Paul McAuliffe (Dublin North-West, Fianna Fail)

Tomorrow, Friday, 10 October, is World Mental Health Day. It was first celebrated in 1992 as an initiative of the World Federation for Mental Health. In many ways, the conversation on mental health has completely transformed since 1992 when I was a teenager. I look with great admiration to the many people who are able to talk about their mental health now. I distinguish between mental health and mental illness. We have come a long way on lifting the stigma from mental illness but we still have an incredibly long way to go.

With regard to the budget and mental health, I welcome that the Minister of State is with us today and I welcome the commitment in the recent budget for funding of additional resources for mental health services. There have been significant developments in mental health resources in Ireland in recent years. We must always strive to achieve and support those who are more vulnerable and who experience mental health crises. I particularly welcome the measures outlined in the budget that will see major investment next year in crisis supports and suicide prevention.

I heard the Minister of State say at a press conference that this was her sixth budget in the portfolio. I have to say that while we will always find reasons to criticise Ministers and their performances, and challenge them to do better, I pay tribute to the Minister of State's commitment to this portfolio. She wears it very passionately and she believes in what the portfolio can do. I have seen some of the benefits and changes delivered in her time.

I understand there are an unprecedented 300 new staff for mental health services, which will represent 9% of the total growth of 3,300 staff in the health service next year. The total allocation for mental health for 2026 will amount to €1.6 billion. This is record funding and it has increased for the sixth year in a row. Mental health funding was increased by more than 50% in 2020. This was an apt time for it to happen, given what happened with the Covid pandemic. There was not only the virus itself, and we know the subsequent impact on mental health for every generation. Sometimes we focus on younger people alone, and the challenge was immense for them, but I think of many older people who were left more isolated and separated from their connections during the pandemic. I have seen the impact this has had, in terms of local community groups and support groups. Many older people have not got back out or engaged, and they feel a bit more vulnerable. Much of this has to do with their mental resilience.

I was particularly pleased to see in the budget specialist nursing team out-of-hours services in all model 4 hospital emergency departments. I will come back to this because it is a particularly important intervention. There will be three new crisis resolution teams, including the drop-in Solace crisis cafes, to support people in crisis. There is 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 services, and an additional specialist CAMHS eating disorder team. I know the latter in particular is an area the Minister of State has worked on and has made improvements.

I want to speak specifically about the specialist nursing teams. I had reason to be in an emergency department earlier this year. As, unfortunately, I was waiting, I had the chance to talk to a young man who was beside me. He had suicidal ideation and felt he was in crisis. While he was there he felt safe. He said he felt safe in the emergency department and that being there was protecting him. He knew the procedure because he had been there before. He knew he had to wait until the morning for someone to make an intervention and do an assessment for him to get treatment. Out-of-hours specialist nursing teams in all model 4 hospital emergency departments would make a massive difference to young men like him and to the many other people who present. While many of us might have to wait a little bit longer in an emergency department, someone in a mental health crisis has less resilience to be able to wait for this time.

I particularly welcome the provision of those teams.

With regard to mental health commitments for 2025, last month, the Minister of State, Deputy Butler, welcomed confirmation from the HSE chief executive, Bernard Gloster, that every mental health nursing graduate in 2025 would be offered a permanent position within the HSE by 19 September. We will now have a direct transition from classroom to practice, ensuring a stable and achievable number of nurses to support our health services.

I also compliment the use of apprenticeships in this area and particularly in the area of social care. We can do a lot more on apprenticeships. When we brought in degree-level qualifications for nurses, they spoke about the parity with their colleagues in the nursing profession this provided them. We can do more in the area of social care with regard to that element of apprenticeship, on-the-job training and the availability of skills to the health service that results from it. I encourage the Minister of State to look at applying the apprenticeship model to other social care professions. Some apprenticeships are at master's level. People get a master's level qualification through the apprenticeship model. That is fantastic and we should be doing it more across the health service. It not only provides certainty for graduates at the beginning of their careers, it also ensures that patients benefit more from a stable and sustainable workforce.

Mental health does not exist in isolation. It can be influenced by housing instability, employment or education. It can also be influenced by trauma. I welcome the investment in trauma-informed communities around the country. We know the impact trauma and adverse childhood experiences, ACEs, have and how that can impact how people engage with public services. I encourage all public services, including front-facing counters in local authorities and so on, to ensure that staff are trauma informed because trauma can often impact how people interact with services.

The Mental Health Act has been in place for 25 years. While elements might work, we need mental health legislation that better reflects the current growing needs of those seeking help. I supported the passage of the Mental Health Bill 2024 through the Dáil in July and I welcome its continued passage through the Houses. If I am correct, it is with the Seanad at the moment. We must continue to reduce mental health stigma and promote the broad range of services and supports that are available to people in communities right across the country, which I understand the Minister of State is actively doing.

It is often said that there is no health without mental health. That becomes all too true in the winter months. Longer nights and colder evenings mean that people do not have the same freedom to get out and circulate, often leading to a sense of cabin fever or isolation. We must remember to check in on each other during those times. I make particular reference to the older people I spoke about earlier.

We have a long way to go. In addition to the interaction I had with that young man in the emergency department, people regularly present to my clinics with a housing or social welfare issue but, after a number of minutes, I become aware that there may be a mental illness issue involved as well. It can often be incredibly difficult to navigate anybody through public service bureaucracy but navigating someone with a mental illness - I am making that distinction between mental illness and mental health - through can be incredibly difficult. There are advocacy services to assist those people. While TDs and the citizens' information service can help and support such people, in many cases, people with a profound mental illness can find themselves utterly lost in applying for basic public services. Many civil servants do their very best to guide people through but the advocacy services that are available are very important. I urge the Minister of State to continue with the work she is doing.

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