Frances Black (Independent) | Oireachtas source

I welcome the Minister of State, Deputy Jim Daly, to the House. I am very happy to speak in favour of the motion and I commend my colleague, Senator Joan Freeman, for bringing it forward. I join colleagues in stressing that 24-7 access to mental health services is essential. The funding must be made available to address this need.

Currently, thousands of children are struggling to cope with mental health problems due to the failure to properly resource emergency and acute services. Since 2014, demand for mental health services has gone up almost 30%. As of July 2017, however, almost 2,500 children and young people are still on waiting lists and unable to get the help they need. Many have been waiting for over a year. This is just one example of the urgent need to invest in better public services. It must be a priority for the Government.

From my experience of working in the field of addiction, I know that problems do not arise solely during working hours. The need for 24-7 access to mental health services is essential as it is often out-of-hours or weekends when people need urgent help. People will talk about the cost, but the cost of providing 24-7 access to proper mental health services can be met by the savings on future treatment. The World Health Organization suggests that, in the field of mental health, early intervention is fundamental in preventing progress towards a full-blown disease, in controlling symptoms and improving outcomes. We need to focus on prevention, not cure, and early intervention through proper services is the key to this.

We have made big strides in our ability to speak openly about mental health, but we need the investment in services to match it. Particularly with young people, investing in mental health at early ages represents the most cost-effective action to prevent the continuous increase of mental health problems in all age groups. Our understanding of effective treatment needs to move beyond the concept of recovery as the getting rid of a disorder to the idea of instilling positive values and behaviours which enable young people to flourish, contribute to society and be happy and healthy.

People's younger years are often the peak period of incidence for mental health problems, yet this is where supports and services are most lacking. A major Irish study found that at least one in four Irish teenagers had experienced serious personal, emotional, behavioural or mental health problems, while almost one in ten had self-harmed. Ireland has the fifth highest rate of youth suicide between the ages of 14 and 24 in the EU, with 90% of suicides linked to mental health difficulties. Proper services are key to bringing these figures down. The figures are really shocking and show that we are in a real crisis around mental health.

Dr. Shari McDaid, director of Mental Health Reform, has called on the Government to allocate additional funding to meet the core funding gap in the HSE's mental health budget. It is estimated that €65 million is needed just to meet the current level of demand for care. This is not extra money; it is core funding to ensure that there are adequate beds for people with highly complex and severe mental health difficulties who need long-term residential care. It is the funding to provide residential services for people with eating disorders and it is the funding for services which have a shortage of inpatient beds for people in acute mental distress. It is the resource needed to respond to the 26% increase in referrals to child and adolescent mental health services between 2012 and 2016.

A key area I want to stress, particularly from my own work in this area, is that of dual diagnosis. This is where a person suffers from both a substance abuse problem and another mental health issue such as depression or an anxiety disorder. If we do not treat both together, we cannot beat either. I have worked as a therapist in the Rutland Centre with those who have been in addiction and I have not met anyone who did not also have an issue around anxiety, depression, stress or some form of trauma in their life. As such, these things really go hand in hand.

It is the same with mental health services. People who present with mental health issues will turn to alcohol or drugs to numb out. These issues are very closely linked and we must look at them together in the context of dual diagnosis. Most mental health services and addiction treatment centres in Ireland are currently not organised to treat people holistically. For example, if one has difficulties abstaining from alcohol due to anxiety, one cannot enter rehabilitation services as most residential drug services insist one be "dry" before entry. This is where it gets confusing because one cannot get one's anxiety problem treated until one's addiction to alcohol has been addressed. That is where people are falling through the gaps. As such, we need a joined-up approach and a real system for dual diagnosis.

If we integrated addiction and mental health services, it would help to reduce the suffering of people and their families and the resultant savings could help fund the badly needed 24-7 service which has been spoken about so passionately today. Father Peter Mc Verry, who has been providing accommodation to homeless people in Dublin since 1979, is clear on this. He says:

The holistic needs of the individual are not being addressed. There are too many borders between homelessness, drugs, mental health; you need to be in one category or the other to be dealt with, when you are in multiple categories the system breaks down. And it’s when you are in ‘multiple categories’ that you are most in need of assistance. I don’t see any joined up thinking, or at least the practical delivery of services in a joined up manner. We need to develop multi-disciplinary teams that are capable of dealing effectively with the totality of the problems that people have.

I set up an organisation, the Rise Foundation, which deals with family members who have a loved one with an alcohol, drug or gambling problem. The foundation is in fact a mental health service because it deals with family members who are under huge stress and who are very anxious. In particular where they are the adult children of alcoholics or drug addicts, a lot of them end up with severe depression, suicidal tendencies and sometimes even physical ailments. Unfortunately, this service gets no Government support notwithstanding the fact that approximately 3,000 people have come through our doors. It is very worrying. If even that does not get support, things are not looking good.

I strongly commend Senator Freeman on her fantastic work. She has done unbelievable things. Pieta House is, as we all know, beyond anything else. I know many people, including family members, who have attended Pieta House when they were in crisis. The staff there have been brilliant and I pay huge tribute to the Senator for that.

I commend the motion again and offer my full support for it. My key message today is that we must do better on dual diagnosis and look at the issue around family members who have been reared in homes where there has been alcohol or drug misuse. People are slipping through the cracks and it is not acceptable. If we show leadership on this issue, the savings we make in properly addressing mental health and substance misuse problems will more than compensate for the additional funding needed for these services. I hope the Minister of State can hear what we are saying today. I know he is a good man, that his heart is in the right place and that he is passionate about this issue. I hope that is reflected in next week's budget.