Paul McAuliffe (Dublin North West, Fianna Fail) | Oireachtas source

I acknowledge the motivation of Deputy Ward in bringing forward the Bill earlier in the week. I commend the Minister of State, Deputy Butler, on making this time available to discuss this issue. At the core of both of those things is a recognition that we know the people coming to our clinics need a better service. That is where we have to start. If we get into the game of second-guessing people's motivation, we will not solve anything for those people. When Deputy Cronin said the Government has had 100 years to solve this problem, it is a great line those in Opposition always have at the end of their statements. Let us remember, however, that people with mental health issues 100 years ago were treated in an appalling and abysmal way. To suggest that in 100 years nothing has changed is a glaring example of the hypocrisy of that statement, which I hear over and over again in this House.

That is not to say that mental health services are appropriate. I refer in particular to CAMHS. Equally, I do not judge the motivation of Deputy Ward in bringing forward a Bill to regulate CAMHS. However, the idea that simply regulating CAMHS with one or two amendments to the Mental Health (Amendment) Bill 2023 would somehow solve our recruitment crisis and all the waiting list issues is preposterous. Nobody in the House would say that would happen. The idea that the Government deferring it for a number of months would somehow solve the waiting list crisis is preposterous too. We cannot and should not pretend to people who really need these services. What we are not pretending about is the reform of the Mental Health Act. The work the Minister of State, Deputy Butler, is doing on that is fundamental. It is being done with advocates within mental health. I hope that when the new mental health Bill comes before this House, those in Opposition support the new legislation and the work the Minister of State has done. It will not be long before that decision has to be made.

With regard to CAMHS, I attended this morning's meeting of the Committee of Public Accounts at which we discussed Tusla, where staffing is a real challenge. It is a real challenge in the Garda and in education, mental health services and our health service. All of that results from the benefits of a prosperous economy. We have a prosperous economy, and that provides the resources we can invest in these services. We have made a significant increase in investments. In the last three years, the Minister of State has secured additional resources on an unprecedented level for mental health. That all comes from the economy that supports it. However, it also brings with it the challenge that we do not have enough qualified staff available to be able take up all these positions. We have to find ways to better use the resources we have.

I do not disagree with much of what Deputy Boyd Barrett said. We have a lot of siloed thinking in the system. I often cannot explain to somebody sitting across the table from me why a CDNT will not allow an intervention because it is waiting on an appointment with CAMHS. There need to be much more cross-silo interventions. I hope the new mental health Bill will result in that. In the same way we talk about mental health and addiction, we need to have more of a wraparound service for individuals.

In particular, there is much support in communities that could be available too. The Minister of State visited the Finglas Counselling Service, which is a fantastic service that has been operating in the community for over 30 years. It now has in place a service level agreement, SLA, with the HSE, with more than €100,000 of funding for counselling services. Importantly, it is a counselling service for adults. It has already seen the establishment of the service in a new building, which the council provided. It has the confidence that it has funding now to look after adults, and what has it started to do? It has already started to talk to representatives from the youth centre next door to see whether there is a signposting service they can do. I have no doubt that when it has its governance and it medical model right, its representatives will come back to the HSE and say that perhaps they can help in the space of children too.

Children's mental health services are an entirely different operation from adult mental health services. They bring with them a huge amount of additional responsibility. We will not be able to rely on the community response for child and adult mental health services in the way the HSE relies on community services for adult mental health services. That is because child mental health is so complex for all the reasons pointed out by Deputy Boyd Barrett. Therefore, I do not second-guess anyone's motivation for coming into this House to talk about the issue of mental health among children. Everybody here has the same people attending their clinics and every single one of us wants to make it better.

We also have to think about what is changing in Irish society. There has been a 33% increase in referrals. There is something happening there. Why was there a 33% increase between 2000 and 2021? I spoke about this at the Committee of Public Accounts this morning. Yesterday, I spoke with representatives from St John's Education Centre, which assists people who are struggling in schools or who are early school leavers or school refusals. There is something going on in our schools at the moment. There is something happening as a result of lockdown and many other issues, including the emergence of social media. The 33% increase is in some ways not surprising because of the additional challenges that are there.

We need to keep going with what the Government is doing. I acknowledge that the additional funding in the previous two budgets in particular has been substantial. I reject those within Departments who suggested that the Minister of State, Deputy Butler, was looking for money she could not spend. I can tell them that she will be able to spend the money if she can get it. We have to continue to do that, however. We cannot rest on our laurels. Far more needs to be done. We have not seen the full extent of what will come at us. We need to look at organisations, such as youth services, which are perhaps engaging with young people in a different way and in a different space. It is not a clinical space, but perhaps the space a youth centre provides gives us an opportunity to start a conversation around mental health. I would make a differentiation between mental fitness and mental resilience and mental health and mental illness, because they are very different things. Often, when we talk about the issues in schools and the challenges for young people and so on, it is all at that end of the spectrum around mental fitness and mental resilience. Mental health and mental illness is an entirely different thing. It involves a medical intervention. Like any other service such as those dealing with cancer or stroke, we need to have the interventions in place.

I heard during the week the announcement regarding the improvements to women's mental health we have seen over the last number of years. I hope that over the coming years, TDs in this House are able to stand up and talk about the same improvements in mental health services that come out of the Mental Health Act and from additional funding. We are not there yet, but we are going in the right direction.

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