Dáil debates

Wednesday, 26 January 2022

Youth Mental Health: Statements

 

6:37 pm

Photo of Cathal BerryCathal Berry (Kildare South, Independent) | Oireachtas source

I thank the Ministers of State for their detailed opening statements. I am very grateful for the opportunity to speak on this important topic. Considering what we have all been through as a people over the past the past two years, I cannot think of a more appropriate topic to discuss tonight because it is a crosscutting issue that affects every party in the House and every home in this country. We all know where the problems are. Rather than listing all of the problems, I will focus on solutions which, if implemented, would have a disproportionately positive effect on the situation regarding mental health, in particular youth mental health.

My first point relates to parity of esteem. There have been improvements over the past few years, but mental health and, in particular, youth mental health, still does not enjoy the same status as physical and general health in our public health system. It was mentioned that €1.15 billion is going into mental health services this year alone, which is a substantial amount of money. However, it is less than 6% of our health budget. The view of the WHO is that 12% of a national health budget should go towards mental health. The Sláintecare report recommended 10%. I am conscious of some of the comments made during this debate. The health budget is substantial. I am not asking for more money for health. Rather, I am asking for a greaterpro rata prioritisation for mental health. That is a reasonable thing to ask for. Again, this is not about income, but rather outcomes.

If there is extra money for mental health services, the first thing we have to do is, as colleagues mentioned, focus on mental health infrastructure in this country. Young people who present in crisis to an emergency department should be treated like a paediatric patient in that there should be a separate channel for assessment and waiting for psychiatric patients. The idea of having someone who is experiencing an acute psychotic episode mingling with general patients for four or five hours on a trolley is asking for trouble. We need a discreet and separate channel to deal with psychiatric patients from an emergency health point of view.

We need properly resourced crisis teams in our hospitals. Other Deputies mentioned the need for liaison psychiatry. When I talk about a crisis team, I am not talking about a single exhausted clinical nurse specialist, but rather a fully staffed multidisciplinary team working 24-7. That is the standard of care that is needed.

My next point concerns the mental health lead for the HSE, on which I agree with the Ministers of State. They asked for, and have, our full support. The Regional Group proposed in a motion last summer, which was accepted, to create a new appointment in the HSE for a dedicated lead. I have an open question. I do not think the Ministers of State need our support. I do not think primary legislation is required, but the Ministers of State can correct me in their reply to this debate. It is entirely within the gift of Paul Reid and the HSE to create this appointment and give those working in mental health a seat at the top table to make sure they get their just desserts. That is what we would do with the additional money.

We also need to focus on community mental health. I am happy to hear the Minister of State, Deputy Feighan, mention social prescribing, which I am a big believer in. We should not over-medicalise everything. There are serious mental health issues and diagnoses, but a sizeable minority of mental health presentations can be dealt with in the community. Social prescribing is about encouraging people to join clubs, art societies and engage in physical fitness, and also de-medicalise and de-stigmatise mental illness. It is all about building up people's resilience and confidence. Very few people mention the key component, namely, self assurance and people being happy in their own skin, which is their real armour against physical and cyber bullying and anything else that is thrown at them. From a community perspective that is important.

I am glad Jigsaw and SpunOut will establish additional teams around the country. The Minister of State, Deputy Butler, mentioned that those services have 66% coverage across the country, which begs a follow-up question. When does she envisage that we will hit 100%? Is there a plan to get from 66% to 100%? Perhaps she could comment on that in her closing statement.

My last point concerns recruitment and retention. We have not time had time to read in detail Dr. Maskey's report on the CAMHS service in south Kerry. He deserves much credit for it, as does his team. There were a multitude of factors at play, which I totally accept, but by far the most dominant was a lack of clinical governance, oversight and supervision. If we do not have clinical consultant psychiatrists on site we will have problems. If we get the people right, the problems will melt away. We cannot have supervision if we have no supervisors.

One takeaway that is deliverable is the establishment of a clinical lead in the HSE from a mental health point of view. People are well capable of speaking for themselves, but I do not detect any resistance to that in the Chamber. Can the Ministers of State indicate in their closing statements when they envisage this person could be in place?

Comments

No comments

Log in or join to post a public comment.