Mary Moran (Labour) | Oireachtas source

I welcome the Minister of State, Deputy O'Dowd, back to the House this evening. I commend my colleague Senator MacSharry on the spirit of the Bill and the intention behind it. The Bill as proposed is not in accordance with Council Directive 92/83/EEC, which deals with alcohol taxation and taxes on related products that are applied in respect of their nature and strength. The Bill seeks to introduce a levy on alcohol products from take-away facilities, which would represent a clear violation. I commend the spirit of the Bill but cannot support it for these reasons.

I agree that the Minister of State, Deputy Lynch, has made every effort to provide better mental health services throughout the country in the past three years under limited and difficult circumstances. It is important to highlight this aspect when we debate the matter.

Health, especially mental health, can be a contentious topic not only in this House but in many forums. I have stated previously that it is important that we as public representatives reach out to the groups and members in our local communities to continue the campaign to erase the stigma around mental health. In Dundalk, along with service providers and representatives from the town, we created the Dundalk positive mental health forum, which facilitates discussions and events for the public on a regular basis. We meet to discuss the mental health issues in our community. At the start of this year we got great support from our local radio station, Dundalk FM, which allocates a one-hour slot once a month to discuss positive mental health issues. It is very good because we need to bring this out into the community and do all we can to reduce the stigma. I am aware of many excellent groups and individuals throughout the country who engage with their local communities in a variety of innovative and necessary ways, and they have made a very real impact. However, as we are all aware, the mental health services are not up to par. I say this with the utmost respect for the Minister of State, but the truth is the truth. We have children who are being completely left out of the picture because they are in an age bracket in which they are too close to adulthood but not close enough. There is a major problem for children between 16 and 18 years of age who are not being looked after. The Child and Adolescent Mental Health Services programme seems to stop at 16 years of age. The services maintain that they take children of that age, but I can talk about umpteen cases in which people are not being seen. In an Adjournment debate some months ago I raised the particular case of a child with an intellectual disability who could not be seen because he fell within that age group. Every child matters and every child should be afforded the same level of support when it comes to their mental heath, whether the child is one year old or 17 years old. It is most unfortunate that children with an intellectual disability, particularly in that age group, do not have access to the support services available. We need to ensure that we look after these children as best we can at the earliest possible age so that they can have the best start possible before the additional weight of adulthood is placed on them.

I can confirm that in my area in County Louth no child psychiatrist is available for children with an intellectual disability in the age bracket from 16 to 18 years. This is something I have brought up continually. CAMHS will not see children in this age bracket. This means that for two years the service fails this group of children. They must wait until they are 18 years of age to receive the supports they deserve. Furthermore, once a child reaches the age of 16 years, the paediatric services stop. Again, the child is lost for two full years.

Whether a child has an intellectual disability does not matter. People do not seem to understand that we have a major problem in this area. I realise the Minister of State, Deputy Lynch, is not in the House but, as a fellow Louth man, I call on the Minister of State, Deputy O’Dowd, to take this matter further.

Last week saw the publication of the Mental Health Commission's annual report, which detailed the good and, unfortunately, the unacceptable aspects of our mental health services, particularly with regard to children. Last year there were 408 child admissions, 91 of which were admissions to adult units. I adverted to this point in my maiden speech in the House when I said I was keen for change so that children with mental health difficulties would not be placed in adult units. I for one am very sorry that three years later we still have children being placed in adult units. Only 31 of the 91 admissions were admitted to child and adolescent units. Again, a total of 68% of these admissions refer to children in the 16-to-17 age bracket. It is the same problem. We are failing these children. I can categorically state that children in this group and their families leave the care of paediatricians and are then lost to the system for two full years. At that stage, we have an entirely different set of problems when those children are admitted back into the system.

The question of what happens while they are in care is important. I have visited some institutions where I have witnessed a lack of consistency in treatment. After a patient is discharged, one week she might see one doctor and the next week she might see a completely different doctor who is in place to deliver the same function as the previous doctor. I am not a mental health expert but anyone who knows anything about trying to deal with people with mental health problems, as far as I am aware, knows that consistency is vital and key to improving their health. Consistency and trust are vital in providing mental health services, not least for all our children. The report also highlighted that less than half of the services met the standards for therapeutic services and programmes, that staffing only reached a level of 44% and, more worryingly, only 60% of services provided individualised care plans.

The Bill seeks to raise funds through the levy to enhance the functions of the National Office for Suicide Prevention. Funding for this office has increased since the Government took office from a level of €4 million to €8.8 million. Since its establishment in 2005, the office has made strides in terms of the national strategy document Reach Out. The overall mental health services budget for the year stands at approximately €766 million. I recognise that every cent is utilised, although perhaps not as effectively or efficiently as we would wish. It is our job as legislators to see a better return and better provision for our euro.

The Department of Health and the HSE have begun work on the new strategy for suicide prevention managed by the NOSP, and it is expected to be completed by the end of the year. I eagerly await the publication of this strategy and hope that this will provide a better overall strategy for a problem that has been locked away for too long. I have many problems with the mental health services in our country.

Finally, I wish to raise an issue I have raised previously during the past three years, that is, the case of those who have been on antidepressants for a considerable period and who are likely to continue on such medication.

I am aware that another conversation is taking place about the pros and cons of antidepressants. However, there is a serious need to consider making long-term illness cards available to those who have been informed that they will be obliged to take medication for life in order that they might retain their equilibrium. Medication required to maintain one's medical health is just as important as that required to maintain one's physical health. We cannot draw distinctions on these matters any longer. I understand the difficulties and hope to discuss the matter further with the Minister.