Frances Fitzgerald (Fine Gael)

I welcome the Minister of State, Deputy Devins, thank him for attending the House and wish him success in his important portfolio.

Some of the points raised by the Minister of State were disturbing. For example, he quoted from the recent mental health awareness and attitudes survey which showed that the public underestimates the prevalence of mental health problems in the population. This is a continuation of the denial on mental health issues we have seen due to ignorance, fear and lack of education on mental health issues. It shows the significant challenge that remains to normalise attitudes to mental health difficulties.

I recently spoke at a breast cancer seminar run by the Marie Keating Foundation. As I went in to talk I met a nurse who has been working with breast cancer patients in St. Vincent's Hospital for a long time. She remarked that it was wonderful to see the level of support now for breast cancer patients which was not available ten years ago. There was complete silence on breast cancer and it was almost stigmatised. Thankfully that is changing, although not for all physical illnesses. Cervical cancer still attracts quietness, denial and even stigma, and people are nervous about discussing it. However, we have made great advances.

In mental health a significant challenge on dealing with stigma and denial must be met. On the Order of Business I said Senator Harris noted that by discussing it in the House, we help change the tenor of the debate and ensure mental health issues, including those relating to suicide, are spoken about and normalised. It is clear from the research the Minister of State quoted that every family is affected by mental health issues, just as every family is affected by physical health issues. We must create a society in which people can easily get the help they need so that they can resume their normal lives quickly. Dealing with stigma in mental health is still a major issue and a real challenge. I welcome some of the innovative approaches being taken which the Minister of State mentioned. They are very important.

However if a child has a mental health difficulty which his or her parents want to have assessed, most local clinics will tell them there is a waiting list and that unless the child is suicidal or it is an emergency, he or she cannot be seen. Will the Minister of State take an interest in this to see what can be done to change it? It is all there in A Vision for Change, but most parents seeking help for children with mental health difficulties cannot access help quickly. Some clinics have closed their waiting lists, which are up to two years. Most clinics have waiting lists of several months. It is critical that there is prevention and that action is taken at an early stage when a child experiences problems, yet this is difficult. The same applies to adult mental health care. It is difficult to access help quickly, and in mental health, as in physical health, this is critical. Access to help and counselling remains an issue, especially for more vulnerable and disadvantaged groups. It is not easy to get the counselling help needed.

As the Minister of State said in his paper, thousands of people attend accident and emergency departments owing to self-harm. The National Office for Suicide Prevention says the figures we have are probably an underestimate. While I note the Minister's point on more nurses being available at accident and emergency departments, many who attend hospitals with self-harm do not get the help they need after the episode. That is another area in which we must invest more resources. Spending on mental health as a percentage of our gross domestic product is low by international standards. I welcome the work being done by the National Office for Suicide Prevention and the Irish Association of Suicidology, whose recent conference in Killarney was excellent. It was addressed by President McAleese. I will mention later some of the points that arose at the conference.

Everybody knows somebody who has dealt with a mental illness or a mental health issue and somebody who has recovered from such an illness and gone on to resume normal life, which is an important message to convey. Ireland's record of dealing with mental health and assisting those with mental illness is shameful and inexcusable but, thankfully, we are moving away from that. However, we must work in partnership to change cultural attitudes to mental health issues.

The National Office for Suicide Prevention has initiated some innovative measures. Its campaign, Your Mental Health, is worthy of mention. The Minister said the worldwide web can be an ally or a foe. It is most important that we use it as an ally in the area of mental health. The potential to reach the young people who are most at risk of suicide by using the Internet should be developed. The number of hits the Your Mental Health campaign has received on the Internet is a positive sign. That young people have been making positive comments on the Bebo site is tremendous because these are the people we must reach. Young people, particularly young men, are very vulnerable and if we can reach them through more modern methods, we should develop that.

Of course, more funding is needed in this area. I urge the Government to invest that money; it is money well spent. The priority areas that require funding include supporting mental health awareness campaigns to reach vulnerable young people. We have learned a great deal from research reports and should implement some of their findings. We should also support community and voluntary organisations. Pieta House in Lucan in my constituency provides people with tremendous counselling support. In addition, we must focus on accident and emergency departments. It is a cry for help when people come to those departments after harming themselves. This is where we should reach out to them and ensure they are given counselling and ongoing help. That is not happening.

Another obvious area, in which everybody has a responsibility to take action, is the disposal of unwanted medicines in family homes. Such medicines are a crucial risk factor for young people, as has been well documented. We must convey the important message that, where people suffer from conditions which sometimes carry frightening names such as bipolar disorder, schizophrenia or depression, these conditions are manageable, people can get on with their lives and there are effective and helpful treatments available. We must ensure the stigma that undoubtedly continues to be associated with mental health issues is removed.

The suicide statistics are shocking. It is now the greatest cause of death among men and women under the age of 35 years on the island of Ireland. While in recent years an average of 11,000 people have presented at hospitals following deliberate self-harm, the Irish Association of Suicidology believes this figure represents only the tip of the iceberg. It believes the real figure for deliberate self-harm could be up to 60,000. This is a huge number of people. It is suggested that more than 25% of adolescents have had suicidal thoughts at some point in their lives. There is obviously a difference between having suicidal thoughts and deliberate self-harm or being at risk of suicide, but it is a serious epidemic. For that reason it is important we are discussing it in the House today.

President McAleese gave a wonderful address about suicide in Killarney. She said each statistic represents an untold story of loss, depression, social dislocation, breakdown in relationships, substance abuse, distress or some combination of those experiences. Great credit is also due to the President for mentioning an issue that has not received a great deal of coverage in the context of its relationship with mental health issues or suicide, that is, the link between suicide, attempted suicide and sexual identity. This is most important. The Oireachtas committee which dealt with suicide prevention during the term of the last Dáil noted that young homosexual people were far more at risk of suicide than their heterosexual peers. This is an area to which we must be increasingly sensitive. There is still a great deal of homophobic bullying in schools and we must challenge that behaviour and declare it unacceptable.