Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

For too long, mental health difficulties were seen as a personal failure and something to hide or be ashamed of. I think we are all familiar with those days, which I hope are becoming more distant. While that damaging misconception is changing, which is a welcome development, underlying stigma persists, particularly self-stigma. Last December, St. Patrick's annual attitudes survey found that 22% of respondents would "consider it a sign of weakness" to seek mental health supports for themselves, compared with just 9% if it was a friend, family member or colleague from work. This shows that internalised stigma is still one of the biggest barriers to seeking help.

While there is no doubt that we all need to challenge how we think and feel about our own mental health, this does not absolve the State of its responsibilities. Even when someone does take the positive step to seek help, too often, they find that the services are just not available or not available on any reasonable timescale. This is borne out by the long waiting lists that exist. In May, 491 children were still waiting for over a year for CAMHS. While unacceptable, it is not really that surprising, given that 35% of CAMHS psychiatry posts remain vacant, which is a shocking indictment. In primary care psychology, which is less of a headline grabber, a shocking 9,239 people have languished on the waiting list for over 12 months. More than 8,000 of those are children.

I do not doubt the Minister of State's commitment to improving services but those figures are just inexcusable. Almost 9,000 children have been waiting over a year for mental health services on the Minister of State's watch. We cannot become numb to this or even accept it in any way. These children are being utterly failed by the State. Parents who have sought help for their child are effectively having the door shut in their face. That is why the continued lack of regulation in community CAMHS is extremely concerning. An election is looming, as we all know, and the new Mental Health Bill has only just completed Second Stage. It is hard to see that Bill even reaching Committee Stage in the lifetime of this Dáil. We have waited too long for it. That is why the regulation of community CAMHS should have been prioritised as I and others were calling on the Government to do. It could have been done via an amendment Bill last year. In both the Mental Health Commission's interim and final reports, its primary recommendation was the immediate regulation of CAMHS. It is inexcusable that we are still waiting for that to happen.

Regarding the mental health budget, we are still some way off reaching that 10% figure of the overall health budget. While it is welcome that investment has increased, next year's mental health budget will still only represent 5.8% of the total health budget. That is only a 0.1% increase on this year's funding. If Ireland is to catch up with the rest of Europe and provide services in line with international best practice, then funding must be increased substantially. This year, the specialist group on acute bed capacity identified an immediate shortfall of 832 acute psychiatric inpatient beds but instead of taking urgent action to address this deficit, the HSE has established another group to assess the situation and deliver a strategic capital plan.

In 2018, the Joint Committee on the Future of Mental Health Care recommended increasing the acute psychiatric inpatient capacity to 50 beds per 100,000 of population by 2021, three years ago, but we are still only at 23.8 beds per 100,000 people. That shortfall needs urgent attention. Unfortunately, the reality is that the State is failing people at every level. Talk therapies and other early intervention services are chronically under-resourced and the service generally is overly reliant on medication as a stopgap. This overmedicalised model is not good for people experiencing mental health difficulties. The lack of community services is putting further pressure on acute services as conditions are left to deteriorate to the point where they become an emergency.

Our mental health system needs a radical overhaul to create a proactive and community-based service supported by fit-for-purpose emergency care. This will not be achieved with piecemeal policies and initiatives. We have a plan but it needs to be implemented. Since Sharing the Vision was published in 2020, only 48 of the 100 policy recommendations have progressed, with only three fully completed. This Government is good at saying all the right things on mental health but where is the follow-through? Statements are no substitute for services.

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