Aubrey McCarthy (Independent) | Oireachtas source

I welcome the Minister of State. I am grateful for the opportunity to speak on a matter that affects society as a whole and certainly affects the area that I have volunteered and worked in, which is mental health supports in Ireland. A recent study by the European Commission showed that 44% of Irish citizens reported difficulties accessing mental health services. That was the highest rate in the EU. It also found that 63% of our population have experienced emotional or psychosocial problems in the past year. That means Ireland is ranked the third highest among all the EU nations. Despite that, Ireland only allocates 5.1% of its health budget to mental health initiatives. That falls way short of the WHO's recommended 12% and the Sláintecare reform, which recommended 10%. We are way below that level.

That underinvestment is evident in the staffing of areas of mental health. Some 30% of permanent consultant psychiatry posts are vacant at the moment. We have limited infrastructure for mental health. Only 22 acute mental health beds are available per 100,000 of population when the EU average is 70. I know we must cut our coat according to our cloth, etc., but this is an area about which I am passionate.

The situation is particularly dire for individuals who are facing dual diagnoses. As the Minister of State knows, dual diagnoses are where mental health issues coexist with substance abuse issues. A study by Mental Health Reform highlighted significant barriers for that cohort, with individuals saying there is poor collaboration between services, a lack of training of professionals and limited access to a continuum of care for such dual diagnosis individuals. The result is that many people are being turned away from mental health services due to having a substance misuse issue. They are being turned away from rehabilitation facilities because they have a mental health issue and, therefore, fall through the gaps without adequate support. With my experience of setting up Tiglin, nearly 20 years ago now, I have seen people impacted by addiction. I have seen at first hand the many families who have come to me with a son who has been smoking synthetic cannabis for many years, which has played havoc with his mind, and the chap in question now has a diagnosis of schizophrenia or something similar. There are considerable barriers in this area. Rehabilitation centres, such as Tiglin, Merchant's Quay Ireland and Cluain Mhuire Community Mental Health Services are underfunded to deal with the clinical needs that are presented. Hospitals are often unable to help people with their mental health issues because they are presenting with a substance misuse issue. It is in this gap that I believe people are losing hope and families are despairing. I have seen that at first hand. We are also losing people who can easily be saved.

The gap I have mentioned hampers recovery but also leads to repeated cycles in mental health institutions and the justice system. That could be avoided. Millions are spent every year to incarcerate individuals with dual diagnosis, which underscores the need for joined-up thinking.

From working in the sector, I think we need to treat the whole person. Let us stop treating the mental health issue separately from the substance misuse. We must establish an integrated care system so an individual is treated for both issues at the same time under the same roof.

We need to train our front-line staff, including doctors, nurses and carers. They need the tools to deal with dual diagnoses. A full debate is needed in this area as we cannot deal with dual diagnoses on the basis of outdated training formats.

Some €93 million has been spent to outsource to private healthcare in the past year. That is unsustainable for our economy. We need to invest in our own system and not just buy capacity but build it. As has been mentioned, we need to end the shame and stigma that go with mental health issues. We to reframe things so that when somebody is asking for help, it is seen as an act of strength and not of weakness.

My point is that we need to bridge the gaps in the area of dual diagnoses. Ireland's mental health supports require an effort on the part of all policymakers, stakeholders, healthcare providers, NGOs and society at large to prioritise integrated care, invest in the service and educate the people. We can then ensure that all individuals in the cohort I have mentioned receive the support they need.

At the end of her speech, the Minister of State said it is a whole-of-population and whole-of-government issue, which was welcome. I thank her.