Dan Neville (Limerick, Fine Gael)
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I thank the Ceann Comhairle for providing me with the opportunity to raise this matter. I recognise the work of the National Disability Authority in the context of the national survey of public attitudes to disability in Ireland. That survey is quite disturbing in many ways. There has been a drive on the part of many NGOs, Government organisations and others to remove the stigma relating to and encourage a better understanding of disability and create opportunities and promote equality for people with disabilities. Unfortunately, the survey to which I refer indicates that our attitudes in respect of these matters is not good.

We must be concerned in respect of this survey, particularly as it shows that negative attitudes towards disability are actually hardening and that there has been a deterioration in attitudes towards people with physical and intellectual disabilities in the past five years. Among the survey's main findings are that 34% of people with disabilities face restrictions in socialising and that almost 24% of people in general would object if children with mental health problems were in the same classes as their child. In addition, some 21% stated that they would object if a child with an intellectual disability or autism was placed in a class with their child. The survey further indicates that only 37% of people agreed that adults with intellectual disability or autism should have children if they wish. This is down very significantly from a figure of 64% in 2006. In addition, only 56% agreed that people with mental health difficulties had the same right to have sexual relationships as those without disabilities.

The Government should take immediate action in respect of the findings contained in the survey in order that we might stop people with intellectual disabilities slipping further away from mainstream society. The entire objective in respect of destigmatising the area of disability was to ensure people would reach their full potential and play a full role in society. It can be inferred from the survey that the will to achieve this objective is slipping.

Kathleen Lynch (Cork North Central, Labour)
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I do not intend to restate the statistics provided by Deputy Neville. I fully accept his commitment not only to this area but also to mental health. Not alone has he spoken about this issue through the years when no one else wanted to speak about it but he definitely educated many people with regard to mental health and the topic of suicide.

The National Disability Authority, NDA, conducted surveys of attitudes to persons with disabilities in 2001, 2006 and 2011. The 2006 survey showed marked improvement in the public's attitudes towards people with disabilities, save in relation to those with mental health difficulties. Unfortunately, the NDA's survey completed in 2011 shows a serious deterioration in attitudes towards persons with all types of impairments, although there is some evidence that gains made in 2006 regarding attitudes towards those with mental health issues have been retained. The survey found a general hardening of attitudes towards people with all types of disabilities, whether in schools, the workplace or in community life. Some of the survey findings are truly worrying.

Only 48% of respondents agree that children with sensory impairments should attend the same schools as those without disabilities. This is down from 58% in 2006. Almost a quarter - 24% - of respondents said they would object if a child with mental health difficulties was in the same class as their child. This is up from 21% in 2006. We are meeting somewhere in the middle and attitudes are definitely hardening. Only 62% believe children with physical disabilities should attend the same schools as children without disabilities. A total of 21% would object if a child with intellectual disability or autism was in the same class as their child. This is up significantly from 8% in 2006. Only 37% agree that adults with an intellectual disability or autism should have children if they wish, and this is down very significantly from 64% in 2006. Only 56% agree that people with mental health difficulties have the same right to have sexual relationships as those without disabilities.

The survey also demonstrates that people in general are less comfortable living beside a person with a disability, whether physical, sensory or intellectual, but have most difficulty living beside those with mental health difficulties. All of the statistics will be on the record but at this point I would like to state that regardless of whether people have difficulty living next to a person with a disability, and the survey shows the greatest difficulty is with regard to those with mental health difficulties, it is a fact that people with mental health difficulties live either with us or near us in communities.

We should be grateful the Government is determined to push on with the changes and advances being made not only in mental health but also with regard to people with disabilities. We need to confront these attitudes. We have funded programmes such as See Change, Make a Ripple and other fine campaigns. Advertising on mental health issues has had a profound effect. Funding local groups with regard to the social interaction that needs to take place with people with disabilities and people with mental health difficulties has made a huge difference.

A total of 26% of people with disabilities said people's attitudes posed a barrier to their participation in life activities. This contrasts with only 3% of people without disabilities who reported such attitudinal barriers. One argument constantly made with regard to attitudes is that one cannot legislate for attitudes, and this is true. One cannot legislate to force someone to change his or her attitude. However, as Jack Straw once said, one cannot legislate for attitudes but one can legislate to ensure someone's attitude will not detrimentally affect someone else's, and this is the course we should take. The survey also found that people with disabilities are twice as likely to be socially isolated from family and friends than those without disabilities.

International evidence outlined by the NDA has shown that personal contact and collaboration with people with disabilities on an equal basis is the most successful way to achieve attitudinal change. We have funded SHINE to co-ordinate the two year See Change campaign to promote positive attitudes to those with mental health difficulties. The survey would suggest this has been significantly successful.

We now have the national disability stakeholder group, which is a cross-departmental group at the centre of government. Up to this point its membership was comprised only of service providers and Government agencies. It now has a range of people, including those representing the mental health area, people with physical disabilities and those with life experience of what it is to have a disability. Recently, two people with intellectual disabilities were appointed.

We are pushing out the boat and we are determined that attitudes, legislation and how people live their lives with disabilities will change. However, I agree fully with the Deputy that we have so much more to do.

Dan Neville (Limerick, Fine Gael)
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I thank the Minister of State for her reply. While we cannot legislate for attitudes, as she stated, we can campaign to change them. We saw the result of significant investment in the very successful campaign on road safety, which is often quoted as a headline. The level of finance is not available for similar investment in this area, but there should be a level of support for attitudinal change. Often people use the word "stigma" very loosely but do not fully analyse or understand exactly what it means. It means using negative labels to identify people with mental health problems and disability. It is at the root of fear and misunderstanding of these issues. People hold negative opinions towards people with disabilities and mental health problems simply because they do not understand the issues involved and because they rely on myths and misconceptions about the areas. International research and policy documents identify stigma as one of the most persistent barriers to understanding the problems with mental health and disabilities and the importance of these areas.

The Minister of State mentioned the objectives of See Change and the examination of their effectiveness. It is important to put those on the record. See Change wants an environment where people can be more open and positive in their attitudes and behaviour towards mental health; greater understanding and acceptance of people with mental health problems; greater understanding and knowledge of mental health problems and of health services that provide support for mental health problems - that would also apply to people with disabilities; and a reduction in the stigma associated with these issues and the need to challenge discrimination.

Unfortunately, attitudes towards mental health create a misunderstanding among people and that misunderstanding leads to people with a disability or a mental health problem having low self-esteem. They feel isolated and hopeless, and that can deter them from seeking help. Responding to that stigma people with disability or mental health problems can sometimes internalise the public attitudes to which I referred and become so embarrassed or ashamed that they often conceal the symptoms and fail to seek treatment. There is a knock-on effect from those attitudes in terms of the way people provide and obtain treatment for conditions that can be treated. Improvement can be obtained in terms of quality of life and contribution to society.

Kathleen Lynch (Cork North Central, Labour)
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I do not have any additional back-up notes but everything the Deputy said is correct. It is about continuously speaking out in public and treating the issue in its normality. That is what we must do. People with disabilities are contributors to society. They work, are part of our community and contribute, not just to the public purse but to the social discourse as well.

The emphasis in terms of mental health and disability is often compared to the road safety campaign. Deputy Neville rightly said it is the insidiousness of stigma, and the hidden attitude, that is difficult to deal with. I am not dismissing the people who did such an exceptional job in terms of road safety but there are physical things that can be done in regard to road safety to make the roads safer and prevent accidents happening. There is a different attitude towards mental health and disability and the greatest barrier is the insidiousness of that attitude. The Deputy is right. The attitude sometimes can prevent people from reaching out for help, and seeking that help too late can mean one is left with an enduring condition. I agree with everything the Deputy said.

Dan Neville (Limerick, Fine Gael)
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May I briefly respond?

Tom Hayes (Tipperary South, Fine Gael)
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Both the Deputy and the Minister were given a good deal of latitude.

Dan Neville (Limerick, Fine Gael)
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Regarding the campaign against attitude and stigma, it was a former Minister in the Minister of State's party, Noel Browne, at another time who destigmatised and changed attitudes towards tuberculosis. It can be done. The examples exist of how that can be achieved.