Sorca Clarke (Longford-Westmeath, Sinn Fein)

Tomorrow is World Mental Health Day. I acknowledge everyone who has experienced mental health difficulties or illnesses, those experiencing them right now, the families and friends who have stood beside them and those who have lost a loved one. Every one of us knows someone who has struggled; many of us have been that someone. When talking about mental health, we cannot only talk about statistics. We must talk about the people - that young person who dropped out of school because their anxiety became too much, the person who hides their depression for fear of being judged or the person in recovery, rebuilding their life brick by brick.

These people could be any one of us.

Sinn Féin believes in a country where if someone has a mental health crisis, he or she will receive appropriate care in a timely manner. However, our mental health services are in disarray because of years of Government neglect and a lack of investment. I was incredibly disappointed this week to see the paragraph in the budget expenditure report that was essentially copied and pasted from last year’s. There are serious concerns about the complete failure to provide a detailed breakdown of mental health spending in this year’s budget and again I see that replicated in the Minister of State’s press release of yesterday. The failure to release full information is unfair and not right and means there are now unclear and undefined funding measures, or any measures, to be funded in 2026. It shows no ambition and a lack of urgency when it comes to mental health. It appears very much to be another box-ticking exercise in the budget, a paragraph to be included, not the crisis that needs to be solved. If the Government is banking on words rather than actions, people see through that. Stakeholders see through press releases and soundbites to this not being the priority for Government that it needs to be. Not just the Minister of State’s Government but successive Governments have failed on mental health and there is now a legacy of missed targets, increased waiting lists for CAMHS and psychology, and a postcode lottery for other areas of care.

The review into CAMHS by Dr. Maskey and the Mental Health Commission should have stopped the Government in its tracks, with children being misdiagnosed, mistreated and lost in a system. As of April, the over 4,500 children waiting on a first time appointment with CAMHS - a significant increase - were being failed. The over 23,000 children waiting on a psychology list at the end of April were also being failed. Some 11,500 of them have been waiting for more than a year. While I welcome the funding put aside to reopen Keltoi - it is our policy, so why would I not? - the Mental Health Bill the Minister of State spoke of did not mention dual diagnosis despite being almost 200 pages long. I see it in the Minister of State’s speech, though, and that is welcome.

There is currently no dedicated mother and baby perinatal mental health unit on the island. That should also be a priority for the Government.

There is little to no new funding that anyone can identify for national clinical programmes such as eating disorders or suicide reduction. Last year, more than 500 people were diagnosed with an eating disorder, which was more than 100 cases more than in 2023. There were 894 referrals for treatment, which is up 33% on the previous year. While I will always welcome any announcement for new eating disorder beds, no one seems to be able to clarify when these beds will be open and ready to serve patients despite the urgent need for them. People living with eating disorders and their families need clear answers and firm deadlines. The urgency cannot be overstated. Under a previous model of care, the additional 20 eating disorder beds identified as needing to be opened between 2018 and 2023 never happened. No funding was allocated. I give credit to Ms Andrea Gilligan and her Newstalk “Lunchtime Live” show and to Sean, Angela, Jane and Paula. They have been contributing to that show for the last number of weeks. They contributed their lived experience. It was incredibly difficult listening, and heartbreaking at times, but it was also incredibly powerful. They spoke of the waiting lists. They spoke of delays after obstacles followed by more delays. They spoke about it taking up to 26 weeks for an initial assessment and the lack of eating disorder specialists or medical professionals trained in eating disorder care. They spoke about being unable to access supports until a formal diagnosis, which was compounded by waiting lists for assessments. They spoke of being forced to travel abroad for medical care that should be available here.

We currently invest about 6% of our health budget in mental health, far below international benchmarks and well behind countries like Finland, where mental health is treated as a priority. In real terms, this translates into longer waiting times, more waiting lists, more staff under pressure and more of the people who desperately need assistance being told “No”. I note from the Minister of State’s speech that she spoke to the REOs and stressed to them the importance of filling CAMHS teams. A key objective is to reduce CAMHS waiting lists to eliminate those waiting for over 12 months. Is the Minister of State really sending the message to parents whose children are in crisis that 12 months is an acceptable length of time for a child to be waiting on a CAMHS appointment? For every press release she puts out, there are people sitting in silence who are struggling and in desperate need of help they are unable to access. Record investment means nothing if it never reaches the front line and it is cold comfort to somebody who is waiting over a year for a psychological appointment or to the person with an eating disorder sitting abroad today. We constantly hear about this record funding, but when are we going to see record change? Until the Government matches words with effective investment, the situation will continue.

I note the Minister of State said that the recovery focus "must be built on the twin pillars of clinical expertise and lived experience". We have an ample amount of lived experience. What we do not have is the expertise. The Minister of State spoke of unfilled posts. We have people who are trained and good at their jobs working in positions but they are not accessible because they are drowning and firefighting due to these waiting lists. Often, they are one of very few in a team that is not fully resourced.

Overall, this Government’s legacy is one of heartbreak and children being denied every opportunity to reach their potential. I agree with the Minister of State when she says mental health is health. I agree with her when she says there needs to be parity of esteem. I do not agree with what she put forward in terms of funding, plans or solutions because they have proven to be ineffective. If somebody breaks a leg today, he or she is treated straight away. If somebody is having a heart attack, the system moves heaven and earth to save that person, and rightly so. However, if somebody is having a mental health crisis and standing on that same knife edge of fear and despair, what happens? More often than not, he or she is told there is no bed, no doctor and no appointment for years. There is no help available in the here and now and that can be the difference between life and death. That is not equality, it is not appropriate care and it is not parity of esteem. A person struggling with depression or a child waiting on CAMHS deserves the same access to care as somebody living with a physical illness. This means that recovery and support are not privileges, but rights. When we talk about building a fair Ireland, we cannot do that unless we give mental health the same standing and support as any other part of our health system.

This World Mental Health Day, let us stop and reflect and let us recommit in every aspect to building parity of esteem. More importantly, let the Government start delivering it. We have done tremendous work on breaking the silence on mental health. Communities across the country have done tremendous work by themselves. Nobody asked them to; they saw a need and they stepped up. Talking may save lives, but let talking lead to action that delivers for every town, village and community in the country. Last year when we published our mental health action plan, Sinn Féin laid out a fully costed five-year strategy not just to give hope to people that it was possible to transform our service, but to deliver a fresh start for mental health care. The plan would ensure that care was built on fairness, access to high quality services, early intervention, prevention and suicide reduction and ensure parity of esteem between mental and physical health. There would be universal counselling, a new child and youth mental health service, more community teams, intellectual disability, ID, teams, CAMHS inpatient beds and early intervention psychosis teams backed with multi-annual funding certainty for all clinical programmes from eating disorders to psychosis to ADHD adult teams and self-harm and suicide reduction as well as those critical additional inpatient eating disorder beds and community-based services, and a full ED roll-out of a self-harm and suicide reduction programme embedded across primary care and everyday clinical practice, with consultant liaison psychiatrists at every emergency department.

We need an action plan to combat loneliness and isolation, which far too many of our people experience. We would legislate to obligate any Government to uphold a "no wrong door" policy. I welcome the residential dual diagnosis Keltoi facility, which I referenced earlier, but we need crisis resolution on a regional basis, not just in model 4 hospitals.

There are no model 4 hospitals in the midlands, yet the Minister of State repeatedly says "midlands" without giving the definitive location. I have said umpteen times and will say it again that Ireland is not a doughnut; the midlands is a big place. We need to know where it will be, how it will be staffed and when it will be opened for people. We need that all-island, mother and baby, perinatal mental health unit. Critically, we need multi-annual strategic workforce planning, matched with an increase in graduate and postgraduate training places.

The Sinn Féin plan would move us decades away from the situation of today, from underinvestment and a lack of proper management to a system that is community based and proactive, backed by multi-annual funding and long-term planning. Where the Government fails to deliver, people suffer. Nowhere is that more evidenced than in the waiting lists for psychology, CAMHS, primary care services, specialist services and acute services.

I ask the Government to please learn from its past mistakes. Publish the detailed budget. Tell us where it plans to spend this money. Tell us what programmes it is planning on funding and let the stakeholders review that in its entirety.

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