Mary Butler (Waterford, Fianna Fail)

I welcome our counterparts from the Swedish parliamentary friendship group to the Public Gallery of the Chamber. I had the pleasure of meeting Mr. Lars Mejern Larsson and the other members of the group during my St. Patrick's Day visit to Denmark and Sweden earlier this year and it is fantastic to have them and the Swedish ambassador to Ireland in the Gallery for this important debate. I also welcome mental health organisations and, in particular, representatives from Shine.

I am grateful for this opportunity to discuss the important topic of mental health today on the eve of World Mental Health Day. It was an absolute honour and privilege to be reappointed as Minister of State with responsibility for mental health by the Taoiseach in January of this year and to be the first person to represent the mental health portfolio at the Cabinet table. It is a real milestone for mental health in Ireland to have a seat at Cabinet and we are the envy of many in Europe for having such an influence in government.

Mental health is a subject I am very passionate about and not just because I have held the role of Minister of State for the past five years, delivering six budgets in a row. My interest and energy come from lived experience in my own family and community. For everyone in this Chamber, and everyone watching from the Gallery and online, mental health issues touch us all. As I say every day, there is no health without mental health.

Reflecting its importance to us all, a lot is happening in mental health right now. The second implementation plan for our national mental health policy, Sharing the Vision, was launched in April 2025, providing a policy delivery roadmap for the next three years, including the expansion of crisis supports and community alternatives, the first phase of which I announced yesterday. Work on the successor to our national suicide reduction strategy, Connecting for Life, is continuing at pace following a successful public consultation earlier this year and I hope to launch the new strategy early in the new year. Earlier this week, I secured an unprecedented level of new staffing growth in the budget, of 300 whole-time equivalents. In the coming weeks, the Mental Health Bill will complete its journey through the Houses of the Oireachtas. These important developments speak to the work of thousands of people across the country to make mental health services in Ireland modern, person-centred, recovery-focused and accessible. It is my hope that we will continue to work together, across all parties in the House, to reduce the stigma associated with mental health difficulties, to promote the message that recovery is possible and to deliver legislative reform so that quality services are accessible in the right place at the right time.

Over the past decade, Ireland has made significant strides in mental health literacy. More people understand what mental health means. More are willing to talk about it and more are seeking help. The stigma that once silenced so many is slowly being dismantled. However, we must be honest that there is still more to do. Stigma persists, especially when it comes to more enduring mental health difficulties and illnesses. We must continue to challenge it through education, empathy and leadership, and by example.

One of the most powerful tools we have is conversation. Talking openly about mental health and suicide can save lives. Silence is dangerous and we must encourage people to ask for help, to check in on one another and to know that it is okay not to be okay. Suicide prevention begins with connection. Every one of us has a role to play as friends, family members, colleagues and neighbours. Initiatives such as Shine's green ribbon campaign encourage a culture where people are not judged or labelled because of their mental health difficulties, but rather we are encouraged to understand, to be inclusive and to better respond to people's diverse needs.

Part of the benefit of our collective stigma reduction efforts is that more of our people are coming forward seeking mental health information, help and treatment across our full range of services. I recently announced €2 million in funding for new counselling supports for men. The funding is targeted at assisting with stigma reduction and to actively encourage men who otherwise would not usually avail of counselling to seek help with their mental health, to assist men in accessing mental health services and to provide much-needed support for men experiencing a mental health crisis. The supports went live on 1 September this year. They are available via GPs and are being actively promoted through a national campaign targeting men. The initiative will provide over 15,000 free counselling sessions to men through accessible supports over the phone and in-person, and I will be receiving regular updates on the uptake of the sessions. I am happy to report that men are already reaching out and some appointments have already taken place. These sessions are a lifeline and I urge anyone who needs support to reach out.

For our young people, learning about mental health and navigating services at the same time can be overwhelming. That is why we launched SpunOut's Navigator tool, a digital resource that helps young people aged 14 to 34 find the right support, tailored to their needs. It integrates curated content, guided and self-guided experiences. Whether for counselling, peer support or crisis help, Navigator is a trusted guide in a complex world.

I am delighted to say that since going live in June over 17,500 sessions have taken place, of which nearly 16,000 are new users. It is great to see such take-up and I encourage all young people and people who work with young people to try it out. In an era of misinformation and disinformation, it is so important to have appropriate person-centred care for young people. The green ribbon that I proudly wear and Navigator are just two examples of how much richer our mental health system is in Ireland because of the community and voluntary sector. Organisations like SpunOut, Shine, HUGG, Pieta and Jigsaw are the backbone of mental health supports in Ireland. They offer compassion, expertise and localised care that meets people where they are. I want to thank every volunteer, every staff member and every supporter who makes this work possible. Your impact is immeasurable.

Ireland has made significant advancements in recent years to promote recovery-orientated care by centring input from people who have used services, and their family members. We want to place people at the very centre of mental health services and supports. We want to empower them to take the lead on their own recoveries and journeys through a partnership approach. The HSE’s mental health engagement and recovery office was specifically set up to integrate lived experience expertise into the development, delivery and review of our mental health services. If we want our services to really be recovery focused, they must be built on the twin pillars of clinical expertise and lived experience expertise. I have been a vocal advocate and supporter of this approach since taking up the role.

I have embedded these principles in the governance and implementation structures for Sharing the Vision. This ensures that the voice of lived and living experience is reflected at all levels, including in the national implementation and monitoring committee which oversees the delivery of the policy. I am happy to be supporting the HSE mental health engagement and recovery office with its collaboration with the World Health Organization in the recent launch of a toolkit to support integrating lived and living experience practitioners into wider policy, services and community. I also look forward to launching their inaugural lived experience learning event next Wednesday, 15 October. I really believe that other policies throughout Government would benefit from a similar focus on codesign and inclusion of lived experience and I hope this event will kick-start the spread of the good practice we are seeing in mental health.

Today, we mark World Mental Health Day, a day of reflection, solidarity and renewed commitment. This year’s theme, Access to Services - Mental Health in Catastrophes and Emergencies, is both timely and urgent. It reminds us that mental health support must be resilient, equitable and accessible, especially in times of crisis, whether that be a natural disaster, a public health emergency or a personal trauma. This year’s theme is a call to action. Crises fracture communities. They leave emotional scars and they can expose the inequalities embedded in our systems. Mental health care in these moments is not a luxury; it is lifesaving. It gives people the strength to cope, the space to heal and the support to rebuild.

We learned this both during and in the aftermath of the Covid pandemic. Many younger people did not get a chance to develop their social muscles, while many older people did not get a chance to flex them. Afterwards, some in each cohort struggled to adapt to the post-Covid world. Many of them are still struggling. Whether it is a young person avoiding school or social situations, or an older person who has yet to regain the confidence to step outside the door and say, "Hello again, world", we need to acknowledge the impact of crises like these and develop responses to support people in real time and in the aftermath. I am really proud of the work of organisations in Ireland like ALONE and men’s sheds, to name just two. They are doing a lot of work to address these issues.

Feeling helpless in the face of immense global crises, like the devastation in Gaza or the accelerating climate emergency, can also weigh heavily on our mental health. A sense of powerlessness can often bring anxiety, grief and emotional exhaustion, especially when the suffering feels distant yet deeply personal. It is very natural to feel overwhelmed when the scale of injustice or environmental collapse seems beyond our control. In Ireland, however, we carry a long tradition of compassion and collective action. The resolve of the Irish people to raise our voices, whether in solidarity with Gaza or in defence of our planet, is a powerful reminder that even in despair we can choose courage, community and hope.

Mental health does not exist in a vacuum. It is shaped by social determinants such as housing, income, education, employment and social connection. Mental health begins with security - a roof over your head, food on the table and safety in your community. If these basic needs are unmet, mental health suffers. We must address the root causes. We must ensure that mental health is not just treated after the fact, but protected through social policy. We must meet every person’s needs, not just for survival but for dignity and mental health. To do this, we must ensure a mental health lens is applied to all Government policies. From housing to education, from social protection to climate action, every policy decision has an impact on mental well-being.

I was very proud to sign the World Health Organization declaration on mental health in all policies on behalf of Ireland in Paris in June of this year. This is not just a health issue. It is a whole-of-government issue and it demands a co-ordinated and compassionate response. The strength of both our mental health policies, Sharing the Vision and Connecting for Life, is that they have a much wider focus on initiatives that cut across multiple branches of Government. Positive examples of cross-departmental collaboration over the last number of years include the high-level task force, which focuses on the mental health and addiction challenges of those who come into contact with the criminal justice sector. This has involved extensive co-operation between the Departments of justice and Health, with good progress being made on diverting very vulnerable people away from the criminal justice system and towards our healthcare system. I was very pleased to jointly launch the community access support team in Limerick late last year, for example. This key initiative between the HSE and An Garda Síochána will bring more focused interagency care as envisaged under Sharing the Vision. A key priority of the project is to lead with a compassionate mental health response to vulnerable people rather than a policing response, and the emerging results from this pilot are very encouraging.

My Department colleagues also work closely with Department of housing officials to deliver on the commitments as set out in the national housing strategy for people with disabilities and Sharing the Vision. This cross-government co-operation directly improves outcomes for people with disabilities and, since 2017, has resulted in over 3,000 people with a mental health-related disability being assisted to access housing in the local community, which provides an essential foundation to support their recovery. I have also provided the HSE with additional funding to support the recruitment of housing co-ordinators to support people with a mental health difficulty secure and retain independent tenancies. This is what policy should be about: making a real difference.

Significantly, in June last, I oversaw the establishment of an interdepartmental steering group for mental health, with representation from all Departments and chaired by the Department of Health. This new group will work to ensure that mental health is considered as a priority issue in policy development and delivery across government.

Travellers are identified as a priority group within both Sharing the Vision and Connecting for Life and face many challenges in relation to mental health and suicide. I have consistently provided significant funding for Traveller mental health in the annual budgetary process, including almost €1 million across budgets 2025 and 2026 for initiatives codesigned with representative groups of the Traveller community. We will continue to develop and deliver Traveller-led evidence-based policy and service interventions. In addition, I have established a Traveller mental health specialist group under Sharing the Vision structures to take a wider cross-government lens on issues facing the Traveller community that impact their mental health.

 For a decade now, Connecting for Life has provided us with a comprehensive cross-government plan for how we can reduce suicide in Ireland. Reducing deaths by suicide is a complex task, but evidence and experience internationally show that real reductions in suicide rates can be achieved by involving the whole community, the whole of government and all of society working in unison. That is exactly what we have done in Ireland through our policy implementation structures, which go from the cross-sectoral group of key Departments and agencies, right down to individual resource officers for suicide prevention co-ordinating local plans for their own areas.

Permanent improvements to our approach to suicide reduction from Connecting for Life have included development of the model of care to manage self-harm presentations to emergency departments through the national clinical programme for self-harm and suicide-related ideation, enhanced bereavement and crisis support services including culturally appropriate services for Travellers, and media monitoring activities to ensure safer media reporting of suicide.

Work to develop a successor suicide reduction strategy to Connecting for Life is well advanced. The previous strategy has been formally evaluated. The Department of Health ran a public consultation survey earlier this year which received almost 1,900 submissions, with a further 200 people attending in-person consultation sessions. The significant response by the public to this consultation demonstrates the strength of feeling to reducing lives lost to suicide in our country. The voices of those with lived experience will be central to shaping our next national strategy. We know already that suicide rates in Ireland are reducing, which is encouraging. Recent studies show the suicide rate in Ireland decreased by approximately 25% between 2001 and 2021. However, every death is one too many. Every death is so devastating for that person, their loved ones, friends and communities. There is no greater tragedy than someone deciding life is not worth living. As Minister of State, I never lose sight of this. We must be even more ambitious in our next suicide reduction strategy.

In budget 2026, we have made mental health a priority, with a major focus on crisis support and suicide prevention. We are deploying specialist mental health nursing teams into every model 4 emergency department across the country. This will ensure that people in acute distress receive timely and compassionate care. This is an important initiative. Nurses, clinical nurse specialists and advanced nurse practitioners will work out of hours from 6 p.m. to 2 a.m. They will support the non-consultant hospital doctor on call. It will be a step change to have dedicated people working in the emergency department and not on call from another part of the hospital. It should make a significant difference.

There is over €15 million in new funding for crisis support and suicide reduction measures in budget 2026. As I said, this includes specialist nursing teams. It also includes three new crisis resolution services including drop-in Solace crisis cafes as community alternatives to emergency departments in areas with model 3 hospitals. They will be located in Donegal, Kerry and the midlands. It also includes 12 additional suicide crisis assessment nurses to support people in crisis who present to GPs in their communities. They will be distributed on a geographical basis. There is increased funding for suicide prevention community and voluntary organisations, including Pieta; funding to implement a new suicide reduction strategy; and funding to develop a new crisis response pathway for children and young people, with 19 new CAMHS specialist doctors for emergency liaison and out of hours.

Budget 2026 is a continuation of the investment and recruitment which are critical to modern and responsive mental health services. An additional 300 whole-time-equivalent staff will be hired in mental health services in 2026. This represents 9% of the total growth in health service staffing next year. The total allocation for mental health services for 2026 will be almost €1.6 billion. This investment supports the implementation of our national mental health policies across a broad continuum, from mental health promotion and prevention to early intervention.

In addition to our major focus on crisis supports and suicide reduction, budget 2026 will also include investment in funding to implement the new digital mental health strategy, a new talking therapies fund for providing community therapy services, additional mental health peer support workers, additional core staffing for adult mental health teams, a new dual diagnosis team, funding to reopen the Keltoi treatment centre, and new consultants for perinatal mental health. It will also include two new liaison teams for mental health services for older people, a new early intervention in psychosis team, a new adult eating disorder team, an additional specialist CAMHS eating disorder team which will bring the number to 16, two new mental health with intellectual disability teams for children, five new mental health discovery colleges for young people and funding to open ten new intensive care rehabilitation unit beds at the National Forensic Mental Health Service. I also secured funding for 17 whole-time equivalents to reopen the beds closed in Cherry Orchard and funding for 30 new staff for the new children's hospital that will open next year.

Having announced what we intend to do next year, I will take a moment to reflect on progress made in mental health over the past five years. All I have said will not work unless we get the 300 whole-time equivalents recruited and in place as quickly as possible. One of the main focuses next year has to be to make sure we can start recruitment immediately. I have already spoken to several regional executive officers across the six regions about getting the staffing done.

Social prescribing services are now available in every county, with over 5,500 people accessing the service each year. An evaluation is now under way to assess how the service is performing and the outcomes for people who use it. New and expanded crisis resolution services are providing alternative care pathways to emergency departments through both multidisciplinary crisis response teams and drop-in Solace cafes. Initial findings are indicating that they are significantly reducing emergency presentations to acute hospitals by up to 20%.

On youth mental health, while we have made a lot of progress there are some areas where I would like to see more, including CAMHS. In 2023, I launched the new national child and youth mental health office in the HSE to improve leadership, operational oversight and management. The office published its youth mental health action plan in February which sets out a clear roadmap across 16 themes to ensure children and families have equitable and timely access to high-quality mental health care. CAMHS receives approximately €167 million in dedicated funding annually. In addition, approximately €110 million is provided by Government to community and voluntary organisations each year to develop mental health supports and services, with much of this focused on children and young people. A priority for me is to improve access to community CAMHS and to reduce waiting lists. Throughout this year I have been carrying out a series of visits to all HSE regional areas to impress on the teams that I need more from them. I also stressed the importance of filling all approved posts for each CAMHS team to ensure better delivery of services. A key objective for me in reducing community CAMHS waiting lists is to eliminate waits of over 12 months. At the end of August, after visiting 21 teams, there was a decrease of 121 children - almost 17% - waiting more than 12 months compared with the end July. This is progress and reflects the focus on the issue but more needs to be done. While CAMHS is an incredibly important service for some, we must also make sure we continue to invest in upstream early intervention youth mental health services. When I visited the 21 teams, I noticed the turnaround in the Limerick area is unbelievable. It now carries only 3% of the waiting list whereas the Cork and Kerry region carries 24%. In Donegal, three CAMHS teams work together and see a lot of children. They support one other so that siloed nature is gone. Cavan-Monaghan has nobody on a waiting list. There are three regions that are significantly challenged in relation to waiting lists, however. The most important thing we can do is keep supporting the teams and focusing on those waiting. I secured funding to open two new early intervention youth mental health Jigsaw services in Waterford and Clare. This brings our national coverage for early intervention youth mental health services from 67% to 74%.

The Mental Health Bill will continue its progress through the Seanad. Second Stage concluded a couple of weeks ago. I look forward to debating many amendments to the Bill in the weeks and months to come.

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