Trevor Ó Clochartaigh (Sinn Fein) | Oireachtas source

Cuirim fáilte roimh an Aire Stáit. Tá ábhar an-tromchúiseach agus an-tábhachtach á phlé againn. Aithním go bhfuil brí an Bhille atá á chur chun cinn ag an Seanadóir MacSharry tábhachtach agus go bhfuil an reachtaíocht seo á moladh aige le toil mhaith. Tá deacrachtaí beaga againn leis, áfach.

We acknowledge the good intentions of the Bill presented by Senator MacSharry, focused as it is on the need to enhance resources for mental health services and suicide prevention. In the Dáil, Sinn Féin has a comprehensive Private Member's motion that seeks progress in the development of mental health services and suicide prevention. This is particularly the case with regard to increased staffing, which is seriously deficient at present. The motion has secured all-party support, a welcome development.

However, with regard to this Bill, we do not favour the central proposal. Funding for mental health services and suicide prevention should be allocated directly from the health budget and should not be dependent on the sale of alcohol, no more than funding for primary care or physiotherapy or any other aspect of health care should be so dependent. I acknowledge that we must address the issue of below-cost selling of alcohol as a matter of urgency. The position of Sinn Féin is that it should be banned and we favour increased taxation of alcohol. If a portion of this is to be ring-fenced, it should be devoted to awareness raising and education on the dangers of alcohol, directed especially at young people. On the Sinn Féin Dáil motion in the Chamber, Sinn Féin health spokesperson Deputy Caoimhghín Ó Caoláin pointed to the report of the Mental Health Commission published two weeks ago, which makes alarming findings. The report of the Mental Health Commission shows that only 44% of psychiatric hospitals and mental health facilities are compliant with staffing level regulations. The report also makes clear that since 2007, staffing in mental health services has been reduced by the implementation of recruitment embargoes and the employment moratorium. Such policies are endangering the delivery of competent and responsive community-based services, as envisaged in A Vision for Change, the Government's mental health strategy. It is of huge concern that the commission reports that children are being admitted to adult units. Some 91 admissions, representing 22.3% of all child admissions, were made in 2013.

Suicide is a complex issue that demands a national, cross-departmental co-ordinated response. There are many risk factors for suicide. A 2008 review of the evidence suggests that living in an area of socioeconomic disadvantage and being unemployed are risk factors, as is having a diagnosis of a mental disorder, including depression, schizophrenia, personality disorder or a childhood disorder, which can increase the risk of contemplating suicide. Misuse of alcohol and drugs is a known risk factor, as is having previously self-harmed. Adolescents who have experienced sexual abuse are at high risk. In general, the national suicide prevention framework will require a cross-departmental response and it is vital that Departments outside the Department of Health, particularly the Department of Education and Skills, the Department of Children and Youth Affairs and the Department of the Environment, Community and Local Government, are involved in developing the actions under the framework.

A key priority for suicide prevention is the development of an adequate 24-7 crisis support service for people experiencing severe mental or emotional distress. A Vision for Change states that a protocol for crisis intervention should be agreed upon for each area by the local community mental health team and that the agreed response should be available 24-7. The policy also recommends that each mental health service area should have the facility of a crisis house that offers brief respite to those suffering a crisis where hospital admission is not appropriate.

The HSE should ensure that 24-hour, seven-day crisis intervention is available in every mental health service as a matter of urgency. It is also important that such 24-7 crisis services are culturally competent so that they are accessible to people from minority ethnic communities, including the Traveller community. Finally, it is important that there is an effective 24-7 crisis service available to people who are homeless. There is a need for all sectors and groups working in the area of suicide prevention to share resources and work together more effectively and efficiently. The National Office for Suicide Prevention also needs to co-ordinate its funded programmes towards agreed strategic priorities and ensure the programmes are funded to a level that can meet identified population risks and needs. For example, initiatives should be available throughout the country and targeted at higher-risk groups. The suicide prevention framework should prioritise marginalised groups, all of whom have a higher risk of experiencing mental health difficulties. It should also prioritise children and young people, given the clear evidence that early intervention is cost-effective. The framework should incorporate clear commitments from the Department of Education and Skills and the Child and Family Agency on mainstreaming mental health promotion within schools. The HSE should ensure that all community mental health teams provide a 24-7 crisis intervention service as recommended in A Vision for Change. The Sinn Féin motion in the Dáil this week seeks to refocus the Oireachtas and public opinion on mental health and suicide prevention and the need to implement A Vision for Change by ensuring sufficient resources and firm political commitment. We are seeking all-party support for our comprehensive motion.

I note that Senators on both sides of the House are critical of Government implementation of policy at present. I remind Senators that we will be debating budgetary issues in the autumn. I hope they will show the same resolve when we are discussing the budget for mental health when the time comes. Proper funding should be put in place to roll out the services we have called for.