Shane Cassells (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State, Deputy Butler, for coming to the House to address this critical issue, namely, the need to reinstate a director of mental health services. I know the Department of Health has competing demands from cancer care to cardio to treatments across the board, but the need for us to grasp in a definitive way the issue of mental health is one I see as a pressing emergency in this country. Nobody knows that more than the Minister of State because, since her appointment, she has been a champion of kicking down doors, changing attitudes and creating new ways of doing business. There is a commitment in the programme for Government to reinstate this role, which existed from 2013 to 2017 and was then merged into another aspect.

Why do we need a director of mental health services in this country? We have a new mental health strategy in Sharing the Vision but there is no point in the Minister of State doing so much good work in crafting new policy unless there is someone there driving that strategy for her and making sure we are getting the results we need. One man I have spoken about here previously, who is a champion of positive mental health and who has used his national profile to campaign on the issue is Rory O'Connor, a fellow Meath man who runs Rory's Stories on Facebook and has a huge following not just in terms of his humorous take on Irish life but because he uses his profile to speak about mental health with a series of thought-provoking pieces. He has battled his own demons in the past and chronicled them in a top-selling book. I spoke to him before coming to this Chamber and he said, "Shane, a big storm is coming and we need to put up the umbrellas as best we can."

He told me how through his engagement with schoolchildren - he conducts talks in schools throughout Ireland every week - he can see in the faces of 17 and 18-year-olds how they have suffered immensely. It will take them years to come to terms with the impact on their mental health and development as young men and women from the isolation they experienced during lockdown and to deal with the fallout from that prolonged period of isolation away from normal life. He also spoke quite extensively about the impact on men in their 60s from his work with men's sheds. These are people who would not normally be well able to express their emotions and how they are feeling. He said he can see from that that there is a significant problem in that regard as well from going around and meeting men in these men's sheds. Those were his words to me: "Shane, a big storm is coming and we need to put up the umbrellas as best we can."

I am calling for the reinstatement of this role of director of mental health services.I know that the Minister of State has done a huge amount of work even in the last week. I know that she has introduced a new scheme and has allocated €1 million for 16,500 talk therapy sessions, which are free of charge for those who have been impacted by the isolation of Covid-19. That is the kind of work that the Minister of State has been doing and I praise her for that. However, as I said, the call here is to ensure that we reinstate the directive for mental services so that we drive that strategy that the Minister of State wants to see happen.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank Senator Cassells so much for raising this issue in the Seanad. It is a hugely importantly issue. I have consistently sought the reinstatement of a national director for mental health post in the HSE since coming into my post a year and a half ago. The previous mental health strategy, A Vision for Change, recommended that a national mental health director be established under the leadership of a national director to prioritise the mental health agenda and to drive it centrally within the HSE. The important line was to drive it centrally.

This was achieved with the appointment of the first HSE national director in 2013. The programme for Government commits to examining the reinstatement of the national directorate for mental health. I am confident that I have the full support of colleagues in this matter. Given the importance of mental health, we now have an Oireachtas sub-committee on mental health. The sub-committee is chaired by Senator Black who is here in the Seanad. Senator Black could stand here and talk about what I am talking about today, which is the importance of being able to drive the vision in relation to mental health. As part of the HSE structural changes, the post of national director for mental health was disbanded and a new national director of community health service operations subsumed the operational role of the existing national directors for primary care, social care, health and wellbeing, and mental health. The previous national director post for mental health was split into two separate dedicated leads at assistant national director level, one within community operations and one within community strategy. An additional three new senior roles were introduced. These were a chief operations officer, a chief strategy and planning officer, and a chief clinical officer.

Standing here today, I am not trying to take anything from these fantastic people who are doing phenomenal work every day of the week and who are driving on the challenges we have in mental health. However, let us stop and think of the two years we have come through with Covid-19, as well the fact that we do not know what we will see in the next year or two regarding people with long Covid and, especially, older people who are trying to reconnect with society, young people who have been really challenged regarding their junior certificate and leaving certificate examinations, hybrid education, moving onto college, as well as the ordinary cut and thrust of every day life. It has been challenging for people. Now, more than ever, I strongly believe that we need a national director for mental health within the HSE to drive our new mental health policy, Sharing the Vision. It is an excellent policy. However, policies are fine, but implementation is key.

It would be remiss of me not to speak about the situation that has occurred in Kerry in the last two weeks. To update the House, I am taking a three-pronged approach to how we rebuild confidence in CAMHS throughout the country. First, there will be an independent audit on compliance, structure and process. We will look at team composition, we will look at the skill mix, we will look at the clinical operation in governance and we will look at access to services, which are important.

The second part of the three-pronged approach is that we will do a full research piece. We will speak to service users and to young people about their experience nationally. This will be done from an academic focus. However, it is important to speak to young people from all over Ireland about how they got on when they were referred to CAMHS.

The third part, and an important part, is an audit of the prescribing practice. This will be a full audit of the 73 CAMHS teams through the country regarding their prescribing practice. The whole purpose is to design the audit, to collect, to collate and to report.

A non-adversarial approach will be adopted in compensation. Details will be worked out in consultation with my Department and the Office of the Attorney General.

Shane Cassells (Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank Minister of State for that response. I want to pay tribute to the Minister of State for stating that she is driving this. She wants to see the reinstatement happen. This is because she knows that this will drive the change in policy that she wants to achieve in the whole area of mental health in Ireland. As the Minister of State said, there has been much discussion, in particular about youth mental health, in the last few weeks.

As we exit Covid-19, we now see that people, and young people in particular, are reconnecting with society. Some are embracing that fulsomely, while others are not so much. They are finding that tough. They are the people who we need to make sure that we protect. As the Minister of State said, there are a huge number of good people working in her Department and in agencies right throughout the country in the area of mental health. However, there are gaps in the service. As the Minister of State said, we do not know what we are facing in the years ahead as a result of the fallout from this. Life is challenging in normal times. It has become even more challenging because of this prolonged period of isolation and withdrawal from normal life. We need to make sure, because we do not know what we are facing as a result of this prolonged period of isolation, that we have a director of mental health services to face that storm and to make sure that we achieve what we need to achieve in protecting our people.

Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The rationale provided at the time for the restructuring of these posts was to enhance integration. I have no problem with enhanced integration across care groups, which is of course required. We want to take the stigma away from mental health. I can understand the rationale. However, because of where we are today in 2022, there is an ongoing need for a dedicated focus on mental health strategy with national-level leadership within the HSE. It is vital to have this important post of HSE national director of mental health reinstated to give strategic direction to the development and improvement of mental health services.

I assure the House that I will continue to engage with the HSE on this important matter. I know that the Minister of Health, Deputy Stephen Donnelly, will be speaking to the HSE this weekend. I have also discussed this with the Taoiseach. All are supportive. I can stand here today and say that I know that I have the support of everyone in both Houses to have this post reinstated. I thank the Senator again for raising this issue which is important and timely.