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Statements on Health - Senator Black asks Minister Harris to implement vision for change recommendat

If mental health was addressed it could reduce the pressure on hospital beds. It is imperative that mental health is recognised and afforded appropriate priority within the wider health agenda to reflect its contribution to the burden of disease in Ireland and its impact on other areas of life. The Healthy Ireland survey reports that almost 10% of the Irish population aged over 15 have a probable mental health problem at any one time. This equates to approximately 325,000, based on the census 2011 population data. Almost 20% of young people aged 19 and 24, and 15% of children aged between 11 and 13, have had a mental health disorder. According to the Suicide in Ireland survey, suicide is the leading cause of deaths in young males, exceeding road traffic accidents and cancer. There is a strong correlation between physical and mental health difficulties and a recently published report by the substance abuse and mental health services administration in the US found that adults aged 18 or over with any mental disorder or major depressive episode in the past year were more likely than adults without these conditions to have high blood pressure, asthma, diabetes, heart disease and stroke. In terms of health service utilisation, adults with any mental disorder used both emergency departments and hospitals more than those without a mental disorder, leading to higher health care costs.

The Healthy Ireland framework states that it is important to acknowledge the interplay between mental health problems and chronic disease. Depression is a very important public health problem and is often comorbid with chronic conditions. Mental health problems such as depression, when existing with any chronic condition, incrementally worsen health compared with having depression or chronic conditions alone. This reinforces the need to improve mental health well-being as a public health priority to reduce disease burden and disability and to improve the overall health of populations, tackling risk factors and promoting protective factors for lifelong health and well-being in the early years.

Building children's and adults' resilience to adversity is a central requirement of any population health framework. Healthy Ireland continues to report that mental health problems have huge personal impacts on those who experience them and result in significant costs relating to loss of productivity, premature death, disability and additional costs to the social, educational and justice systems. It is estimated that the economic cost of mental health problems in Ireland is €11 billion per year. Despite the high costs of mental health difficulties to Irish society, including the wider health sector, resources for mental health services continue to be disproportionately low compared to resources for physical health services.

In 2017 there will be a 3% increase in revenue funding for mental health. However, this is much less than the 7.4% increase in revenue funding for the overall health budget. In 2017, mental health funding represents just 6% of the overall health budget, which is significantly lower than other leading countries and lower than recommended in Irish mental health policy. A Vision for Change recommended that the proportion of the total health budget allocated to mental health should be progressively realised to 8.24%. In both Britain and Canada the proportion of funding is approximately 13% and in New Zealand it is 11%. The current funding allocation will do little to redress the historical underfunding and decades of neglect of Ireland's mental health system, let alone put in place the foundations for a modern mental health system as required by national and international standards. In addition, the impact of failing to adequately invest in the development of mental health services will continue to have an adverse effect on other areas of society, including the wider health environment. Could the Minister make a commitment that the proportion of the health budget allocated to mental health be increased to 8.24%, in line with the recommendations in A Vision for Change?

I also wish to highlight some issues around the lack of services and the denial of help for people with dual diagnosis. Dual diagnosis is the term used for people who are experiencing a mental health problem and a substance misuse issue. The presentation of dual diagnosis is now considered to be the norm rather than the exception. Dual diagnosis presents many challenges for health services. It is difficult to treat and has poorer outcomes such as increased risk of self harm and suicide. In the UK, 74% of users of drug services and 85% of users of alcohol services experienced mental health problems. Dual Diagnosis Ireland, a registered charity, states that 76% of services fail to offer a specific service for people with dual diagnosis. People must be dry to access most addiction rehab services, but they cannot get dry because of mental health issues such as social anxiety issues and they drink to reduce this anxiety. Another problem is that addiction treatment services usually do not assess for other mental health problems.

The main problem experienced by people who have dual diagnosis is that when they present themselves to a rehabilitation centre they are not treated for their underlying mental health issue and when they present themselves to the mental health services the substance misuse is not addressed. I recently heard a woman in Cork talk about her sister who had dual diagnosis but would not be accepted into a drug treatment centre as she was not clean and who was subsequently raped while living on the streets. The fact that something like this can happen in our society is an indictment of our health services. There is general agreement that integration between mental health and addiction services is sorely needed and long overdue.

I commend the Minister on his support for the Public Health Alcohol Bill and I feel that the passage of this legislation would not only address our unhealthy relationship with alcohol but would also help alleviate the 1,500 hospital beds taken up every day because of alcohol misuse. I have no doubt this legislation will save many lives and I hope the Minister's party support him on this Bill.

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