I thank the Leas-Cheann Comhairle for the opportunity to mark World Mental Health Day 2024. It is a day that allows us to reflect on the importance of mental health as a vital element in the overall good health of every individual – there is no health without mental health.
It is also an appropriate day to reflect on the huge progress that has been made in mental health policy and service delivery in Ireland since World Mental Health Day was launched on 10 October 1992. Ireland has made significant advancements in recent years in promoting recovery-orientated care with input from service users and carers and a co-ordinated approach to stigma reduction around mental health.
Our current mental health policy, Sharing the Vision, and our suicide reduction strategy, Connecting for Life, both speak to these ambitions. The goal of our policies is to focus on the mental health needs of the whole population, framed by the underlining principles in Sharing the Vision of trauma-informed care, focus on recovery, respect for human rights, partnership and valuing and learning. I regularly speak about the hard work and effort it takes to reflect these principles in policy delivery. It is essential that the people who use our services are at the heart of the design, development and delivery of the supports we build to serve them. Lived experience must be central to all we do. I have seen the value of the service improvements achieved through including the voice of lived experience in service design on my visits to local mental health facilities and peer-support services as part of my work.
The HSE’s mental health engagement and recovery office was specifically set up to integrate lived experience expertise in the development, delivery and review of our mental health services. If we want our services to be really recovery-focused, they must be built on the twin pillars of clinical expertise and lived experience expertise. I firmly believe that mental health is everyone’s business, and I also believe that recovery is everyone’s business. This message is at the heart of all the work we do.
In August this year, to further strengthen the voice of lived experience in policy implementation, I approved a call for expressions of interest to join the national implementation and monitoring committee steering committee for a member with lived or living experience. I expect to appoint the successful candidate in the coming weeks. This inclusion of the voice of lived and living experience will bring an additional patient-focused voice to policy oversight. I look forward to the positive impact that will have in strengthening the recovery approach in policy implementation and new service design and delivery.
The theme of this year’s World Mental Health Day is “It is Time to Prioritise Mental Health in the Workplace”. It is important that we foster workplaces that are supportive and free of mental health stigma, and that we support those with mental health difficulties to find work, remain in work and benefit from the fulfilment, well-being and sense of purpose that can come with employment.
This morning I was delighted to support an event hosted by the HSE’s mental health engagement and recovery office on the continuing development of individual placement supports, or IPS as it is known. IPS is an internationally recognised, evidence-based programme to support people with mental health challenges returning to or commencing work. This event was designed to inform and support those involved in placement supports, including service delivery and planning for the growth of the service in Ireland.
I was pleased last week to be able to provide significant additional funding in the budget for peer-support workers and recovery co-ordinators, to continue to place the core concept of recovery at the heart of the services we provide and to ensure people can retain and find employment throughout their recovery journey.
For individuals with mental health challenges, the opportunity to work can be transformative. It fosters a sense of purpose, promotes social inclusion and significantly contributes to their recovery journey. We know, sadly, that traditionally people with mental health difficulties have a much higher instance of unemployment than the rest of the population and IPS is essential in addressing that issue. It became a mainstream programme under the mental health engagement and recovery office in June 2021 and since then I have secured a direct investment of €3.6 million for individual placement support. We have over 500 individuals currently being supported by IPS, a great success story. Reducing workplace discrimination through awareness, training and engagement with people living with mental health challenges creates healthier, more inclusive work environments.
We have been hugely successful in promoting open conversations about mental health difficulties and about reducing stigma, shame and discrimination, which in turn changes attitudes and approaches to mental health. This morning a letter from me was delivered to all Members of the Oireachtas, encouraging them to take the "Let’s Talk About Suicide" training programme which I launched for the HSE earlier this year. This presents a unique opportunity for all Deputies here today, and all Members of the Oireachtas, to contribute to the conversation around World Mental Health Day and develop their skills in this area. I also ask that they encourage and support their staff to undertake the training. It is so important.
Working with our voluntary and community partners in front-line and advocacy services, initiatives such as See Change’s green ribbon campaign encourage a culture where people are not judged or labelled because of their mental health difficulties. I congratulate Chime on a fantastic month of September in which it promoted the green ribbon every day of the week and encouraged people to wear it, end the stigma and talk about their mental health difficulties. We have invested over the years to support an environment where people do not hesitate to seek help and where early intervention supports are available for those in need, and we need to promote at every opportunity the concepts of positive mental health and recovery.
More and more people now talk openly about their mental health needs and receiving support and acceptance from family, friends and mental health services. However, I will always strive to do better and there is still much for us to do. One of the most significant pieces of work in mental health this year and a priority of mine since my appointment as Minister of State with responsibility for mental health in 2020 is the publication of the Mental Health Bill 2024 on 31 July. Containing over 200 sections, the Bill will replace the 2001 Act with a more human rights-based and person-centred approach to mental health legislation and put in place a more robust legislative framework in which mental health services will be delivered and regulated.
It will update the involuntary admission process, modernise provisions related to consent to treatment and provide enhanced safeguards for people accessing inpatient treatment. A new stand-alone Part relates exclusively to the care and treatment of children and young people. In addition, the Bill will introduce, for the very first time, a robust system of registration, regulation and inspection of all community mental health services, including community CAMHS.
I welcome the Mental Health Commission’s important role under the legislation to set appropriate standards for community mental health services. The Bill passed Second Stage in the Dáil on 18 September 2024 - I thank everyone for their support - and my officials are now working to prepare any necessary amendments as quickly as possible ahead of Committee Stage.
Continued investment and recruitment are critical to modernise a responsive mental healthcare service for those who require it, both in specialist mental health services but also in the key areas of mental health promotion, prevention and early intervention. Last week was my fifth budget in my role as Minister of State with responsibility for mental health and older people. I am pleased that the 2025 health budget secured a further rise in spending on mental health to almost €1.5 billion. This marks the fifth consecutive year that an increase in funding has been provided to develop and support mental health services and it exemplifies this Government’s commitment to delivering on our policy objectives.
Mental health funding has increased by 44% in the lifetime of this Government. This clearly underscores the focus that we have placed on ensuring our mental health services are safe, accessible, modern, and person-centred. The additional funding allocated to mental health services since 2020 has allowed for significant expansion of the mental health national clinical programmes, including the eating disorders and the crisis resolution models of care. This has led to incremental but significant, service improvements. To date, I have secured funding of approximately €35.7 million for the development of the national clinical programmes under the current programme for Government. The national clinical programme on self-harm and suicide-related ideation is now in place across all our accident and emergency departments, and the programme is now being enhanced in our communities through the recruitment of suicide crisis assessment nurses, known as SCAN nurses, including six recruited last year. For eating disorders, 11 teams are in place with services now being delivered to people with eating disorders. In May 2024, I announced the establishment of a new team for Dublin south-west, Kildare and west Wicklow, which along with the further two I announced last week will bring the total number of eating disorder teams nationally to 14. One of the teams announced last year was a CAMHS eating disorder team to be based in the Limerick and mid-west area. We are just finalising where the second one will go. I am very keen that it will go to an area that does not have any such service currently.
I was particularly pleased to secure funding for a further four teams for ADHD in adults to complete the national roll-out of this programme. Budget 2025 will also provide funding across the national clinical programmes for two additional early intervention in psychosis teams, the two additional eating disorders teams I just referred to, two additional dual diagnosis teams, as well as posts for the programmes on mental health with an intellectual disability, self-harm and suicidal ideation, and psychiatry of later life. These are valuable developments in services that have been experiencing increasing demand. Thanks to this investment, more people across the State will have the opportunity to benefit from these services.
Connecting for Life is Ireland’s national strategy to reduce suicide. We continue to deliver on cross-sectoral policy recommendations in this area while commencing work on its successor strategy, which will build on its successes but also learn from its challenges. Last year, one-off funding was secured to enhance services in this area for those bereaved through suicide. Under budget 2025, this funding will now be recurring and additional new development funding will be provided for a variety of suicide prevention initiatives, including suicide bereavement liaison supports and funding for Pieta’s national counselling service for people affected by suicide and self-harm.
One of the measures I announced last week, which I believe is among the most important, is the provision of €2 million to expand counselling in primary care, CiPC, with a particular focus on men. We will work on expanding eligibility for CiPC to include those with GP visit cards. It is a priority of mine to make counselling supports accessible to more people. It really worries me to think of people, particularly men, not getting the help they need because of the cost involved in getting counselling. This expansion of CiPC will focus initially on engaging with men who as a group have been less likely to avail of counselling supports. We need men to reach out, and expanding access to this service means that appropriate supports will be there when they do.
I am happy to report that progress on developing a new whole-of-government national mental health promotion plan is at an advanced stage with publication intended before the end of this year. This will represent another milestone in implementing one of the key policy goals of Sharing the Vision. Positive examples of cross-departmental collaboration through the implementation of Sharing the Vision include the work of the high-level task force to consider the mental health and addiction challenges of those who come into contact with the criminal justice sector. This work involved extensive co-operation between the justice and health Departments.
I have secured an additional €2.1 million in funding to facilitate the opening of 18 beds in the National Forensic Mental Health Service in Portrane. Opening these beds will allow patients to move through the various levels of support offered by the care pathway in the hospital and, in turn, will allow for further admissions across the hospital. This important new measure advances key recommendations of the high-level task force report on mental health and addiction and will also greatly assist to help to alleviate pressures on referrals from the Irish Prison Service.
I also welcome the launch of the implementation plan for the National Housing Strategy for Disabled People. This implementation plan was launched by our colleagues in the Department of housing in June 2023. The strategy will directly improve outcomes for people with disabilities. Since 2017, more than 3,300 people with a mental health-related disability have been assisted to access housing in the local community, which provides an essential support to recovery. I have provided the HSE with additional funding to support the recruitment of housing co-ordinators to support people with a mental health difficulty to secure and retain independent tenancies. Policy should be about making a real, positive, tangible difference in people’s lives.
Travellers are identified as a priority group within the Sharing the Vision and Connecting for Life initiatives. They face many challenges in relation to mental health and suicide. Significant additional ring-fenced funding of €365,000 has been provided for Traveller mental health initiatives in budget 2025. In addition, funding of €200,000 for the national Traveller counselling service, which was allocated on a one-off basis for 2024, has been mainstreamed under budget 2025. This will bring the total funding for Traveller mental health to €565,000 for 2025. This money will be used to provide ring-fenced supports with oversight from the national Traveller mental health working group. This will build on previous years to expand the national Traveller counselling service and ensure this culturally inclusive counselling service receives the support it needs. In addition, funding will be provided for culturally appropriate suicide bereavement supports for Travellers in order to ensure that the services which are provided at a very sensitive time for families and communities are responsive to their particular needs.
As I said at the outset, it is my firm belief that there is no health without mental health. The Government and I, and my colleagues in the House, believe in the importance of well-funded mental health facilities. I believe the Government and I have shown our commitment to this statement through the provision of additional ring-fenced funding for mental health services and through our commitment to the introduction of a modern and fit-for-purpose legislative framework to provide human rights-based, person-centred and recovery-focused care. I look forward to hearing the views and opinions of my colleagues. I appreciate those Members who are present on a Thursday afternoon to speak about mental health and positive well-being. Gabhaim buíochas leo.