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Covid-19, Mental Health and Older People: Statements (Continued)

Thursday, 29 April 2021

Dáil Éireann Debate
Vol. 1006 No. 3

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(Speaker Continuing)

[Deputy Pat Buckley: Information on Pat Buckley Zoom on Pat Buckley] We can sometimes have a fairly heated debate in here, but when progress of any kind is made it must be welcomed.

It would be remiss of me not to congratulate the Minister without Portfolio, Deputy McEntee, on the birth of her baby boy this morning.

I wish to touch on the surge capacity requirements in mental health hospitals and the €13.5 million in additional funding that will be allocated for that purpose. I welcome that funding. I also welcome that the CAMHS investigation is going ahead.

There were WikiLeaks. Now there are "Aire-leaks" when it comes to good news on coming out of lockdown.

There are still families in desperate trouble. I spoke to two yesterday and asked them for permission to use their cases to highlight the isolation caused by Covid. Families are in desperate need, older people have never been so isolated, which has a knock-on effect, and people with disabilities have practically been written off.

I wish to raise a specific case. Obviously, I have edited it. Mrs. X has been a carer for her 81-year-old mother for a number of years. She also has a brother in his 50s who was in appropriate day care for five days per week, but when Covid arrived, that service closed down. She took it upon herself to assume caring responsibilities for him as well. After a number of months, she wrote to the Department - she was inquiring more than anything else - to see whether she would be entitled to additional financial or physical supports. Unfortunately, the Department wrote back and docked €34 per week from her payment for looking after her mother. The Ministers of State can imagine the stress that can cause for people who are at the pin of their collar trying to do the best they can.

A second case involves a family of a child with severe autism. Since Covid started, the family has received no respite care, speech and language therapy or just about any other support. They are taking it in shifts. The husband normally gets three hours of sleep per night. When I spoke to him, I said that we could bring their case directly to a Minister. He said that what was happening was not fair and that, as a principle, people in such circumstances – he knows many families in the same situation or worse – should be treated fairly. He wanted me to bring that point to the floor today. He also told me that, last weekend, he met a couple of his friends who were in a similar situation and that, although they started the conversation, they had to stop because it was so depressing. Unfortunately, some parents in this situation were not strong enough and took their own lives. The pressures are enormous. He told me that he and his friends were still here to help where others had found it too much and had taken their own lives because they could not cope. He told me that that was the conversation he and his friends had and that they had to stop because it was getting so depressing. Those were his words, not mine.

I welcome any progress in mental health services, but let us not forget anyone. We must remember that, when we come out of Covid, we will still have a health problem, a mental health problem, a housing problem, people losing their jobs and a problem with disability services. Let us plan for the future.

Deputy Holly Cairns: Information on Holly Cairns Zoom on Holly Cairns I join others in congratulating the Minister, Deputy McEntee.

  I am seeking an update, albeit not on the funding that is to be allocated for the treatment of eating disorders. That has already been announced and is funding that was not spent previously. Rather, I am seeking an update on the number of beds for inpatient care. There are only three currently. Has there been any work on addressing this situation?

  The challenge of Covid-19 has reminded us that personal health and well-being are no longer solo pursuits, but ones that require cohesion, collective effort and mutual respect across all life stages. In his submission to the health committee last October, Mr. Martin Rogan, CEO of Mental Health Ireland, highlighted that mental health issues affected people of all ages. I welcome this session focused on the mental well-being of older adults, who are often overlooked in these conversations. The elderly have been identified as a group especially impacted by the pandemic. Although necessary, cocooning and the closure of social outlets have increased isolation. A volunteer on ALONE's support line reported to RTÉ that "A lot of the issues that people would ring with, would stem from loneliness." The difficulty of bereavement at this time has taken its toll and the clusters of Covid in nursing homes was a major source of distress.

  While the vaccine roll-out and safe reopening of society will make a significant difference, we cannot let the lessons of Covid slip away. First, we need to fund mental health. The World Health Organization recommends that countries dedicate 12% of health spending to mental health care. In Ireland, the figure is less than 7%. Not only must the Minister of State, Deputy Butler, ensure adequate resources are allocated, but she must also secure special interventions to treat the pandemic's legacies. For example, reduced activities for older adults living with dementia has caused distress and exacerbated behavioural and psychological symptoms, and nursing home residents have experienced relapses in their mental health due to restrictions on visitors and therapies. While these measures were necessary to save lives, we must act quickly to alleviate any regression.

  Now that increasing numbers of older people and healthcare professionals are vaccinated, we need safe ways for them to interact as soon as possible. A multidisciplinary approach needs to be at the centre of this response. Increases in depression and anxiety are strongly related to declines in activity - this is a crucial factor in the well-being of older adults - as well as sleep quality and cognitive functioning. Geriatric psychiatrists, psychiatric nurses and psychologists can drive medical treatments, but we also need occupational therapists, physiotherapists and other therapists to help provide holistic care. I know from community hospitals in west Cork that music and art therapists have a positive effect. We need to ensure that these professionals are facilitated in getting into hospitals and nursing homes as soon as possible.

  Second, who cares for the carers? The difficulties faced by our older cohort are also experienced by their carers and families. Carers are consistently undervalued by Governments. The amount of supports and payments offered to them compared to the work they do and care they give is disgraceful. They receive plaudits from Ministers, but they need much more. Family Carers Ireland's budget submission, entitled "Life After Lockdown", outlines the measures they need, such as an increase in the carer's support grant and increased home care hours. We need the Government to implement these proposals. An holistic response to the mental health of older people will recognise the vital role that carers play.

  Third, the Mental Health Commission's report on services for older people, released in December, is sombre reading. It states:

Despite the increasing elderly population, we are currently not providing a nation-wide, comprehensive mental health service for older people. We have highly-trained and committed specialist clinicians, yet we have only 66% of the recommended number of specialist teams, which themselves are only staffed at an overall level of 54%.

The report's author, Dr. Susan Finnerty, highlighted an "alarming" underprovision of acute mental health beds for the elderly and "serious under-resourcing" of community mental health services for the same population. She also explained that "Older people's mental health is an increasingly important area of public policy that does not get the attention it deserves." This needs to change now. The Government must vigorously address the issues raised in that report.

  The World Health Organization has stressed two interconnected elements to help improve the mental health of older people by alleviating feelings of anxiousness, anger, stress, agitation and withdrawal. The first element is practical and emotional support through connections with family and community and the second is the role of healthcare professionals in providing the expert help that individuals need. Over the past year, we have seen families, neighbours, volunteers and whole communities provide this first type of support. Now we need the State to deploy all of its resources to address the second.

Deputy Brendan Smith: Information on Brendan Smith Zoom on Brendan Smith I join colleagues in extending my heartiest congratulations to the Minister, Deputy McEntee, and her husband.

As we know, Covid has presented myriad challenges and difficulties for the past 15 months. Once the virus is suppressed, there will be many other problems and legacy issues to be addressed. We must now put in place the necessary supports. People of all age groups losing their routines, be those work, learning, sport or social contact, has had a damaging impact on the mental health of many. Supporting positive mental health must be a continuing priority for the Government. We need much-improved State services and additional supports for voluntary organisations that provide professional services. I know from speaking to a number of GPs that there is a large amount of anxiety and panic disorders in all age groups, especially among teenagers. Some GPs have outlined to me that some young people are presenting with physical symptoms that turn out to be manifestations of stress.

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