Jillian van Turnhout (Independent) | Oireachtas source

I welcome the Minister of State, Deputy Kathleen Lynch, to the House and welcome the opportunity to have this debate. As I told the Minister of State recently when she appeared before the Oireachtas Joint Committee on Health and Children, I am disappointed that we do not have actual figures. Since the monitoring group for A Vision for Change was disbanded in 2012, I have found it difficult to obtain real figures. How can we applaud measures or focus on issues without such figures? I am concerned about their absence.

How can we track what is happening if we do not have that information? Ensuring the money is ring-fenced is good but not good enough, because the impact is not being felt by people.
In preparing for today's debate, I set out to discover what the reality of the mental health service is for people who need to avail of it. I have permission from an individual who has been in hospital for eight weeks receiving treatment for depression to quote from her blog. She says:

We are always told to reach out and surround yourself with people who care about you. But the one thing no one tells you about depression is that it is a lonely place to be even if you reach out and are surrounded by lots of supportive people. You feel alone and stuck in your head no matter how many people are around. That can be a scary place to be.

She says of her depression:

I felt myself retreat into a place of darkness and anxiety which has left me feeling invisible. Forget Harry Potter and his invisibility cloak. If you want to experience invisibility in real life, try a bout of depression.

Of the treatment she has received she has this to say:

While the nurses and doctors have been wonderful and are working under pressure and with a lack of resources, the mental health system in Ireland leaves a lot to be desired. The fact that I have been in hospital for almost three months and for the most part the only intervention I have been offered is medication says a lot about the lack of recovery-focused support.

In talking to this person, it is clear there is an urgent need for therapeutic supports. As it stands, we rely far too much on medication. People working in the system have told me that children are being drugged. By the time those children get to see a specialist, their mental health needs are masked. We must talk about how money and resources are being utilised in a situation where services are stretched and cannot meet demand. The person writing the blog explained that she has been kicked off a HSE service user group because she has missed two meetings during her stay in a HSE hospital. I am appalled by that.
The Minister of State said in her speech that there has been significant progress in reducing the numbers of children admitted to adult acute inpatient facilities. Mental Health Reform, on the other hand, has pointed out that there was actually an increase in the numbers of children in adult facilities last year. I have not met anybody who agrees that a child should go into an adult psychiatric ward, but the figures show the numbers are increasing. The Minister of State also referred to additional bed spaces for the child and adolescent mental health services, CAMHS. I understand she shares my view that we must have national co-ordination rather than self-selection by units.
My main concern relates to children with complex needs, most of whom are being moved around the country and end up in an adult bed. For most people, their first experience of mental health difficulties will be in their teenage years. Their treatment by the health service at this point will frame how they deal with mental health issues and recovery for their entire life. It sends the wrong message when young people with complex needs are shunted around the country. Moreover, the most recent report by CAMHS shows that more than 50% of children and adolescents are waiting longer than one year for treatment and only 24% are treated within 13 weeks of presenting. That is just not good enough. By the time an appropriate adult knows enough to refer a child for treatment, so much has already happened in that child's life.
Several Members referred to the Health Information and Quality Authority. A recent report by that body on foster care in Carlow, Kilkenny and south Tipperary found there were 45 children waiting to access psychology and mental health services. The majority of these children have complex needs and some are waiting in excess of three months. As the Minister of State will recall, I argued that CAMHS should have been transferred into the Child and Family Agency. Within this small geographical area and in the case of a particularly vulnerable group of children, namely, those in foster care, HIQA is telling us that 45 are not getting access to the services they need.

I agree with Mental Health Reform when it referred to improving our evidence base. We need to make sure that the National Suicide Research Foundation ensures that homeless status and ethnicity, including the Traveller community, are used as identifiers and caught in our statistics. We have much more to learn.

The Minister of State is aware of my views on direct provision. It exacerbates and increases the likelihood of such problems arising. At a recent meeting of the Joint Committee on Health and Children we heard Dr. Carol Coulter, when speaking about the child care law reporting project, say that when women suffer a total breakdown, their child ends up in care because of their mental health condition.

I welcome the Minister of State's support when Senator Gilroy spoke about the removal of the practice of ECT. It is barbaric and I cannot understand why it is still practised.