Grace O'Sullivan (Green Party) | Oireachtas source

This is another real life and death issue for young people of the south east. I thank the Minister of State for coming into the House this evening. This debate is due to my intervention on the Order of Business in the Seanad last week. I took the view that it was necessary due to the details that emerged from the Oireachtas Joint Committee on the Future of Mental Health Care, of which Senator Freeman is Chairman.

The committee revealed that three consultant psychiatrists in the south east were handing in their resignations and due to finish up in mid-July. I was shocked and alarmed to hear that. The committee and subsequent media reports set out how these resignations pose a serious risk to the immediate provision of mental health care in the south east and demonstrate that the situation there is close to a state of emergency.

I will outline the problem as I see it. There may have been disparate reasons for the resignation of these particular consultants, but, as alluded to by others, Dr. Kieran Moore was clear in his contributions to the committee. He said that his resignation and that of others was due to the continually declining conditions in mental health services in the region. After 16 years of providing a service in Wexford, he had finally had enough. For the good of his patients and his community he went public. He claims that the service should have 30 clinicians but has only 5.5 staff currently available. The buildings those people work in are not at all suitable. Community healthcare organisation 5, incorporating Carlow, Kilkenny, south Tipperary, Waterford and Wexford, seems to be the political orphan. It cannot get appointments or business cases taken up and acted upon by Tusla and HSE management.

Dr. Moore's indictment of conditions was reinforced by the resignation from the HSE of the widely respected President of the College of Psychiatrists of Ireland, Dr. John Hillery, in February. He told the Family Carers Ireland conference on Monday last that his early resignation was in reaction to the HSE's failure to deal with major staffing problems. He blamed the Government for failing to increase the mental health budget, despite recommendations from A Vision for Change more than a decade ago. He declared that doctors were faced with the moral distress of not being able to access the resources needed to help their patients. We have seen over the past year that such distress is particularly acute in the south east.

Now is not the time to discuss the ongoing emergency in emergency cardiac care provision in Waterford and the surrounding counties, but the issue is relevant in the light of a larger denial of adequate health provision in the south east. This is especially the case since University Hospital Waterford lost its regional hospital status.

To add to the personal testimonies of Dr. Hillery and Dr. Moore, today we received the latest report from the Ombudsman for Children on the experience of young people of mental health care in Ireland. The report does not make for happy reading. I trust the House will indulge me if I quote certain extracts from the report. The report reminds us that Article 24 of the UN Convention on the Rights of the Child recognises the right of children to "the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health". Article 24 further provides that state parties to the UNCRC, like Ireland, must "strive to ensure that no child is deprived of his or her right of access to such healthcare services". The World Health Organization definition of health is quoted as a "state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

How far we are from that vision currently? Today I met and talked to student representatives from the Union of Students in Ireland and Waterford Institute of Technology, including Celine Casey, who is the WIT students' union welfare officer. She outlined how of the 482 cases she had dealt with this year, more than 400 had some mental health aspect while almost 300 were primarily mental health related.

Ireland has one of the highest levels of chronic depression and anxiety in the EU, at 12.1% of the population. The narrative about asking for help is now well established. What is not is the access to the actual help that people are meant to seek. That any young person is left on a waiting list for more than a year is appalling, but that 2,500 children have been left waiting over a year for a psychiatric appointment is a national disgrace.A total of 209 children below the age of 18 have been waiting more than a year for an appointment with a psychologist in County Wexford, a full 10% of the national figure, despite the fact that Wexford makes up just 3% of the national population. Why are Wexford's children singled out for this cruelty? Mental health made up 13% of the health budget in 1984; in 2017, it was down to 6%, a staggering decline in the face of rising problems. We are here discussing the specific situation in the south east, and that there is a regional disparity in mental health delivery was sadly proved last year with the housing of young people in adult care units in the area. We know that other regions of the country do not face the same pressures, despite the national level of crisis. The Minister of State has talked today and previously about the fact that these and other vacant posts are now being advertised, but I want the Minister of State to tell me a number of things. What emergency provision is the Government making for the delivery of mental health services in the south east when the three resigning consultants' notice periods come up in mid-July? Hiring their replacements will take a long time.

I know my time is up. I have some more comments to make and I will reply to the Minister of State's own reply. There are a number of issues even in the Minister of State's statement that just do not add up. He talks about the Galway psychiatric-----