Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House and thank her for her very comprehensive overview of the progress that has been made in the provision of mental health services and the health policy reform that is progressing in this area. There are two major challenges. First, there is the whole area of reform, on which A Vision for Change sets out a clear pathway. The second area that is the subject of public debate on a daily basis is suicide. There have been number of references to how we have tackled road traffic accidents and the deaths associated with them over the past ten or 15 years, but we have not made the same progress on suicide.

In 2009, 2010 and 2011, 552, 495 and 554 people, respectively, died by suicide. The figures for 2012 and 2013 show that more than 500 people died by suicide in each of those years. Suicide affects not just the person who dies, but a wide group of people. Between 2009 and the present, at least 25,000 people have been directly affected by suicide. There is a multiplier effect beyond that, particularly in terms of knock-on effects for young people attending school or college. It is frightening.

In regard to dealing with young people, we need to consider having a greater emphasis in the education system on new ways of dealing with the issue. There are some programmes in place, but I wonder whether we should be doing a lot more in that area in our secondary schools, in particular. Councillor Liam Brazil from Waterford wrote to me to highlight this issue recently. He said, "Suicide is not for a day, a night, a week or a holiday. Suicide is final. It is a permanent solution to a temporary problem." Young people, in particular, have temporary problems which make them think that the only way forward is to end their lives. We need to do a lot more work on helping young men aged between 18 and 25 years, especially in the education system.

We have set out a clear programme for mental health and the development of the health care sector, involving new systems and staff, upgrading and further training. This is a new approach. In fairness to the Minister of State and the Department, an additional €135 million has been allocated for mental health since 2012 when this year's budget is included. The Minister of State outlined the figures. In 2012, 416 new posts were approved, of which 411 have been filled. There were 447 new posts in 2013, and the most recent figures available to me indicate that 352 of these have been filled. This is impressive, given that the funding was not easily obtained, and it is indicative of the commitment of the Department and the health service to growing and developing this service.

Staff have been taken on to further strengthen community mental health teams in adult and child mental health services and to advance activities in suicide prevention. These staff will be pivotal to improving the services made available to people who have mental health problems or who suffer from depression. The reform programme includes development and reconfiguration of general adult teams to include psychiatry of later life, as well as child and adolescent community mental health teams. It is not easy to introduce reform in any health service. Set procedures and policies have been in place for many years, and making changes is a slow process. It is not possible to change overnight, because people will have worked the system for many years. One finds that many of the people who work in the health service initially sought change, only to become frustrated when the change never came. They themselves became entrenched. One good thing about what is happening now is that it provides a clear pathway and targets.

The report published by the Mental Health Commission made interesting reading. While some progress has been made, much more is required. We need to expedite that progress. In its report dated 25 June 2014, the commission noted that there was 90% to 100% compliance with 15 of the 31 standards for the provision of inpatient mental health services among inspected providers. However, fewer than half of these services met the standards for therapeutic programmes and staffing, and only 60% provided individualised care plans. There were 408 child admissions to approved centres in 2013, including 91 children who were admitted to adult units and subsequently discharged and admitted to dedicated adolescent units when beds became available. Of all child admissions in 2013, 68% were of individuals aged 16 or 17 years.

The Minister of State is correct that the Mental Health Commission plays a similar role to HIQA. The latter has improved standards in a range of areas of the health service, and I have no doubt that the commission will do likewise in assisting in the upgrading of services and providing health care. We have a lot of work to do in this regard. A huge number of dedicated and committed staff are working in the area.

It is important that there be no watering down of funding in this area. That is the worst thing that could happen because people would suddenly find, having set out a clear programme for the next three to five years in a particular unit, that funding is not available and the programme must be brought back a step or, in some cases, ten steps. It is important that the commitment given by the Minister, the Department and the HSE continues and that we can work towards improving mental health. We have made very little progress on suicide and we need to prioritise it. We must work to provide a support mechanism for people so we can reduce the rate of suicide and, for once, make real, serious inroads, as we did regarding road traffic accidents and deaths. I thank the Minister of State for the work she has done to date and wish her well during the term of the Government in ensuring the targets she has set in her Department and the HSE are met over the next 12 to 18 months.