Pauline Tully (Sinn Fein) | Oireachtas source

The Minister of State is welcome. She will be aware that I come from Cavan, which has had one of the highest rates of suicide in the past few years. It has twice the national average. It is distressing that so many, especially young men, are taking their own lives, but it extends to men and women of all ages, unfortunately.

I commend the staff in mental health units in the community and hospitals as well as those who work in SOSAD, Pieta and many of our family resource centres, FRCs, which also provide counselling to people. They have gone to some lengths to get accreditation to do so. We need to build capacity in our teams in the community and hospitals and support those organisations such as SOSAD, Pieta and FRCs. I think of families who have lost a loved one due to suicide. It is devastating to lose someone in a sudden way, but it is worse when it is by suicide because people constantly ask themselves whether they should have said or done something or noticed something. That can sometimes lead to a further suicide. Supports for families bereaved by suicide are extremely important and need to be increased.

According to the Mental Health Commission, an estimated 51,000 people access their first mental health support through emergency departments or medical wards. Other Members have mentioned that emergency departments are not suitable places. They are very busy. People have gone in seeking mental health support, but because they physically do not look like their need is urgent in comparison with some other people who are waiting on services, they are often left for hours. We have had instances of people leaving emergency departments and taking their own lives because they did not get help. We should look at having specialised units within the emergency departments that are just for mental health services so people can be admitted in that way.

I have spoken to a number of people who were admitted to a psychiatric ward through emergency departments or otherwise and got support who said they are almost afraid to admit they are feeling well again because they will be discharged from the unit and it is extremely hard to reach out again and get back in if they feel unwell again. The nature of mental health is that people can feel great one day and not the next day. Many people are afraid to admit they are feeling a little bit better, in case they need support again and will not be able to access it on time. It is probably more community mental health teams that need to be built so that people know they have support and can get it when they need it in a fast manner.

I also spoke to a lady who has been engaged with mental health services in Cavan for a long time. She has seen her consultant once. Every time she goes to an appointment, she sees a different person. This is happening in both child and adult mental health services. There is no consistency. People see a person who does not know them or their needs and they have to go over everything again. When this woman made a complaint about this she was not listened to. She then requested a visit from her nurse and that was refused because she had made the complaint. She was told that if she had a problem with it she should go to Your Service, Your Say. I am afraid people who have used Your Service, Your Say do not get results at all. She has also been on medication for more than a decade and it has not been reviewed in that time. People's needs change. The medication she was prescribed ten years ago was what she needed at that time but her need may have changed since then. Also, we need to make sure medication prescribed for something else - looking at the overall picture to make sure all medications are not doing damage together - can be given at the same time.

I echo the calls around dual diagnosis in addiction services in particular, but also in children's services for children who are autistic and perhaps suffer from anxiety. They are being thrown from CAMHS to the CDNT and back again and they are not getting the supports they need. Teams that would look at both of those items together were to be set up. I would love an update on those. For adults, the issues are intertwined. People with addiction issues often have mental health issues or people who have mental illness often end up drinking or taking drugs to make themselves feel better and it worsens the problem. We need to make sure our services are providing a dual diagnosis service.

On eating disorders, the Minister of State indicated a number of teams have been established. Are they all operating at full capacity? Teams may be established, but if they are only operating at 50%, they are not able to assist. We need to ensure the eating disorders teams are there because it is something people can get help to recover from.

People between the ages of 15 and 18 who are admitted to hospital through an emergency department are often not deemed suitable to go into the children's ward, but they are not adults so they cannot go into an adult mental health unit. Is provision being made?