Martin Daly (Roscommon-Galway, Fianna Fail) | Oireachtas source

I am grateful for the opportunity to speak as a TD and GP about an issue of deep concern to my constituents in Roscommon–Galway and, indeed, people across the country, namely the status of our mental health services.

While I fully acknowledge the very significant personal commitment of the Minister of State, Deputy Butler, and that of the Government in prioritising mental health care, delivering the Sharing the Vision and Connecting for Life strategies, introducing the new Mental Health Bill, and having provided additional funding of almost 40% since 2020, bringing the figure to €1.5 billion, it is clear that significant challenges remain. We must be honest about the gaps in the system and take decisive action to address them.

Mental health professionals, GPs and families on the front lines are raising serious concerns. Mental health services now receive a smaller proportion of the health budget, at just 6%, than they did over three decades ago.

That is significantly lower than the UK spend of 9%. This long-term decline in proportional funding has made it increasingly difficult to provide timely and accessible care, even as demand continues to rise. Even then, the Government must ensure that current funding is effectively targeted.

We do not have enough community or inpatient capacity. In the Roscommon acute unit, there are 24 acute beds. Eight of those are taken by people ready for discharge for the want of appropriate accommodation in the community. Some are in those beds for years rather than months. In my constituency of Roscommon-Galway, care has become increasingly inaccessible. GP psychiatry referrals, both adult and child and adolescent, are returned without actual assessment or a recommended pathway. In no other part of the health service is an experienced GP's referral for a second opinion bounced back without assessment. Acute and chronic services are overstretched, and patients in crisis are struggling to get the care they need.

We cannot ignore the impact of modern lifestyle factors on mental health. Social media are contributing to rising levels of anxiety, depression and low self-esteem, particularly among younger people. Children and adults who have had mental health issues associated with neurosensory disorders or ADHD have until now had no adequate pathways for assessment and treatment. I welcome the Minister of State's statement on the establishment of that service.

Increasing prevalence of substance abuse is leading to increased anxiety, depressive disorders and psychosis. Our services must be resourced not only to treat those in crisis but also to provide early intervention and prevention strategies.

Eating disorder hubs have been either not rolled out or inadequately rolled out, denying young people, especially young women, timely intervention for a disease that has such a high morbidity and mortality, causing untold misery to sufferers and their families. I welcome the Minister of State's statement of the expansion to 14 units. I hope that they are fully operational and that the additional two units will be established forthwith.

Capacity is the issue. There are not enough inpatient beds, meaning that people in severe distress often cannot be admitted. We have approximately 24 beds per 100,000 people. The European average is 75 per 100,000. We have moved away from institutional inpatient care to the community, but there is always a need for inpatient treatment for people. The stark reality remains that one needs to be exceptionally ill to get into hospital. Staffing shortages across psychiatric services continue to place immense strain on the system. In the community, we do not have enough fully resourced multidisciplinary teams to provide early intervention. Without adequate staffing, prevention becomes impossible and more people end up in crisis.

I know this Government is committed to improving mental healthcare. The expansion of the national clinical programmes for specialist mental health services is a welcome development, and I acknowledge the significant efforts to roll out self-harm and suicide-related services across all emergency departments. However, we must ensure that these services are properly staffed and extended into the community, where they are equally needed. When we moved from the institutional care model for mental health services, we promised people reinvestment into community psychiatric services. It was never going to be less expensive, just a more appropriate, humane delivery of care in people's own communities. The investment has not happened as intended. We see a third of patients in inpatient beds for more than 12 months and high rates of readmission. That reflects a failing community sector. We must have capacity in the community sector, whether it is supported living or robust community support for people in their own homes.

I know that the Minister of State and this Government share my commitment to improving mental health services. We have taken important steps but we must continue to listen to the concerns of patients, families and mental health professionals. By working together, we can deliver-----

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