Marie Sherlock (Dublin Central, Labour)
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I welcome the Minister of State, Deputy Butler, to the Chamber. I note that we have mental health campaigners in the Gallery. They are all very welcome.

Mary Butler (Waterford, Fianna Fail)
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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.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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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.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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I commend everybody who works in mental health services across the country. Many people's first port of call is their GP. The GP is the rock they can cling to and sometimes the only access they have to someone who will help them.

In her opening statement, the Minister of State said this year's theme was “Access to Services – Mental Health in Catastrophes and Emergencies”. I was quite taken by that because of an issue I have raised with the Minister of State before and want to raise again. A young man from Sligo, Jimmy Loughlin, was unfortunately murdered in February 2018 by a mental health service user. This issue has gone on for some time and his family wrote to the Minister of State on 11 August. The family also wrote to other members of the Government and to the CEO of the HSE but has not got a response yet to that particular letter.

I have a copy of a letter the Minister of State sent to Michael Loughlin, the father of the young man who was killed, on 25 July. The letter stated a review was in the final stages and a draft would be received in the coming weeks. It stated that once the report was finalised, the HSE had confirmed that it would contact the Loughlin family to discuss the findings and recommendations. The Minister of State also promised that her office would be in touch with the HSE and would discuss those findings and recommendations with the family when this happened. We are now in the middle of October and we have not seen this review. After the tragic event it went through, the family sought and expected a full review. A serious incident report is something that, statutorily, is normally carried out. It was not carried out, we are told. We understand it was started but stopped.

My colleague has mentioned people who break a leg or get a heart attack. Of course, services are there for those people. If the service is not there, that particular person can suffer huge consequences. If the service is not properly there when a person with a mental health condition contacts mental health services and goes into the system, that can have a tragic outcome. Suicide is often at the end of that route. In some of these cases, and in this family's case, it was not suicide; it was an innocent member of the public that suffered. This is not the only such case. There are others. People have come to me and we see other cases unfolding all the time. The absence of follow-up in mental health services to acute situations like this can have tragic outcomes for any member of the public as well as for the service user, yet the Government is stonewalling this family and stopping us finding out the truth. This situation is similar to many others around the country.

Across the water in Britain, there was a case where three people were killed and a report was done into it. The Government over there conducted an immediate, full and thorough investigation into it to find what lessons could be learned. Why are we not doing that here? Why are we allowing this to continually happen? It is totally at the Government's door that it does not ensure mental health services are in place to protect people - not just the unfortunate service user, but others who may face fatal consequences if this is not done.

Marie Sherlock (Dublin Central, Labour)
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I welcome the opportunity to speak on World Mental Health Day. Enormous work is being done across the country by many groups, both informal and formal. Progress has been made on breaking the stigma in our communities in recent years. However, it is important to say that stigma is alive and well in workplaces and in the medical profession when people present with a long history of mental health conditions and then seek assistance for physical health conditions but are effectively not afforded the seriousness and consideration they should be. There has been progress but, by God, we still have a long road to travel.

I acknowledge the Minister of State's commitment to her role in recent years. We sharply differ on some issues but there is no doubting her commitment. I also want to acknowledge the presence of Deputy Roche, who has spoken so powerfully about his own family. When people speak out, particularly public representatives or others in positions of influence, that can be a wake-up call to services and as to the reality of mental health in this country. We know from research that 42% of all adults in this country have experienced a mental health illness. Just under half of the population will experience a mental health crisis or illness at some point in their lives. That is enormous.

The Minister of State spoke of the structural factors and it is important to speak of those here. Homelessness, the lack of affordable housing and, in some cases I know very well, the lack of access to disability services, particularly for children, can have a devastating impact on the mental health of parents, children and families. It should harrow us all to know one in ten adults in Ireland has at some point attempted suicide.

The Minister of State referenced the significant challenges for adolescents since the pandemic. We know from research by the RCSI that one quarter of adolescents have described their mental health as bad or very bad and one in ten reported attempting suicide following the pandemic.

The critical point is that our mental health services were very much in the dark ages. There has been some improvement but there is a long road to travel.

It has already been said that heart attacks, strokes and falls are not nine-to-five issues and for a long time our health services have recognised that with 24-7 availability of care. For mental health, it is a very different story. I was glad to hear this week's announcement of the specialist nurses or advanced nurse practitioners who would operate in emergency departments. I hope there will now be a separate pathway. The Mental Health Commission made clear last year how inappropriate it was, and how out of step Ireland was, that those presenting with a mental health crisis were filtered to an ED. They are first filtered for their physical health and then referred for mental health. We all know the long hours people spend in emergency departments and to think that people spend hours on end waiting for the appropriate care, particularly when it is a mental health crisis, is horrendous. We know 51,000 people annually access mental health services for the first time through emergency departments, so the lack of out-of-hours services and appropriate spaces is critical.

I welcome this week's announcement but I have two questions. First, it is important to have the advanced nurse practitioners or specialist nurses providing that service, but where is the referral to the consultant psychiatrist in the hospital on a 24-hour basis? Second, will the Minister of State clarify what "out of hours" truly means? Many of us would expect it to be 24-7 but I hear today the service is until 2 a.m. That is better than 5 p.m. or 6 p.m. but it is still not on a 24-7 basis.

Nor is it clear whether that is for Saturday and Sunday. We need to have that clarity. In my constituency we have had children in adult emergency departments waiting for days for a service to become available. It points to the lack of inpatient mental health services for children.

In regard to CAMHS, the announcement this week is to be welcomed. We have not seen the clear commitment on funding. Only when we see that will we be sure that is going to be there. The 300 additional staff is to be welcomed. However, in the context of now having 248 fewer staff compared with December 2023, it is really a case of running to stand still in CAMHS.

In regard to the length of the waiting list, I hear what the Minister of State said. Some regions have upped their game for a variety of reasons and other areas have not. There are 4,554 children waiting to be seen. Deputy Clarke referred to the more than 23,000 people waiting on the psychology waiting list with over 11,000 waiting more than a year. Last week we heard from the Minister for Health that there will now be special interventions with regard to occupational therapy, speech and language therapy and physiotherapy for children's disability services. We did not hear anything with regard to psychology. To my mind, any child waiting 12 months or longer or any period of time is utterly unacceptable. I am told it is complex and that it is difficult to recruit psychologists, but something dramatic has to be done.

Outsourcing is the unspoken piece of the mental health funding story. In 2018, €46 million was spent on private providers for psychiatric and mental health care. That figure was €80 million last year and we are spending an additional €13 million sending people to the UK for care. As the HSE has itself acknowledged, mental health expenditure on private placements is contributing significantly to the overall mental health expenditure. That level of outsourcing is unacceptable and reflects the deep and structural failings within our system. Earlier this year we spoke about eating disorders and the number of people who have to travel. Again, we have differed in terms of the words being used here but saying that people are choosing to travel seems inaccurate. Those families do not believe that they are choosing to travel. They feel they have no service available to them here. The reality is that in this country, according to the Health Research Board, 76% of inpatient admissions for eating disorders are to private facilities or private charity providers. That is simply not good enough.

I note the commitment in the budget this week but we have a long road to travel to ensure there is sufficient provision for those suffering one of the most difficult mental health conditions. Of all mental health conditions in this country, eating disorders actually have the longest of inpatient stays.

The lesser-spoken part of the mental health piece is mental health clubs. Regarding the piece about prevention, support and assistance to those who got a prevention from additional hospitalisation, for those who have long-standing mental health conditions that is important. In my constituency, two mental health clubs were closed down in the past number of years, Shines on Mountjoy Square and the 245 Club in Drumcondra. I met four men earlier this year who have a long history of suffering from schizophrenia and want to set up a mental health club. They came looking for help. They have worked it all out. They have a business plan. They themselves need this service but they recognise the need in everybody else as well. We do not have enough of these mental health clubs, which are vital yet simple service provisions that are effective in keeping people out of hospital and ensuring there is the support and framework around them.

Peter Roche (Galway East, Fine Gael)
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I commend and thank the Minister of State, Deputy Butler, for all she has done in this regard. I thank her for her constant support and engagement with me in my role as the Fine Gael spokesperson on mental health. I welcome our visitors to the Public Gallery.

As we mark World Mental Health Day 2025, the message could not be clearer. It is access saves lives. This year's global theme is access to services. Mental health in catastrophes and emergencies carries particular weight here and indeed in Galway because for too many people in Ireland the catastrophe is never too far away and it is happening every day in the corridors of our emergency departments. I have raised the issue in the Chamber previously. When a person in acute psychological distress reaches the point of seeking help and the first and often the only option is to present to accident and emergency, they arrive there not with a broken bone or a visible wound, as was mentioned earlier, but with unbearable emotional pain. What they need and want is a system that is designed to receive them. They sometimes sit for hours, sometimes overnight in crowded waiting rooms. They are triaged, assessed and left to wait again, often in surroundings with noise, distress and lack of privacy in many instances. Some leave before being seen. Some do not make it back. Every time this happens it suggests our system has failed a family, another community and another future.

As was mentioned, we would never ask a heart attack patient to sit in the waiting room of a hospital while their condition worsens, yet we do that every day to people in the throes of a mental health crisis. This is not compassion, this is not care and it is not sustainable. It is time we created a separate, direct and dignified pathway for individuals presenting in mental health crisis, one that allows immediate referral to access the psychiatric and psychological team, bypassing the standard accident and emergency route. This is not a luxury but an urgent reform rooted in basic humanity and common sense. We already have strong models within our healthcare system, including liaison psychiatric teams, crisis cafés, 24-7 helplines and community response hubs. However, they are somewhat fragmented, inconsistent and in many cases inaccessible. We need a national standard, a standard integrated crisis pathway that ensures no one in mental distress is left behind in a waiting room.

When we talk about crisis, we must also talk about our children. Pieta House recently shared a heartbreaking reminder that one in three people, which is a high statistic, under the age of 18 who turns to it for help is only in primary school. A case like Orla, who was just 11 years old, told her therapist she did not want to be here anymore. These are not isolated cases. They are cries for help from children who feel unseen, unheard, or burdensome. They are children who need understanding, not silence. No parent should ever have to hear those words from their child. No child should ever believe that their family would be better off without them. That is why accessible, early and compassionate intervention must be at the core of every form of delivery.

Most recently, the heartbreaking loss of Adam Loughnane, a 34 year old man from County Galway who tragically died by suicide after presenting himself at University College Hospital Galway, reminds us all that behind every policy delay a real human life exists. In Adam's case, he was described as a gentle soul, a man who sought help, who did what we tell people to do, to reach out, go to your hospital, ask for support. His death has rightly prompted a hospital review. However, it must also prompt national reflection and reform. No person should ever walk into an Irish hospital seeking help and leave feeling unseen, unheard or unsupported.

Behind every statistic is a family holding its breath, a parent who does not sleep, friends who blame themselves, a child wondering why help did not come. As someone who has walked alongside families in my constituency of Galway East, I have seen the human cost of delay, disconnection and neglect. Mental healthcare is not an optional add-on to our health services. It is a moral obligation. The men and women who present, in distress, at accident and emergency departments are not numbers on a page. They are our neighbours, colleagues, children and parents. They deserve to be met, not with confusion or queries but with understanding, expertise and hope.

On this World Mental Health Day, I call again - and I know my call will be heard - on the Minister and the HSE to establish a dedicated national crisis response pathway for mental health with trained staff, designated spaces and seamless referral to psychiatric care. When a person reaches out for help, that moment is sacred. It may be the first, but it may also be the last attempt to live. We have a duty as legislators and leaders to follow human beings and make sure the hand they reach out to is there to hold them, not to make them wait.

Like the Minister of State, I come to the table with lived experience. Tragically, we lost our son and close friends of our son, in what was felt by me to be a crisis year. It was 2010. The figures at the time were escalating to somewhere around 500 people per year. Perhaps because of what I, others and support organisations have done over the years in offering advice, support and help - I commend all the people who did that because they have provided remarkable service - as the Minister of State mentioned, there has a welcome reduction in the number of people losing their lives by suicide. We have a lot more to do in that regard, but I am heartened and pleased that we have looked at the best pathway forward.

I want to continue to support the Minister of State in respect of this matter. I thank her for taking these statements today. Many of us have lived experience. Sometimes the story is told with a very heavy heart, but it is important that we allow people to understand the heartbreak, torment and loss that goes with losing a child or a number of people in a community. Sometimes we might look back and say it was avoidable. In this instance, all we can do is look forward to a stronger and better system.

Verona Murphy (Wexford, Independent)
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I thank Deputy Roche. We understand just how personal this is to him.

Ruairí Ó Murchú (Louth, Sinn Fein)
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I am glad to have this opportunity to speak on World Mental Health Day. Like previous speakers, I thank and commend all those who work in mental health services, for both the State or the organisations that do absolutely necessary work.

I was very taken by what Deputy Roche said. It obviously came from the heart. Unfortunately, it is the worst aspect of the detrimental impact mental health difficulties can have on lives and families and the real anguish involved. We all may have dealt with some of this in our families, but, fortunately, not in quite the same way as Deputy Roche and his family. My heart goes out to all those involved.

While we will never have a perfect system. We will have arguments about resources and particular cases. We need to find a better framework. I was very taken by what Deputy Roche said in the context of it all being about pathways. The problem is with systems we set up in this State in many cases. We sometimes talk about integrated systems and there being no wrong door, but we constantly build silos, circumstances and imperfect access pathways. Whether we are talking about CAMHS, community services or departments of psychiatry such as that in Crosslanes, Drogheda, it is all imperfect. We have all had many people come to us who cannot access services and some who come to talk about family members who do not want to access services. The latter do not realise the anguish they are causing. Deputy Martin Kenny spoke about a brutal case, and we have to look into cases like that from a point of view of making sure we do everything possible to mitigate or avoid the impact. Those are the worst of circumstances.

We also understand the world we live in, the issue of drugs and how there is sometimes an overlap with mental health services. We are constantly told about people who cannot access services when they are in psychosis because of underlying addictions. We need to find a means to deal with these sets of circumstances. The Minister of State has dealt with issues such as ensuring the likes of SOSAD has funding. She met Maxi's Law campaign, which is about ensuring we can offer equality in mental health services. We have issues in Our Lady of Lourdes Hospital in Drogheda regarding access to services.

Verona Murphy (Wexford, Independent)
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Thank you, Deputy.

Ruairí Ó Murchú (Louth, Sinn Fein)
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We have to look at all of this. I welcome some of what has been said, but we definitely need better pathways.

Liam Quaide (Cork East, Social Democrats)
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I thank the Minister of State for being here. I commend Deputy Roche on his heartfelt and powerful testimony. I thank him for sharing it with us.

In response to the mental health allocations in the budget, I want to be constructive and fair. I welcome the crisis support cafés that were announced, the focus on suicide prevention and the increase in CAMHS inpatient bed capacity. However, it is also important to state that the Sláintecare report recommended that at least 10% of the overall health budget be spent on mental health. This year's allocation of almost €1.6 billion represents only 5.8% of the overall health budget. Last year's budget allocation for mental health was 5.7% of the overall health spend, so the Government is moving towards that 10% at a snail's pace.

Meanwhile, many people who are desperately in need of multidisciplinary intervention in secondary and tertiary mental health services will have to continue to wait extended periods because of the recruitment restrictions still in place under the pay and numbers strategy. The latter has resulted in the decommissioning of an as of yet unknown number of essential community mental health and inpatient posts, which, in turn, as resulted in an unsustainable clinical burden being placed on existing team members. Anecdotally, I know of many posts that have been vaporised by the pay and numbers strategy. The HSE's responses to previous parliamentary questions, one of which I received only a short time ago, involve seeking more clarity with follow-up questions to me only to obfuscate the details further. Until we get beyond the pay and numbers strategy, we cannot really get serious about resourcing our mental health services and that is the case from primary care up to intensive mental health support for people with the most serious and urgent mental health difficulties.

Two days on from the publication of the budget, transparency in reporting is a long way off. We need to see a more detailed breakdown of the mental health allocation to analyse it properly. We need to know, for example, how many inpatient beds for people with life threatening eating disorders will be provided. We currently have three of the 23 beds recommended in the model of care. We need to know how many residential placements will be funded for the vulnerable cohort of people who have an intellectual disability and co-existing mental health difficulties.

It is extremely disappointing that no capital funding appears to have been committed in this budget to a perinatal mental health mother and baby unit, despite the fact that it was identified as a priority in a model of care that is now more than eight years old. Dr. Suzanne Crowe, president of the Irish Medical Council, wrote in The Irish Independent on Tuesday of the additional suffering caused to mothers with severe postnatal mental health difficulties who are separated from their babies.

This is an acutely sensitive and consequential time for both mother and baby and it is essential that both be supported, along with the mother's partner where that applies, in a therapeutic environment. I say consequential because we know from research and clinical experience that the early stages of attachment are crucial to later mental health and development. The crude medicalised psychiatric wards that mothers with severe post-natal mental health difficulties are currently referred to are likely in many cases to actually deepen their distress further and run the risk of disrupting those early bonds with their babies.

I know from patients and colleagues that those characteristics of many inpatient wards have worsened in recent years as those services have come under more pressure a result of fewer staff being on site and the increasing demand on services. Dr. Crowe states in her editorial that nearly nine years on from the publication of the model of care, no such unit has been built. She said this inertia is unfathomable. Yet there are plans to build other types of facilities, including a 50-bed centralised residential service for adults with severe and enduring mental health difficulties on a hospital site in Glanmire, County Cork at a projected capital cost of €64 million. If this goes ahead the residents will be starkly dislocated from anything resembling community living, living on the grounds of a hospital, and the proposal would be at odds with every mental health policy that has been written since Planning for the Future in the mid-1980s as well as being in breach of the UN Convention on the Rights of Persons with Disabilities. This is a retrograde proposal with no precedent as a new development in recent decades which will send mental health rehabilitation and recovery services into the dark ages where we removed people with mental health difficulties from society. I look forward to further details on the breakdown of the mental health allocations on the budget.

I also want to raise an issue of major concern to psychotherapists and one of great public interest regarding the regulation of their discipline by CORU. The Irish Council for Psychotherapy represents over 2,100 psychotherapists across ten professional organisations. It has raised six critical objections to what is being proposed under this CORU framework and has submitted a detailed policy proposal on that to the Minister for Health, Deputy Carroll MacNeill.

My own background is in psychology. I have the greatest of respect for psychotherapists and I believe there is much about their training that my discipline could learn from and strive to emulate. A core part of psychotherapy training is that the trainee would have mandatory psychotherapy for themselves. The ICP is extremely concerned about the removal of a mandatory personal therapy requirement for trainees under CORU’s proposals. Psychotherapy at its essence is a deep human engagement, often necessarily over a sustained period of time that requires humility, self awareness and constant reflection on the part of the therapist, what the Neville Symington called the core of one person meeting the core of another. It is recognised within the broad field of psychotherapy and psychology that it is essential to face one’s own areas of vulnerability, shame and aggression and become aware of one’s own psychological blind spots before attempting to help a client to do so. Removing this requirement amounts to stripping away part of the essence of psychotherapy and it should be reversed. The ICP is also deeply concerned about the absence of close clinical supervision requirements, no minimum duration for training programmes, a reduction in required clinical practice hours from 500 to 200 and a failure to distinguish psychotherapy from more brief psychological interventions. These proposals by CORU amount to a disregard for European standards jeopardising employment mobility across the EU for psychotherapists and undermining public safety. I urge the Minister, Deputy Carroll MacNeill, to engage with the Irish Council for Psychotherapy as a matter of urgency and to intervene with CORU on this matter.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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I welcome this debate to mark World Mental Health Day. The simple truth is still the strongest line: there is no health without mental health. Today is about removing stigma, yes, but also about showing that the services are there, close to home and getting stronger year-on-year.

Since 2020, funding has risen sharply and budget 2026 builds again on that. I want to commend the Minister of State, Deputy Butler, and her team on securing a record allocation of almost €1.6 billion, the sixth increase in a row. It adds 300 new staff across services and puts real weight behind crisis supports and suicide prevention. In short, it backs what clinicians, families and service users have asked for: earlier help, easier access, better alternatives to emergency departments and more joined-up care. That is the direction of travel and it is the right one.

Funding will establish specialist mental health nursing teams out-of-hours in all model 4 emergency departments, so if someone arrives at 11 p.m. in acute distress, the right expertise is there at the right time. We will also see three crisis resolution services with associated Solace crisis cafés in Donegal, Kerry and the midlands, giving people a safe, community-based alternative to the ED.

I welcome plans to expand the suicide crisis assessment nurse service working with GPs, because many people first reach out in primary care. These are practical fixes to real-world issues people and practitioners regularly face. The opening of 21 acute CAMHS beds, including ten at the new National Children’s Hospital is very welcome as is the reopening of 11 beds at Linn Dara. These are badly needed, as are the ten new intensive care rehabilitation unit beds at the National Forensic Mental Health Service in Portrane. That increases capacity where pressure is most acute and it builds a more humane, therapeutic pathway for recovery.

For children and young people, a priority is early help: two new early intervention youth services, a digital single point of access so families are not lost in the maze, more eating-disorder capacity in CAMHS and discovery colleges to equip young people with skills and confidence. When help is easy to find, it is easier to take. We are expanding talking therapies, rolling out a digital mental health strategy and growing peer-support roles because recovery is often peer-led and community-anchored. We are strengthening the national clinical programmes, dual diagnosis, perinatal mental health, early intervention in psychosis, adult eating disorders and services for older people, so the specialist help is there when general support is not.

Crucially, progress is not just on paper. The Mental Health Commission’s latest reports show continued falls in seclusion and restraint, a hard-won shift towards human-rights-based, person-centred care. That is what service users have asked for and that is what services are delivering.

The Government is also investing in the fabric of care and facilities which is welcome. Some €31 million in capital this year, the largest single-year mental health infrastructure allocation, funds safer inpatient environments, community hubs and specialist capacity like the new eating disorders hub at Mount Carmel, with feasibility work for Ireland’s first mother and baby perinatal mental health unit.

I want to place a particular focus on men’s mental health. Men are more likely to die by suicide and less likely to seek help early. I really welcome the Minister of State, Deputy Butler’s ring-fenced allocation of €2 million for more than 15,000 free counselling sessions for men, with supports available by phone and in person, and targeted work with young Traveller men through Exchange House. The aim is simple: lower the threshold, fit services around men’s lives and tackle stigma head-on.

However, we also know that care does not start and end in clinics. It starts where people live. In my area, for example, the men’s sheds in Dún Laoghaire, Blackrock and Loughlinstown are quiet powerhouses: a bench, a kettle, a shared project and suddenly the conversation is made easier. You do not have to call it therapy for it to be therapeutic. Government can help by signposting, backing social prescribing and making sure local grants and premises are there for groups that hold men in the community before they ever reach a crisis point.

Progress also means joining the dots across Government, housing, education, work and justice. The new interdepartmental steering group for mental health, bringing together 14 departments alongside the HSE and the Mental Health Commission, is designed to do exactly that, aligning delivery with Sharing the Vision and the next suicide reduction strategy informed by nearly 1,900 public submissions, 85% of whom said suicide reduction should be a Government priority.

People told us to make access easier, target supports better and fix the social determinants that drive distress. These voices have been heard. We are seeing the long-term curve bend. Between 2000 and 2021, Ireland’s suicide rate fell by 28%. Preliminary figures show that there were 302 deaths in 2023. We are now at the lowest preliminary level in over 20 years, and self-harm rates are down 12% since 2010. Every life lost is one too many, but it matters that investment, reform and community action are saving lives. Our job is to keep going, to keep investing and to keep reducing the stigma in order that people reach out early and are supported. It was great to see that every mental health nurse graduating this year has been offered a permanent contract, reducing reliance on agencies and giving patients continuity of care. That is investment not only in posts, but in people.

Budget 2026 is really encouraging in this area. The allocations and investment secured by the Minister of State, Deputy Butler, will ensure faster access through out-of-hours emergency teams, more services in the community and work on a single point of access for children and young people at an early stage. The direction is right, with record funding, smarter pathways, stronger community roots and a quiet revolution in how care is delivered, with dignity and partnership at its heart. On World Mental Health Day, let us say clearly to every person who is struggling that help is closer than you think. Please reach out.

Maurice Quinlivan (Limerick City, Sinn Fein)
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As the Minister of State knows, a 2022 report noted that 42.5% of Irish adults met the criteria for at least one mental health condition, while 19% of people have sought professional help to deal with mental health challenges. These are huge numbers and demonstrate how difficult life can be for so many people. One of the most difficult things to do is recognising that something needs to be addressed and then taking the steps to do so. I commend all of those who have taken that brave first step.

World Mental Health Day, which falls tomorrow, 10 October, is a day that can be beneficial in raising awareness of mental health issues. Unfortunately, it can often be very difficult for people to access State supports. In recent years, this has particularly impacted young people who have tried to engage CAMHS. In Limerick, the CAMHS system is being overwhelmed with referrals. Since 2020, the number of young people waiting more than a year for assessments has increased by 145%. In an area of health where early diagnosis is critical, that is extremely disappointing for these kids and their families.

In the absence of available and consistent State support for those in need of mental health supports, volunteers have stepped into the breach. In my home city of Limerick, we are extremely fortunate to have so many volunteers who are ready to assist people. Various groups, run by individuals who give up their free time, have been critical in our efforts to address mental health challenges. I refer to places such as the Haven Hub, where people can walk in and talk to someone who cares and wants to help. There are also suicide prevention teams such as Limerick Treaty Suicide Prevention and Limerick Suicide Watch. These women and men give up their time to walk the city and the banks of the Shannon to offer support and the hand of friendship to anybody who may be considering entering the water in a last desperate act. The Limerick Mental Health Association, which has been in existence for 23 years has done great work in raising awareness of mental health issues and has worked to reduce the stigma associated with the challenges in this regard. I encourage anybody in Limerick to visit its website this week to see all the events that are scheduled to occur.

Last October, the Minister of State and I attended the launch of the community access support team, CAST. There were many false dawns in establishing this team, and the launch date was were pushed back several times. However, it was launched eventually and has become a crucial tool in combating out-of-hours mental health emergencies. For those who are unaware, CAST comprises gardaí, medical professionals and paramedics who assess and respond to mental health issues, particularly out of hours. Between January and May of this year, the team has had over 200 interactions with people. An assessment suggests that 80% of those interactions had an impact on the person in crisis. This project has been a success but it continues to operate on a pilot basis. I urge the Government to ensure that it is maintained and supported through central funding and not funded by already hard-pressed local HSE and Garda.

During the summer, I was heartened to hear the Minister for justice say that this service should be expanded across the State. It really is working. Assistant Garda Commissioner Paula Hilman told the health committee that over 40 people have avoided arrest by availing of support services. As the Minister of State knows, the emergency department in UHL is the most overcrowded in the State. There are positive things being done that should be retained and expanded. Unfortunately, such positive interventions are often quickly followed by a regressive step. One such regressive step was the announcement in Tuesday's budget of the cuts to transport.

Ruth Coppinger (Dublin West, Solidarity)
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Tomorrow is World Mental Health Day. I wanted to give a nod to the fact that with genocide, racism and an increase in violence and brutality worldwide, huge damage is being done to people's mental health. We hope that the peace plan announced today for Gaza will bear fruit, but we still have huge issues of ecocide and genocide that are causing massive damage to the mental health of so many children, in particular those who are orphaned or disabled. I must mention Sudan in this context. I feel it is important to note that. I am wearing a keffiyeh in solidarity with those sentiments. This is a cultural symbol of Palestine, a symbol of fish and nets and olive trees, rather than a political symbol, as it is being interpreted.

It is obviously welcome that the suicide rate in Ireland has reportedly come down since 2020, but suicide is still the most common cause of death among young people. That is a horrific indictment of our system and according to the CSO, it is the most common death for 18- to 34-year-olds. A mental health survey by Laya Healthcare shows that 43% of the population struggle with their mental health. A UNICEF survey has found that Ireland ranks 24 out of 36 countries for good mental health among young people, with one third being unsatisfied with their lives. We have a huge mental health crisis among young people that has to be seriously explored. It certainly does not help that so many young people do not have the prospect of a home of their own and have to consider emigrating and so on. There are obviously other causes too.

The College of Psychiatrists of Ireland and Sláintecare have stated repeatedly that mental health should be 10% of the health budget, but yet here we are again, and it is 5.8%, so it is just over half of what is needed. That really is an indictment at a time when we have a budget surplus. Some patients are waiting more than six months for public counselling. Most people do not bother waiting for public counselling. We all know most people scrimp and save and try to pay for it themselves, a bit like what happens with dental care. but it risen by over 40%. On the CAMHS waiting list, 620 children are currently waiting more than a year for access and 4,437 are waiting for access to an appointment. In 2023, Ireland had 30.7 psychiatric hospital beds per 100,000 inhabitants, compared with an EU average of 71 beds, so it is around half of the EU average. Some of the beds that have been announced are in the children's hospital, so they will not be available for a long time.

I want to mention the 24-7 accident and emergency services that are meant to be available for people who are suicidal. Annually, 51,000 people have a mental health crisis and go to an accident and emergency department. The suicidal ideation action plan for the HSE states that there should be 24-7 mental health services available in most hospitals. However, in hospitals that are 24-7, people who work in that sector have told me that only 70% currently meet the psychiatric liaison accreditation network standards and eight of these departments lack any appropriate space for mental health crisis. People show up at an accident and emergency department and often leave again because they do not get the proper care . Unfortunately, some end up taking their own lives. This has been seen again and again by so many families. The Minister of State admitted that overcrowding and a lack of staff are leading people to go into hospitals when they should actually be getting care elsewhere. Then, they are not seen quickly enough and they end up dying.

The promises regarding 24-7 mental health services that were made a decade ago need to be delivered. Mental health reform is needed in order to alleviate the worst aspects of the problem. A psychiatric nurse is often sent along with a garda to deal with somebody in the midst of a mental health episode. That is not a good approach because some gardaí - I am not saying all - are not trained in this area.

We also know there has been a poor track record of gardaí dealing with people in the throes of mental health crises. It is not a good approach. We know there has to be specialised support for people.

I want to mention the perinatal mother and baby unit, which will cost €13.5 million. It has been promised for the past couple of years but it is still not in place. The lack of such a unit means that when mothers are put in adult units they end up getting separated from their babies. CAMHS is a huge area that needs massive resources. The waiting lists are increasing and the staffing is going down. This needs to be addressed.

With regard to Traveller community mental health, it is some indictment that members of the Traveller community are six times more likely to take their lives. One survey found that two thirds of Travellers know somebody who has taken their life. This study found discrimination and racism to be a major factor. The Traveller mental health action plan was never fully implemented. It was promised in the previous programme for Government and it is urgent.

I want to mention eating disorders. The Minister of State has been challenged on this by many activists. Eating disorders are the most deadly mental health condition. The HSE estimates that 180,000 people are affected by eating disorders. A couple of years ago, 220 people were admitted to hospital for eating disorders. There was a doubling over the pandemic of people aged under 18 being admitted. Many promises were made by the Minister of State regarding eating disorder provision. Bodywhys has seen a 20% increase in demand but it gets very little funding in comparison with other NGOs. Funding is meant to be available to add two new eating disorder teams but where are these services?

In the time I have left, I want to ask about the mental health of LGBT and trans people. From previous debates with the Minister of State, I know it is an issue she is personally invested in. What is the Government's stance on the Gender Recognition Act? My feeling was that the Government supported it. It was introduced ten years ago by the then Minister for Social Protection. During the week, a former Minister for Social Protection was asked about it in an interview. She said that somebody who is trans should be classed as transitioning and not as male or female. She said the Gender Recognition Act should probably be looked at and that it is all very complex. To me, this is a very dangerous signal to be sending out to trans people at this time, when their lives and whole existence are being undermined and threatened. It needs to be addressed by the Government. That person is not in government now but is standing for the Presidency, Heather Humphreys. They are sending out a signal, leaning into this very far right vote, with the disappearance of Maria Steen and the disappearance of a Fianna Fáil candidate.

Verona Murphy (Wexford, Independent)
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The Deputy is aware-----

Ruth Coppinger (Dublin West, Solidarity)
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There is nothing stopping me talking about a presidential candidate. I checked the Standing Orders. I cannot talk about the President-----

Verona Murphy (Wexford, Independent)
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Well I am sorry, it is a ruling that I have made.

Ruth Coppinger (Dublin West, Solidarity)
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You can rule all you like but there is no Standing Order preventing me from doing this.

Verona Murphy (Wexford, Independent)
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Excuse me.

Ruth Coppinger (Dublin West, Solidarity)
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I am talking about a candidate for the Presidency who has raised something in the public domain that the Government needs to address. That is all.

Verona Murphy (Wexford, Independent)
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That is perfectly all right, Deputy. I would just ask you to-----

Ruth Coppinger (Dublin West, Solidarity)
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I am saying they need to address it because trans people are hearing these messages going out.

Verona Murphy (Wexford, Independent)
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It is rather disrespectful to disregard a ruling of the Chair, a ruling that is made to safeguard all candidates and the office of the President. You could have referenced your comments without naming anybody if you wished to do that. It is a disregard of the ruling of the Chair. All I ask is for some respect.

Ruth Coppinger (Dublin West, Solidarity)
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What ruling?

Verona Murphy (Wexford, Independent)
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There was a salient ruling the other day that the office of the President is above political debate, as well as the nominated candidates. I ask Deputy Coppinger to be respectful of that.

Ruth Coppinger (Dublin West, Solidarity)
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I have not seen that.

Verona Murphy (Wexford, Independent)
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It was advised-----

Ruth Coppinger (Dublin West, Solidarity)
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I checked the Standing Orders.

Verona Murphy (Wexford, Independent)
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I am sorry, it was advised at the Business Committee this morning to the senior Deputy in your group, Deputy Paul Murphy. I ask that Deputy Coppinger consult with him.

Ruth Coppinger (Dublin West, Solidarity)
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There was nothing wrong with me raising what was in the public domain.

Paul McAuliffe (Dublin North-West, Fianna Fail)
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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.

Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Access to mental health services should be based on need, not on where you live and most certainly not on your ability to pay. Unfortunately, for many people across this State, that is not the case. I have no doubt that the Minister of State's office and that of the Ceann Comhairle are, like my own, inundated with people who are desperate to access mental health services, especially child and adolescent mental health services. In July 2020, there were 2,112 children waiting for first-time appointments with CAMHS. As of June 2025, there were 4,554 children waiting. The figure has more than doubled over the course of five years. This is why I was so surprised to read that there are only going to be ten CAMHS beds provided under the new budget when there were 20 last time. I do not understand. Perhaps we could get clarity on why there has been a reduction in CAMHS beds. Is this part of the legacy of Fianna Fáil and Fine Gael? Is this what they want to be remembered for? Of those children waiting over a year to access services, 216 are in the HSE area that includes my own constituency of Cavan-Monaghan. A staggering 88 of those children have been waiting for more than 18 months. They continue to be utterly failed by this Government. Families are crying out for help from the Minister of State's Government and, in many cases, it is simply not arriving. There is no help and no support.

I only wish I was standing before this House today to welcome new investment announced as part of this week's budget but the truth is that we do not even know what the Government has done on mental health. Unfortunately, we do know what has not happened for mental health in this State. The Government did not even invest the time to meaningfully update the budget document. A copy-and-paste job was done for mental health. Just seven words were changed from last year's document. It is absolutely pathetic.

Sinn Féin proposed an additional €52 million a year for a revolutionary mental health action plan that would have overhauled child and youth mental health care, provided for free counselling for everybody on referral and made critical investments in vital programmes for eating disorders, dual-diagnosis, ADHD, crisis resolution, suicide prevention and urgent and emergency care. This is the type of investment and policy that could have made a real difference for those struggling with mental health. It is what the people deserve. I ask the Minister of State to make the change. She has the responsibility and she can make the change.

Paul Lawless (Mayo, Aontú)
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I very much welcome the opportunity to speak on this issue. The issue of mental health and suicide is devastating. It affects many families and communities across Ireland. I will speak on a couple of specific issues. The first is that of farmer mental health. This has been very topical in my own constituency in recent days. The last weeks of September were particularly wet and what was essentially a slurry ban was introduced on 1 October. That had huge consequences for farmers. All of the regulations and the challenges associated with them are driving farmers' mental health into the ground. The idea that spreading slurry this week, when it is dry, is worse for the environment than spreading it last week during torrential rain when we saw some of the wettest weeks on record makes no sense and caused great difficulties for farmers. According to Teagasc, 23% of farmers are at risk of suicide. In the same survey, over 55% of farmers reported depression. That is a shocking statistic. When I think back to my own grandfather, who farmed the land with such joy, and remember those days as a child, I think it was a much more enjoyable profession in those days when farmers could concentrate on the job of farming. The Minister of State needs to work with the Department of agriculture to ensure that all of these guidelines work with farmers.

As a TD, I enjoy nothing more than knocking on doors and speaking to people, including elderly people and young people. Many elderly people want nothing more than to chat. Many feel very isolated in their communities. I believe Covid changed everything, particularly for senior citizens. Across the years of the pandemic, the message was that we should isolate from one another and that contact was extremely damaging.

People stopped visiting each other and going to Mass, the pub and matches. Could I have the attention of the Minister of State, please? Many among the cohort in question have continued to live as they did during Covid. The Minister of State now has a big job of work in her Ministry to promote the idea that isolation is damaging. We really need to get that message across. I spoke to a social-dancing teacher recently who identified some of the issues in this area. She said it was so sad that the people she knew so well, who used to go to social-dancing lessons and dances, are still isolating and have never returned following the Covid pandemic. It is important that we get the message out that we need to reverse this trend. It has been on repeat for so many years.

I want to raise a very concerning issue, namely, suicide contagion or cluster suicide. In my constituency recently, a community and town experienced a number of suicides. I reached out to the HSE for help and to alert it to the great difficulty the town, community, friend groups and families were experiencing, and I was shocked by the response. I spent countless hours on phone calls and emails. I had expected that there would be some protocol for a rapid response whereby teams of professionals, including psychologists, would go into the community, identify the friend groups and reach out with supports. Instead, I was asked to share a poster on social media and put it up around the town. Many of the organisations and resources on the poster - including Samaritans Ireland, Pieta House, Childline, SpunOut and www.yourmentalhealth.ie- are very positive, but if the poster is the response to suicide contagion in a community, it is simply inadequate. Several weeks after the contagion, we eventually managed to deliver a community prevention meeting, but meanwhile in the community the friend groups of the individuals concerned were meeting late at night in cars outside filling stations. These were young people of 18, 19 and 20. They were children in many cases. There was no support. Nobody reached out and nobody identified the people as potentially needing supports, signposting and therapy. The response, I believe, was entirely inadequate. Quite frankly, I was frustrated by the lack of proactivity and willingness to intervene and reach out to the community to indicate the supports. A meeting, forum or small group-support mechanism could have been set up in the local community centre, GAA club or elsewhere to help the young people and signpost them to further supports. Instead, there was no real action – let us be honest. I campaigned and fought and eventually we established a community support meeting. However, if the response is just to put up a poster with telephone numbers, it is totally inadequate.

I believe there is a model to follow, namely the one in secondary schools, whereby NEPS staff go into a school, assist students and teachers, signpost supports and try to identify individuals in need of help. However, what happened in the community in question was that the young people most affected had to support each other in cars late at night outside filling stations. I ask the Minister of State to meet me to discuss the matter and determine how we can develop a framework or rapid crisis response team that can go into a community and reach out proactively, not simply throw out a few numbers and ask people to reach out for help. Those most in need of help are often the least likely to pick up the phone but they may be willing to engage if the hand of friendship is extended and there is a proactive approach. I reached out in the hope and expectation that this would happen but it did not. Perhaps as a new TD I was naïve. What happened was inadequate. I would like the Minister of State to work with me and to follow up with me on this.

I want to speak briefly about the CSO data. We need to speak about the difficulties, the tragedy that is suicide and the devastating impact it has. The CSO data on suicide are about four years behind. According to the CSO website, the most recent suicide data are from 2021. I understand there are delays with coroners’ reports and so on, but the delay in this area is a real difficulty. We should be considering the surveying of GPs, funeral directors, parish priests and so on to try to get a handle on the situation.

Martin Daly (Roscommon-Galway, Fianna Fail)
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Tomorrow marks World Mental Health Day, a moment to pause and reflect on our nation’s mental well-being. I welcome the Government’s sustained commitment to improving mental health services right across the country. Next year, the total allocation for mental health will reach €1.6 billion, representing an increase of more than 50% since 2020. This is a remarkable achievement and a reflection of consistent, deliberate investment in the well-being of our people. It means more psychologists, counsellors, nurses and psychiatrists and more accessible care for those who need it most. I commend my colleague, the Minister of State responsible for mental health, for her determination to ensure this funding translates into genuine, measurable change on the ground in crisis care, early intervention and community-based supports.

The plan to add 300 new whole-time equivalent staff next year, representing 9% growth in the mental health workforce by 2026, is another major step forward. New crisis-resolution teams, Solace cafés, SCAN nurses to support GPs, targeted suicide-prevention initiatives for Travellers, expanded CAMHS capacity, new Jigsaw services and the implementation of a digital mental health strategy are the building blocks of a stronger, more compassionate and more modern mental health service.

I welcome in particular two initiatives in which the Minister of State has been involved. The first is accessibility to specialist nursing in emergency departments, where people in distress must face long waiting times before seeing a hard-pressed junior doctor or where they lack access to a consultant. That is a major initiative. Also, there is the men’s online counselling initiative, for which the Minister of State allocated €2 million. It began in September and will allow men, in particular, who are slow to seek psychological help, to access counselling in their own homes without having to attend a centre.

Closer to home, there is very good news for Roscommon and the wider west. HSE West and North West has plans for a new 50-bed replacement psychiatric unit at Roscommon University Hospital. It is to be a modern, purpose-built facility that will replace the existing unit. This is a major and long-awaited development for patients, families and staff throughout the region. A multistorey car park is part of the development and this will finally ease the parking pressure at the hospital and make access safer and more convenient for everyone. This investment will not only provide a better environment for patient care, it will also help make Roscommon University Hospital a more attractive place for staff to work.

We face genuine challenges in recruiting and retaining consultant psychiatrists and high-quality specialist staff in rural areas. Too often, smaller hospitals lose out to larger urban centres, not because the work is less meaningful but because the infrastructure and supports cannot compete with those in the larger centres. That must change if we are to be serious about an equitable mental health service nationwide.

We must make our regional hospitals places of professional excellence, with strong multidisciplinary teams, modern facilities and clear opportunities for clinical and career advancement.

As a practising GP, I see daily the profound human consequences of our modern pressures on mental well-being. The levels of anxiety, low mood and burnout presenting in general practice have risen dramatically over the last two decades, and I believe we are only seeing the tip of the iceberg. What once might have been considered occasional stress and sadness is now, for many, a persistent sense of being overwhelmed. Capacity in general practice is also a major issue, with a growth in population, the need to deal with additional cultural complexity and more complex chronic medical illness care being provided in the community. That can impact urgent access where there is a mental health crisis. This is why those other pathways that have been provided are so important.

The use of antidepressants and antianxiety medication has grown exponentially in this time. Between 2012 and 2022, the use of antidepressant medications more than doubled among children and young people. Among those aged 75 and older, prescriptions have increased by over 50% in a decade, with this group now accounting for nearly a quarter of all antidepressant use. Across Europe, the pattern is the same. Consumption of these medications has more than doubled since 2000, reflecting a wider and deeper tide of psychological distress.

Let me be absolutely clear that these medicines work. They help people and save lives. They are essential in helping people to recover from depression and anxiety and they allow countless individuals to function, work, parent and rediscover hope in their lives. The scale of their use, though, tells us something important, namely, that far too many people are reaching a point where medication feels like the only lifeline available. This is not a criticism of medical care or of the patients who need these treatments. It is a reflection of the world we live in, which is faster, noisier, lonelier and more digitally demanding than ever before. We are witnessing an epidemic not just of illness but of disconnection from community and purpose.

That disconnection is being accelerated by forces we have yet to fully control. Artificial intelligence is now present in nearly every aspect of young people's lives. From homework help to late night conversations, AI chatbots have become constant companions, yet regulation has not kept pace. Earlier this year, Meta quietly integrated its AI assistant into WhatsApp, Facebook, Instagram and Messenger, reaching roughly 3 million Irish users, including an estimated 300,000 children without parental consent, warning or opt out. CyberSafeKids reports that a quarter of eight-year-olds to 12-year-olds and more than a third of 12-year-olds to 15-year-olds are now actively using AI chatbots, not just to gather information but to chat, seek comfort and pass the time. These systems are not designed to nurture well-being. They are built to capture attention, mimic emotional intimacy, create dependency and keep young users engaged for profit. We are already seeing troubling reports from abroad of AI bots engaging vulnerable users in harmful and sexualised conversations, even encouraging self-destructive behaviour. The idea promoted by some in the tech world that chatbots might one day replace therapists or solve loneliness is a dangerous proposition. Artificial intelligence does not understand context or conscience and it cannot detect despair or respond with genuine empathy. It can only mirror what it is fed, sometimes amplifying it in deeply damaging ways.

Ireland faces some of the highest levels of loneliness in Europe. One in three individuals shows patterns of social media addiction. Combine this with the rise of anxiety and depression and the surge in prescription medications and it is clear we are living through a profound mental health challenge. It is one that cannot be solved by algorithms or quick fixes. This is why Ireland must play a leading role in ensuring AI is safe by design, transparent in purpose and accountable in impact. The forthcoming EU AI Act provides an important opportunity, but national implementation will be key, particularly when it comes to protecting children and young people. Platforms that profit from emotional manipulation must be held to account. Child safety cannot be an afterthought or a marketing slogan. It must be a legal and ethical obligation.

As we approach World Mental Health Day and as we welcome historic levels of investment - €1.6 billion for mental health in 2026 - and hundreds of new staff, new crisis supports, new digital pathways and new facilities, like the 50-bed unit at Roscommon, let us also recognise that no system of care, however well funded, can flourish in a society that is becoming emotionally disconnected. Our task is twofold: to build services that respond to illness with compassion and skill and to build a culture that sustains well-being before illness takes hold. This means investing not only in clinicians and infrastructure but also in communities, education and the digital environment in which our young people now live their lives. Mental health is not merely the absence of disease but the presence of connection, meaning and hope. If we lose those, then no amount of medication or innovation will be enough. Let Ireland be the country that combines compassion with foresight, embraces technology, but never at the expense of our humanity, and ensures progress always serves the people and not the other way around. Go raibh míle maith agat.

Máire Devine (Dublin South Central, Sinn Fein)
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Deputy Daly and I do not often agree. In fact, we very rarely agree, but I say "Well done". He articulated the concerns for this generation - our new generation - going forward with the explosion of AI and social media and all that stuff that is really scary. It is good, but most of it is scary for young minds and bodies. We really need to grab hold of it. I ask the Minister of State to push this issue if we can. I am not sure what Department it sits in, but it involves mental health and communications and requires legislation. We need to grab control of it now because it is lashing ahead of us and we are way behind. It is the young people who are so proficient at it. Deputy Daly has articulated that many of them are now on antidepressants. They are looking at social media - girls are in particular - and at the slagging going on there about their image, what they say, what they do and the competition. Then we have AI coming into the mix and making reality unreal. We have to tackle that because our next generation - our next leaders - will be reliant not on one another, but on whatever comes up on their phones.

I also want to take the opportunity to talk about Loreto Centre Crumlin counselling. The Minister of State was kind enough to accept and take an email from me this morning. The centre does vital work in the Crumlin area. I have been out to visit it and I have engaged with it several times. Deputy Ó Snodaigh and I did a site visit there. The people there are volunteers, along with one paid worker. The nuns in Loreto College own the building and were subsidising the centre with the provision of the building, the cost of the heating and the lighting and through financial support. The centre has provided over 3,000 hours of counselling and 350 individuals have been helped. The waiting lists are at six weeks, but this is better than other much longer waiting lists. I do not necessarily want to be downhearted in relation to the HSE's capacity, but it is poor for the number of people in life-challenging situations and difficulties. The centre sees people in the constituency from all incomes and none. It is a mix of everybody in the Dublin 12 area. There is a meeting tomorrow between Mr. Kevin Brady and Mr. Brian Cummins and two Loreto counselling board members, and the request is for €100,000. It is not a lot for what the centre does and I think we need to reward that volunteerism. The money would just be to cover the cost of running the place, upgrading fire exits and things like that.

Verona Murphy (Wexford, Independent)
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I thank the Deputy. She can correspond further.

Máire Devine (Dublin South Central, Sinn Fein)
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Am I finished now?

Verona Murphy (Wexford, Independent)
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You are.

Máire Devine (Dublin South Central, Sinn Fein)
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Okay. Very quickly, then, I just wanted to say-----

Verona Murphy (Wexford, Independent)
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Well, you are finished.

Máire Devine (Dublin South Central, Sinn Fein)
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-----that mental well-being is a community concern.

Verona Murphy (Wexford, Independent)
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I thank the Deputy.

Máire Devine (Dublin South Central, Sinn Fein)
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In September, we celebrated the tenth anniversary of The Tree of Hope. It is community, not necessarily professional. It has to be me, you and everybody.

Verona Murphy (Wexford, Independent)
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You are going to have to correspond. I thank the Deputy. I call Deputy Gillian Toole.

Máire Devine (Dublin South Central, Sinn Fein)
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That went very quickly.

Verona Murphy (Wexford, Independent)
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I know.

Gillian Toole (Meath East, Independent)
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Go raibh maith agat. I watch and I learn.

Máire Devine (Dublin South Central, Sinn Fein)
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What does that mean?

Mary Butler (Waterford, Fianna Fail)
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Keep talking.

Gillian Toole (Meath East, Independent)
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I am very appreciative of all the discussions I have heard, both in the Chamber and in my room today.

There is a fantastic exchange of knowledge, diversity of debate and agreement on many subjects. I have edited out the bulk of my commentary rather than be repetitious. I will keep it with a community focus.

I welcome the annually increased and increasing budget funding and the improving fiscal and human resources to date. There is probably uniformity of agreement on much more needing to be done. With the community focus in mind, I am most grateful to the various community and voluntary groups in County Meath - the men's and women's sheds groups; the ICA groups; Foróige; SOSAD; the youth diversion projects, the age-friendly and the older person's councils - all of which foster that key ingredient of connection. I am very grateful to members of the emergency services, the healthcare professionals, Meath River Rescue and all of the people who work with people experiencing a crisis in their mental well-being and who try to bring them back to a path of recovery. Healthy Meath, this year, in line with the WHO's recommendation, has five ways to well-being: to connect; to be active; to keep learning; to give; and to take notice. Our purpose in these Houses is to enable all of these ways to well-being. We are human beings, after all, not human doings, and our purpose should be to try to enable and to reduce barriers and remove obstacles.

Under the theme of connection are meeting friends and family, attending leisure and sporting groups and building positive relationships. They are all very beneficial to our well-being. Affordable, accessible and efficient means of transport are also essential for enabling these connections. In future, we must critically evaluate the far-reaching impacts of public health policies on anxiety, isolation and depression, particularly from 2020 to 2022. It is fair to say those are ongoing. Various sociological and psychological evidence is showing deleterious and ongoing effects on anxiety, loneliness, our immune systems and ageing.

Under the "be active" heading are enjoying local walks, joining sports clubs and participating in outdoor activities. They all release our happy hormones, such as dopamine, serotonin, endorphins and oxytocin. Planning and development must make adequate provision for these simple and necessary community infrastructure elements. Phase 2 of the land use review must be published as a matter of urgency to ensure the adequate provision of parks and open spaces and community buildings. They are so important in a rapidly developing county such as my own, County Meath.

The third theme of "keep learning" includes recommendations of access to education for all, exploring workshops, courses and lifelong learning. I am very grateful to the library services in Meath, such as those in Ashbourne, Dunboyne and Dunshaughlin, which continuously offer all of these courses and more, especially in building and being points of valued connection to our older people.

The theme of giving includes volunteering or getting involved in local groups that make a difference. Again, our gratitude is frequently expressed in this House to Tidy Towns volunteers and to local heroes enhancing the built environment, fostering pride and a sense of place, and enabling us to take note of our surroundings.

The fifth theme of tomorrow's World Mental Health Day is taking notice. We are encouraged to enjoy nature, practise mindfulness and have moments of gratitude close to home. I pay particular tribute to the increasing number of teachers, early years educators and community practitioners who support individuals, classes and groups in experiencing mindfulness practice. I will give a shoutout to a local person, Ms Una Curran, who is running a mindfulness and well-being course in support of Ratoath Men's Shed this evening.

Our most basic purpose is to treat others the way we would like to be treated. This takes daily effort. Our purpose here is to enable all of these ways to well-being.

Mary Butler (Waterford, Fianna Fail)
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I thank everyone for being in the House this afternoon. First, I thank Ms Nicola Byrne from Shine and the team that have sat through every single word of it. I also acknowledge Deputy Clarke for sitting through every single word of it. When we have statements on mental health, it is normally on a Thursday afternoon. I could nearly write the list of people who will come in to speak because it is always the same. I thank each and every one of the people who have been here today to talk about mental health. If the Ceann Comhairle was not in the Chair, she would be sitting on the benches because she is such a strong advocate for mental health as well.

Verona Murphy (Wexford, Independent)
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Go raibh maith agat.

Mary Butler (Waterford, Fianna Fail)
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I acknowledge Deputy Peter Roche and his lived experience. He spoke about the loss of his son. It was powerful advocacy. The more we talk about mental health, the more important it is. The Opposition has a job to do. I listen and take notes. I take on board what is said. I fervently believe that this is a good budget this year, but we have to deliver the budget. There are 300 new posts across mental health. That is significant. I was never able to stand in this House before and say I had 300 new posts.

As soon as the Dáil went into recess this year, and as I do every year, we started meeting with all the various organisations. I met the executive clinical directors, the clinical leads across mental health, and the NGOs that are our partners and we did two weeks of meetings to try to decide what our focus was going to be. I met with the HSE, with the REOs and the various leads across mental health. It is our job then to try to decide a focus.

I have known for the last few years from my constituency office and from talking to colleagues that the crisis out of hours is significant, that is, during the time the services are closed and somebody is in distress and has suicidal ideation. Thankfully, there is a reduction in the numbers, but one suicide is one too many, as far as I am concerned. It is a very difficult situation for families and communities. The Mental Health Commission's report showed that out of hours was very challenging for many people, but also from the perspective of what we know. People were leaving emergency departments, people were feeling they were not supported and people were feeling they could not sit under the bright lights. That is why we had to do more.

I got my final figure of 300 whole-time equivalents at 4.30 p.m. on Monday. For that reason alone there was not a huge amount of detail in the book on Tuesday, given that I have to work with the HSE and the Department of Health to determine exactly where they are going, but I have a broad outline. There will be 40 whole-time equivalents for nine model 4 hospitals and one model 3 hospital, which is the Mercy hospital in Cork because the list of presentations is so high, with 1,200 or 1,300 people presenting. This is what we worked off of. Those are 40 posts to go into the model 4 hospitals initially. I will try to fund the model 3 hospitals in next year's budget. As I could not fund the model 3 hospitals this year, I decided to put in place crisis resolution teams and Solace cafés. I had been in Donegal during the summer and I had been in Kerry. The third one identified by the HSE is Tullamore-Westmeath. That is where the third crisis resolution team is going.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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Tullamore is in County Offaly.

Mary Butler (Waterford, Fianna Fail)
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I know that, but "Tullamore-Westmeath" is what the HSE identified. That is what it calls the midlands. A crisis resolution team is funded at €1 million a year, recurring, for a multidisciplinary team to work out of hours. There is also the crisis café. I have opened many cafés around the country. The crisis cafés have reduced the presentations to emergency departments by between 17% and 18%, and 20% in some areas. I recently opened one in Sligo.

I want to speak in relation to where other parts of the funding are going. Additional funding of €30 million has gone into CAMHS over the last two years. A total of €30 million has gone in and the waiting list has gone up. At this time last year, the waiting list was at 3,700. When I came back after being elected, it was gone to 4,500. I have visited 21 teams in the past three months.

The waiting list today is 4,144. It was quoted as 4,500 during the debate. It was 4,500 and is now down to 4,144. The reason I prioritise those who have been waiting for longer than 12 months is that I do not want to see any waiting list where people are waiting for more than 12 months. I want waiting lists to be south of that. As a result, we have seen a 16.7% reduction since the end of July into August. That is the result of me going to meet doctors, clinicians and representatives of the HSE.

Deputy Bennett spoke about mental health. There are fewer than five people waiting for service in Cavan-Monaghan. It is one of the areas about which we are pleased. Deputy Quinlivan spoke about Limerick. CAMHS in Limerick has turned itself around completely. I acknowledge his support for the CAST project, which is important.

We have recruited 87 staff into CAMHS this year. Those are new staff. Not one inpatient child in CAMHS has travelled abroad since 2020. I must put that on the record of the Dáil because I must deal in facts. Some children may have travelled privately, outside the HSE, but no child in need of CAMHS support has left Ireland since 2020.

Many Members spoke about eating disorders. When I came into this post in 2020, three eating disorder teams were funded but only one was in place. We now have 11 teams in place and funding for 14. I have funded two more for next year, one adult team in the west of the country and one CAMHS team in the south east. I am not sure of the locations because the HSE, working with the Department, will determine those. I cannot specify. If I could, I would have everything in Waterford but I do not do that. I take a geographical perspective to see what we can do.

Some 100 clinicians are now working in eating disorder specialist teams all over the country. We also have eight consultant psychiatrists. I will be making an announcement soon about our plans to develop specialist eating disorder beds for adults, which will include a proper geographical spread. I will also be making an announcement soon about perinatal mental health and the mother-and-baby unit. We are working on a plan, which is commercially sensitive, under which there will be eating disorder beds for adults and a perinatal unit in Dublin. I cannot say anymore. There will be a geographical spread for the rest of those units.

The model of care proposed in 2018 included 16 teams. Those 16 teams have now been funded and I have already been told we need another, so we have gone to 17 teams. That will come in due course. It will certainly happen.

Other issues relating to the budget were raised. Some 5.6% of the overall health budget is allocated to mental health. However, I got 9% of the available staff next year, which is significant. Of the head count being provided through the HSE and the Department across all health services next year, I got 3,300 staff. That is 9% of the overall, and a head count that will do me. Once I have the staff, I must have the money to pay for them. That is important.

I want to touch on the clusters, which were spoken about. There is a community response to cluster suicides. We have the National Office for Suicide Prevention guidance for local response to suicide. All areas should have a HSE-led integrated group to monitor and respond to clusters. Where young people are involved, NEPS colleagues are involved and respond to children. We are also providing a response by way of bereavement support. It is important to note that we have those supports.

I will say one more thing before I finish. It is the most important thing I want to say today. Let us all get the message out. This is for any Member who has constituents coming to his or her office. At the moment, we cannot get men to avail of supports. If we only take away one thing from today's debate, it should be the site yourmentalhealth.ie/men. Tonight at 5 p.m., Connect Counselling is providing free counselling to people from their kitchen tables, sofas or bedrooms. It is for the farmer who has just come in from milking the cows if he is in trouble. MyMind is providing 5,000 hours of counselling between now and Christmas in 20 different languages to support those who come in on permits and might not speak English or Irish. I have worked with Exchange House Ireland. Supports are now available online for young Travellers. I have worked with the one organisation for retired veterans to provide counselling supports. These 15,000 counselling supports are there. We have worked with the Irish College of GPs. Some 1,200 GPs were on a call three or four weeks ago. They now know that they can support people. There is no waiting list for those counselling supports. There is dedicated money for those, additional to what is there.

On World Mental Health Day, which is tomorrow, it is important that we all talk about our mental health. I ask any men out there to look at yourmentalhealth.ie/men. I ask Members to ensure their office staff know about the site. They can signpost people to those supports, which are needed.

Verona Murphy (Wexford, Independent)
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I thank all Deputies for taking part in the debate. We all live and learn. The debate was scheduled for two hours and 25 minutes and we are on time. I thank the Minister of State and others.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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It was a joint effort.

Verona Murphy (Wexford, Independent)
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There would not be much leniency. I thank Deputies for their co-operation.

Máire Devine (Dublin South Central, Sinn Fein)
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I remind the Minister of State of the issues I raised in respect of Crumlin hospital.

Mary Butler (Waterford, Fianna Fail)
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I have passed on that issue.