Jerry Buttimer (Fine Gael)

I commend the Minister of State for his commitment to his job and, in particular, his account on the "Marian Finucane" programme which touched many of us. While I would not jump into bed with Senator Feeney in calling him the best Minister of State at the Department for Health and Children, he has a very positive approach and commitment to the job. I hope the Government will give him the necessary commitment.

World Health Organization statistics show that Ireland has the fourth highest rate of suicide in the age range of 15 to 24 years in the European Union. As Senator Feeney correctly stated, the members of the Cabinet are out on the plinth talking about the reshuffle when the reality is that 95% of the people do not care about it. Fellow citizens are under pressure, unable to cope and struggling. I refer to the Minister of State's remarks about the need to have person-centred recovery measures in mental health services. We must protect and support all citizens. I have said before in the House that we need to support young and middle-aged men who are very vulnerable and feel isolated and alone, either as a result of losing a job or financial pressure; men who are struggling and cannot cope with being gay; men whose relationships have broken down; men who are left powerless and vulnerable for a plethora of reasons. It is important we strike a note of solidarity with them.

I commend all those involved in the mental health services. I worked as a hospital porter and had the pleasure - I use that word deliberately - of working with patients in Cork University Hospital, formerly Cork Regional Hospital. Men especially were struggling with issues in their lives and I learned to appreciate what life has to give. We are very fortunate to have our mental health and can come here tonight and act as advocates and be a voice for people. As Senator Corrigan correctly said, we must de-institutionalise old psychiatric buildings and close them down. In so doing, it is important to apply the concept of assisted living in its holistic sense and look at the role of the inspectorate. We should not just move patients without joined-up thinking. We must join the dots, so to speak, and put people at the core. We must ensure adults with an intellectual disability are not lost.

I have a concern that the figures in the financing of A Vision for Change are unrealistic. The Minister of State stated €25 million had been given to the HSE prior to 2009. What will happen to the remaining buildings that have not been sold? Who will buy them? There is a downturn in the economic value of property. If we are moving away from institutional care which is the right policy, we must look at patients in these hospitals. We are all aware of individuals who should never have been placed in them and suffered badly. I hope the community support services will have the capacity to meet their needs and that significant funding will be available.

It is four years since publication of A Vision of Change. The Minister of State has stated honestly that its implementation has been slower than anticipated. Dr. Siobhán Barry referred to the need for 1,803 new staff and stated this could take 40 years. While I am not an expert, does the Government know what it is doing and where it is going in the context of implementation of A Vision for Change?

I welcome the Minister of State's remarks regarding the campaign against stigma to be launched in April. I commend his personal commitment. While I do not question his energy in the Department, I question the commitment of the Government to the fulfilment of the aims of this policy document in terms of the sale of buildings, ring-fenced funding, the provision of staff, the role of the inspectorate and the funding mechanism to be put in place.

I was struck by the Minister of State's remarks about citizenship but we still have a long road to travel. I compliment Amnesty International and the children's mental health coalition on their excellent presentations to us in recent months. We need to steer a new course. There needs to be youth participation in schools in order that young people can become voices for change in the way in which mental health is viewed. This is not an issue about beds or institutions. It is not about physical buildings but people. This has to be at the core of our thinking, although it may seem like a very simplistic approach. In any town or rural area there are people who are walking around aimlessly and have no sense of the contribution they are making to society. They feel vulnerable, alone and isolated. They do not think there is support available to them or that there is someone available to help them. We all meet people in our offices every week who are looking for help in seeking housing or filling in basic forms. Many bureaucrats view them as a nuisance or as being four sheets in the wind, so to speak, and dismiss them. The Minister of State is the primary driver of the vehicle. He must ensure we build a coalition to engage in implementation of A Vision for Change. The time for rhetoric is over. The children's mental health coalition made some very interesting points in the four key areas - the four pillars - which include the education system, the criminal justice system and the care system.

I pay tribute to Mr. John McCarthy in Cork and his Mad Pride campaign which has taken advocacy to a new level. I also thank the Minister of State for his work. He is but one part of the wheel which is in need of an overall and an over-arching Government commitment which I hope will be given.