A long-term, non-partisan approach to mental health is needed-Ryan

27 April 2016


I made my maiden speech as a Deputy in the Thirty-first Dáil five years ago and it was on the matter of mental health. I am glad to have the opportunity to also discuss this important issue so early in the lifetime of this new Dáil. The last number of years have been years of great hardship for many people as we were thrust into economic disaster and slowly began on the road to recovery. These harsh times brought into sharper focus the crisis in mental health which has existed in Ireland for many decades. For years, mental health care in Ireland was underfunded, ignored and no longer prioritised. While it is still underfunded, improvements implemented by the outgoing Government, as outlined by the Minister in his introductory speech, are real and welcome. My colleague, the Minister of State, Kathleen Lynch, fought hard to ensure that €35 million was ring-fenced specifically for mental health services in successive budgets over the lifetime of the last Government. While this was nowhere near enough to tackle the crisis of mental health, it represented a budgetary increase and is something the next Government can build on as the economy improves and more money becomes available.

As we make statements in this strange limbo period between an election and Government-formation, we have an opportunity to discuss issues with a little more distance and perspective. With what has occurred over the last few weeks in relation to the mental health budget, it is perhaps the time to discuss and agree on an all-party approach to health care policy which will remain in place through a number of election cycles. Such an approach would benefit and protect mental health provision from further attacks on its budget. In recent days, there has been much discussion of the decision to cut €12 million from the mental health services budget. The justification given by the Minister for the cut has been the need for health spending elsewhere, including on home packages and fair deal, which are important areas and certainly worthy in their own right.

However, if the money was not being spent on the designated line item provided for in the budget, surely it could have been diverted to other areas of mental health spend. This would have sent out a much stronger message about how serious we were about mental health.

I hasten to point out that while there is a major problem in all areas of health spending, for example, trolleys and so on, in hospitals, cutting mental health services is a short-sighted and dangerous move. The amount taken from the mental health budget would not solve the hospital trolley crisis but it would have a major impact on mental health services provision. Significantly, the proposed cut is a third of the total money allocated to mental health spending. My party colleague, the Minister of State, Ms Kathleen Lynch, had to fight hard within the Department of Health to ensure that the small sum of €35 million was provided. Therefore, it is disappointing that the Minister has reduced this amount to plug holes elsewhere. He will be aware that in 2012 alone, 12,000 people presented in accident and emergency units around the country because of self-harm. How many trolleys are full today with patients suffering mental health issues that have led to self-harm? Self-harm can be prevented if there is early intervention but no intervention can happen if mental health services are not fully and properly funded.

It is a mistake to attempt to separate mental health from other forms of health care. Prevention is better than cure. Every death by suicide is an avoidable one. Mental ill health is treatable. No one should die or suffer from chronic mental illness for lack of treatment but we in Ireland will never be able to tackle this issue unless we acknowledge its severe impact, resource the HSE to treat these patients and begin to treat mental ill health with the same level of regard as we do any other form of ill health.

For too long, mental health services have been the Cinderella of the HSE. We cannot keep prioritising everything else over it. That is not sustainable. We need leadership, and I can only hope that the Minister will decide to reverse his decision to cut the mental health care budget by one third. We need to treat the recipients of mental health services with the respect and due care that they deserve. The mental health budget should never be the low-hanging fruit of the health service when it comes to moving money around and plugging financial holes elsewhere.

The crisis in accident and emergency services and the shortage of beds are more visible and mental health will never be as visible and yet one in five of us will experience mental health problems in our lifetimes. That equates to 32 Members of the Dáil. Extrapolate this figure across society and the numbers are dramatically high. Mental health needs to be addressed on a par with every other aspect of the health service and a long-term plan for adequate funding for service provision is required. A non-partisan approach is necessary, as is a long-term vision, to ensure this does not become a matter of lip-service at election time while patients are left without the funding and care that they need and deserve.

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