Frances Black (Independent) | Oireachtas source

I welcome the Minister of State. I agree with Senator Gavan that she has a tough job ahead of her. She is a compassionate person and I wish her well in her role.

As I am sure the Minister of State is aware, mental health activism is a passion of mine in my work as a therapist and a politician. I set up the RISE Foundation to work with and support family members of a loved one who has an alcohol, drug or gambling problem. Often, family members are significantly impacted by someone they love going down that self-destructive route in the form of depression, anxiety and stress. My passion for mental health has always carried through to my politics. As Senator Hoey mentioned, my ongoing efforts and work saw the cross-party Joint Sub-Committee on Mental Health set up last November. I am grateful and honoured to sit on that committee as its Chair.

Mental health is a topic that needs more attention and voices within the Government now more than ever. Since the committee's commencement, we have worked hard to create a schedule of items that it is paramount are accounted for and discussed. None is quite as important as the systemic impact of Covid-19 on the mental health of members of society. Now more than ever, people are feeling isolated, disconnected from their communities and frozen. They are struggling to engage with a future that seems unpromising. Financial burdens seem insurmountable and threatening. This is having terrifying impacts on our people. Everyone, including friends, colleagues and people close to my family, is being impacted. It is our duty to create a framework facilitated by open and in-depth discussions so that we can plan a brighter future.

There is a waiting list for primary mental health care of up to 11,000 people, 80% of whom are children, and the wait is up to two years per person. It is vital that we consider providing lower level preventative supports, promote and support voluntary services, and invest in primary care psychologists. It is also vital that we tackle inappropriate referrals at secondary level, given the issue of dual diagnosis, and support implementation of multidisciplinary teams so that people suffering with illnesses like eating disorders do not have to travel outside Ireland for adequate treatment.We need to tackle the staff shortages in third level care. With the demand constantly rising, the limited number of staff is crippled. These issues are to name but a very few that we must tackle head on to correct each level of mental healthcare.

Only the tip of the iceberg is in view when it comes to seeing the effects of Covid-19 on mental health in Ireland. There are many reasons for this, such as the fear many individuals have of going to hospital during a pandemic, even in a mental health emergency, which forces them to struggle with it alone, and this is so true. Voluntary organisations are struggling to fundraise in these times and so cannot provide the necessary supports they once did.

The nightly announcement of the number of Covid-19 cases and deaths are a very public declaration of how the virus is affecting the population, but privately we know Covid is harming many more, with higher levels of anxiety and mental illness. Medics have reported that the first lockdown caused more people to feel loneliness, depression and anxiety. It sparked an increase in prescriptions for sleeping tablets, anxiety medicines and antidepressants. These figures are only increasing during this lockdown. The reality of the pandemic is that Covid-19 has not affected the population equally. Those with the fewest social and economic resources to alleviate the effects of social restrictions will be impacted the most, for example, those living in deprived areas with insecure and-or low income jobs, insecure housing, single parent households or abusive relationships. It also acutely affects those with existing mental health problems, whose mental health may worsen when access to their healthcare support is restricted. Others who are most at risk at present include those who have lost or are at risk of losing their jobs, those separated from loved ones, healthcare workers, people who face domestic abuse, the elderly, individuals who have pre-existing mental health difficulties, some Covid-19 survivors who are experiencing post-traumatic stress disorder, PTSD, and depression, and those with intellectual disabilities.

The priority for us right now is to plan and anticipate the huge escalation of mental health service requirements and secondary mental health services. It is now emerging that this will peak in the coming months and will last for many months or even years. We have a separate curve to flatten outside of the Covid-19 cases within secondary mental health services. Unless we anticipate, plan and invest in all of our secondary mental health care services as a priority, they will be overwhelmed, with terrible consequences for mental health and the economic recovery of our country. It is paramount that we start to strategise ways to implement greater Government action to respond to the impending mental health crisis and strategise a recovery plan for mental health during, and in the aftermath of, Covid-19.

There is no doubt there has been a huge surge in demand for mental health services which, prior to the pandemic, were already overstretched. The evidence for the impact of Covid-19 on the mental health of the people goes on and on. The reality is we are in a crisis far greater than any of us could ever have anticipated. Covid-19 is no longer our only battle. Our main point of action is to consider how we can provide lower level preventative support and promote and support the voluntary services. We must urgently invest in primary care psychologists and therapists across the board. We must urgently tackle the current issue of inappropriate referrals at secondary level. We need to tackle the staff shortages in third level care, as with the demand constantly rising the limited number of staff are crippled. These points are only a small number of the large tasks we must take on if we are to begin to correct each level of mental healthcare so we can save the lives that are at risk.