despite the fact that nearly all hospital staff are now vaccinated. Despite the opportunities of identifying possible infection risks by using antigen testing in hospitals to screen visitor infection, the HSE continues to avoid any implementation of antigen testing that could resolve this issue. This remains a dark stain on the reputations of many of those charged with leading our national medical response to Covid.
We are also seeing a dramatic rise in the number of people who are becoming overwhelmed by the financial pressures due to Covid, which is leading to increased anxiety, depression and suicide. There is a significant body of people, most privately or self-employed in the State, who have fallen through the cracks in terms of receiving adequate or any State support to preserve their businesses and occupations, as restrictions have forced them to cease operations. If ever there was an example of disparity between the public and private sector pay divide, it is now most clearly evident in the treatment of the situation that many in the private sector find themselves, when their livelihood and financial reserves have been wiped out. Meanwhile, they look at those of us publicly employed who have suffered no disruption to our income because of Covid. Such inequity does much to harbour rage and anxiety, and it challenges self-esteem, which leads to chronic depression and mental trauma.
The rise in social media activity is also creating esteem and addiction issues. Consider the recent evidence of post-traumatic stress being suffered by social media moderators. The rise in online gambling is destroying family incomes. Image and body shaming narratives are polluting young and vulnerable minds, leading to a lack of self worth, eating disorders, suicidal ideation and sometimes suicidal acts.
If Covid has taught us anything it is the need for people to be with other people. It demonstrates the brittleness of the consumer society we have been building for many years, which has left so many people isolated and alone in its wake. We are not out of Covid yet, but we must begin a new national conversation that seeks to enhance life in all its stages, that seeks to include all differentiation, that seeks to value that which we had forgotten and have only recently rediscovered, namely, the understanding that we are all vulnerable yet invaluable, and that we are all in this together. For our society and people to prosper, all must be included and all must be supported. Community must be at the heart of the future political decisions we take as we try to heal and rebuild from Covid-19.
On the new public strategies and reopening from Covid, we have not mentioned resilience anywhere in the back-to-work schemes in the context of new business improvements. We need to look at this and build a resilience component across all Department policies over the coming months as we try to frame a narrative to leave this pandemic behind us.