If you were watching last night’s Young and Troubled documentary on RTE One, you’re probably still pretty shaken up today. You’re probably feeling angry, and helpless, and hopeless. Because the picture painted by this documentary was of a system that is not just failing our young people, it is actively contributing to their suffering.
When someone reaches out for help with their mental health and tries to access services, this is the end of a very long road of often trying to cope themselves, of hiding their feelings, of hoping it would all just go away. The bravery it takes to go to a doctor and say “I’m feeling suicidal”, or “I feel I have no future”, is staggering.
Last night’s documentary showed these brave young people arrive at the door of services after a long battle with their mental health, only to be left languishing on extensive waiting lists. As long as I live, I’ll never forget Millie Tuomey’s handwriting on a form for CAMHS, describing her fears and suicidal thoughts so simply and eloquently; only for it to sit silently in an in-tray in an office somewhere – this tiny cry for help. She was in the system. And yet we were too late to help Millie.
The Future of Mental Health Care Oireachtas Committee published a second interim report on their findings yesterday. And here we are again, looking at another set of recommendations being passed on to the HSE, likely to fall on barren ground.
The recommendations of the report all make perfect sense. Less reliance on medication. More focus on talk therapy. Addressing the serious mental health recruitment and training gaps in the health service. Looking at services specific to minority groups.
We all know this is needed. And we also know recommendations and policies mean absolutely nothing without action. We have seen this in the past with the failure to implement A Vision for Change.
What is at the root of this lack of action? What’s actually going on when an Oireachtas Committee spends valuable time producing yet another report calling for a change in how we manage mental health services – and yet has no joined up plan in place to get these changes over the line? What is it about mental health that makes Government after Government completely fail to make any meaningful change?
Ultimately, effective health strategy can take many, many years to bear fruit. Election cycles are the enemy of any long-term policy. We see it in mental health and we see it across the whole health system. We even see it in housing. Policies with long-term gains fall through the cracks, no matter how effective they promise to be, no matter how many lives can be saved.
Our government know what has to happen to fix things. 30 recommendations in a report aren’t going to transform our mental health system. There have been too many empty promises and policies with little or no action by current and previous governments. There has been a systematic failure to address this issue at any level.
For example, our mental health budget in relation to our entire health budget is far below WHO recommendations – and about half that of our counterparts (6.2% in Ireland vs 13% in the UK). That’s a clear and simple lack of political will and investment.
In fact, it’s not long ago that our Taoiseach, then acting Minister for Health, tried to raid a ring-fenced mental health budget, diverting much needed funds, eventually prevented by a Civil Society Organisation and NGO backlash.
In addition, the last budget, packed with confusing budget jargon suggested a mental health increase which amounted to no increase at all in practice; resulting in the Government being accused of “deliberately misleading” the public. This tactic of confusing the public is a smokescreen for the utter lack of interest in mental health as a priority for investment and an exercise in kicking the can into the next Government.
Not only do we need a lot more investment, we need to know HOW this investment is being spent by the bloated and ineffective organisation that is the HSE.
Also, we know GPs can deal with 90% of mental health issues at the coalface. We know they need resources to manage this, and yet most of them can barely cope with their patient load right now. GPs often have no option but to medicate. Waiting lists for counselling are far too long for people in a crisis, and they find it very hard to diagnose a mental health problem in a ten minute sitting. Less reliance on medication isn’t a choice for most.
I also know what we don’t need now – we don’t need stone throwers. We need solutions, we need action-based approaches. That’s what we have to advocate for – because it’s all very well to blame the HSE or Government – but actually, it’s everyone’s responsibility to drive this discussion forward.
We’ve all heard the stories. We know the young girl who has crippling anxiety and who can’t even get a GP appointment. We know the man who has a dual diagnosis and who is falling between two stools. We know the person who doesn’t get help because they simply can’t face the endless barriers to care. When you are in the midst of a mental health crisis, the system punishes you by creating barrier after barrier to accessing the right kind of care.
We need to join the dots – we see powerful work done by schools, charities – but it’s not systematic and not across the board. Everyone working in the mental health sector knows what needs to be done. Paul Gilligan in his powerful piece for the Examiner this week outlined a systematic response to the mental health crisis – none of it news to anyone.
Senator Joan Freeman on Morning Ireland this morning said the HSE just isn’t listening – and this is completely unacceptable. The HSE has shirked responsibility for the lives of thousands of Irish people who are suffering in communities all over the country, and their teachers, parents, partners and loved ones are suffering along with them.
When we question the HSE here, we are not under any circumstances questioning the people working within the system. We have incredible, dedicated and passionate doctors, nurses and therapists – all working at the coalface, tied up in a system that doesn’t work for them, either. It’s not the people, it’s the system and the organisation which is failing us.
This is the black plague of our generation. This is an epidemic. This isn’t just a few stressed kids. This is a problem which is taking lives, decimating communities. The Government simply haven’t grasped how serious this is. The stories we’re exposed to every day in A Lust for Life, the people we have dealt with, they paint a very grim picture of what is happening right now in every town and village in the country. We are playing a life lottery with this.
A huge part of the problem is our collective fear – we’re afraid of addressing mental health, and so are our Government. We’re crying out for leadership on this issue. But if the leaders of our country don’t show leadership, then how can we effect change on the ground? We do recognise that it can be difficult to lead on such a tough issue – but they are leaders and that’s their job.
The Government like to sell that this is complex. Well actually, it’s really not. True, the reasons for people’s struggles with mental health are often varied and complex, but providing adequate systems of care are not complex.
This is everybody’s responsibility. And when mental health comes into your home, which it does for so many of us, you really recognise how devastating and heart breaking it is not being able to help. There’s nothing I find harder to deal with than a helpless mother who can’t get her child any kind of supports, who is crying out for help, who is being stonewalled by a faceless system who has failed her – and failed her kid.
Looking at Twitter while the programme was showing last night on RTE, there are two main threads of emotion: heartbreak at the rawness and the sadness of a system that is utterly failing our young people; and unbridled anger – that in 2018, we have such a broken system. Please take this anger today and do something with it. Channel it into a letter to a TD. Join a campaign working to change things in the mental health services. Use your voice. It’s time for the people now to rise. Government have the perception of power: but really the power lies in the hands of the people.
The time has long passed for recommendations. Our taxes pay for the HSE, and at the very least we are owed accountability. We are in charge of our government.
If we come at this as a collective, we will find a more effective way of helping to stop the ruination of a generation. Let’s come together in a time when the world seems so fragmented. Let’s glue those pieces together and try to progress this, so our most vulnerable in society know we have their back, we care, and they are not alone.
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