David Norris (Independent)

I welcome the Minister of State to the House. We are lucky that a person with such a passion for and commitment to this area is in this role. I compliment Senator Gilroy on raising the important issue of the involuntary subjection of patients to electroconvulsive therapy. He is probably aware that working with the Green Party, I introduced legislation in the last Seanad that would have dealt with this issue. The legislative process was not completed, unfortunately. Perhaps the Government will consider revisiting the Bill, which relates to a complex area.

I listened with great admiration to Senator Moran's superb and greatly moving speech. It was one of the best speeches I have heard in 25 years in this House. It came from the heart, but it was not just emotional. It put very clear facts before us. All of us of all parties and Governments must take some responsibility for those facts as a community. It is important for these matters to be documented in the manner that was done by Senator Moran.

I would like to comment on a couple of aspects of the Minister of State's speech. A Vision for Change is an excellent document that has unfortunately been left lying around for some time. I am glad that the Minister of State acknowledged honestly at the outset that implementation has been slow. I hope it will speed up under her stewardship. I am pleased that in the last paragraph of her speech, she said €35 million will be ring-fenced annually. I like the sound of that because it seems that something will actually be done.

The Minister of State referred to the question of involuntary admissions, which is analogous to the question of the involuntary subjection of patients to invasive treatment. I was particularly glad to hear her refer to the establishment of a national service users executive. It is important for us to involve people with mental health issues in their own recovery. We need to empower them, listen to them and involve them in these discussions. I was pleased to hear her refer to the See Change alliance and the Make a Ripple initiative, to which I have made a small commitment.

I hope I am not blowing my own trumpet when I mention a learning experience I have had in recent times. Mental health was the first of the three pillars I put down when I launched my bid for the Presidency. I thought it was a quixotic thing, that I was being an idealist. It has astonished me that people have raised this issue with me every time I have pulled into a petrol station or gone into a little coffee shop. They ask me to help to smash the stigma and break the silence on this issue, which is exactly what the Minister of State has been saying. If one is depressed, one needs the help of others to raise the burden off one's shoulders.

It is helpful to take on board the fact that mental illness is just that - an illness. I have been saying for the last six months that people are not ashamed of a broken arm or a touch of bronchitis, but they are ashamed of mental illness. The reason for that is the existence of this stigma. It can be a black mark if one is looking for a job. We need to address that, particularly now that people have been courageous enough to come out and say they have experienced mental health problems. Some 25% of people in this country will experience serious mental health crises during their lives.

I remind the House that Catherine Zeta-Jones had a bipolar episode that was triggered by her husband's throat cancer. Stephen Fry has spoken about the similar difficulties he has experienced. It is absolutely wonderful that distinguished sports people who are regarded as icons in our society have had the courage and bravery to discuss these issues. They are to be commended.

Perhaps we need to consider the definition of "mental health". I think it relates to the old Latin tag, mens sana in corpore sano - a sound mind in a healthy body. It describes how we think and feel about ourselves and other people, how we perceive and interpret what is going on in our lives, and our ability to cope and deal with change, transition and significant events. One's feelings can sometimes become so intense that they interfere with one's day-to-day activities, which leads to physical or behavioural symptoms that can be confusing for one, one's family and the people surrounding one.

We should remember that mental health spans a continuum that goes from positive mental health to mental distress, mental disorder and mental illness. Equally, we should examine the history of how this subject has been dealt with. It is remarkable that Jonathan Swift founded St. Patrick's Hospital in the 18th century when he recognised that mental illness needed to be considered in parallel with physical illness. By contrast, we spent the 19th and 20th centuries building institutions that, by the 1950s, were used to incarcerate 25,000 people. They were sometimes used as repositories for people who were awkward or difficult or were experiencing an emotional crisis. They were left there.

I am sure many of my colleagues have read a moving book, Bird's Nest Soup, which was written by Hanna Greally, who spent 40 years in an institution. When a young psychiatrist recognised that there was nothing wrong with her, she managed to get out even though she had become partly institutionalised.

I welcome the commencement of the deinstitutionalisation process. The problem is that it is a question of funding and implementation. Although community care and alternative services are excellent, they are not yet in place. I do not think we can responsibly put people back into the community until facilities are available to look after them. This kind of aftercare was referred to by other speakers. Although it is good that the number of people in institutions has been decreased to 1,200, it is still problematic.

Electroconvulsive therapy was not the worst of the forms of psychiatry that were practised in institutions in previous times. Lobotomies were carried out. Some Senators may have seen the wonderful series on the Kennedy family that was broadcast recently. It clearly depicted the distress of Jack Kennedy's mother, who emerged from the series as a remarkable woman, when she discovered that her husband had agreed behind her back to have Rose Kennedy lobotomised. The same thing happened to the sister of Tennessee Williams, also called Rose, on whom a central figure in his wonderful play, "The Glass Menagerie", was based. We have an alternative way of looking at these things now which is to see people as human beings and complex organisms with an emotional, rational, spiritual and physical presence. All of us experience periods when we feel sad, hurt, depressed or out of control. It is all a part of being human but sometimes it can become extreme and lead to suicide, a desperately important issue.

I was interested to hear Senator Moran use the phrase "take their own lives". All of us used language whose implications we did not understand, such as "committing suicide". I remember Deputy Dan Neville in this House 15 years ago operating on the decriminalisation of suicide. It is a nonsense to make it a criminal offence. What does one do? Does one imprison or fine a corpse? One cannot do anything to someone who is dead but one can affect the family and that is cruel. One commits a sin or a crime and the churches were wrong to punish the families by refusing to allow people to be buried in sanctified ground and I am pleased that has changed as well. Therefore, the language is terribly important.

I have dealt with Sosad and I was pleased that it was mentioned. I have been there, seen them and they are wonderful people. I have been to Pieta House, run by Joan Freeman, and with Mental Health Ireland, chaired by Michael Hughes. It is a tribute to our health service that people such as Michael Hughes and his colleagues in Dún Laoghaire continue their work and that people who worked in the HSE continue in their retirement. It shows an absolute and real commitment of which I am very proud.

One thing I have learned from studying the issue of suicide is that in 98% of cases the intention is not to end the life but to put an end to unbearable emotional and mental agony. This means it is possible to intervene and there are signs such as giving away something very valued, such as a personal memento, a sporting trophy or a doll retained from childhood, or extended telephone calls with friends who are abroad. It is possible to intervene at that moment. We must publicise and learn what these factors are. There is no doubt whatever that the economic climate has something to do with this. In the past week, a publication of European statistics showed that throughout the European community there has been a correlative rise in the incidences of suicide that parallels economic pressures directly. This is a significant matter.

The three most important mental health problems in Ireland are alcoholism, depression and suicide. We must approach alcoholism. I am extremely sorry to discover that the Pioneer Total Abstinence movement, founded by Fr. Matthew of Cork, is in financial difficulty. I hope some attempt will be made to remedy this. I am not a pioneer myself, I take a drink, but it is a wonderful organisation and they do fantastic work. The influence of these enormous conglomerates is awful. They are no longer Irish companies and we should remember that. They are international organisations which have meetings in boardrooms in London and New York. They look at graphs and decide and predict the drinking habits of the young. It is a remarkably powerful lobby and this Parliament should stand up to it.

I welcome the Minister of State's contribution. This is a good day for Seanad Éireann. There have been excellent speeches all around. I hope the debate will be covered in some of the media because we need the co-operation of the media to ventilate these issues and to support our colleagues who are experiencing these difficulties.