Wednesday 22 February 2017

Mind your head: the battle for mental health

Some €12m originally earmarked by the government for mental health is being re-allocated. Campaigners say it is sending out the wrong message.

Published 08/05/2016 | 02:30

Actress Charlene McKenna and rugby pundit Brent Pope with Cycle Against Suicide volunteer (centre) Clara Hickey launching this year’s event
Actress Charlene McKenna and rugby pundit Brent Pope with Cycle Against Suicide volunteer (centre) Clara Hickey launching this year’s event

Jim Breen truly knew the charity he founded was hitting home for people when he encountered a man named Padraig on his travels. His Cycle Against Suicide group had come to town and Breen was preaching a fundamental message that is central to the charity's world view - it's okay not to feel okay - when Padraig stood up and said he had something to say to the room.

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"Padraig said his father had taken his own life in 1978," Breen recalls.

"I asked him what his father's name was: he said he was Padraig, too. I thanked him. He said it was the first time in his life he had said out loud that his father had taken his own life. He used to tell people it was a heart attack."

Where once suicide was something that heartbroken relatives were forced to endure on their own, and society often looked down on those who even dared broach the subject, here was a perfect example of how much has changed.

"We talk about our mental health now," Breen says. "It's part of the national conversation now. We didn't necessarily do that before and the more we talk and open up about it, the better for all of us. That day, I realised that Cycle Against Suicide and other charities that are active in this year were not just helping people now - and maybe in the future - they were also bringing some comfort to people like Padraig who had to live with that weight on their minds for almost 40 years."

The Cork entrepreneur and businessman founded Cycle Against Suicide in 2013 after appearing on the RTE series The Secret Millionaire. He used the programme to talk about his own battles with depression and his frank words resonated powerfully with viewers.

For the past two weeks, Breen and hundreds of cycling enthusiasts have been cycling around the country spreading the message of Cycle Against Suicide. The sight of hundreds of orange T-shirts cycling en masse has been enough to spread the word that suicide, and mental health generally, are conversations none of us should be afraid or embarrassed to have.

But this year's cycle, which concludes at Dublin's Kilmainham this afternoon, has been overshadowed to an extent by the admission from Health Minister Leo Varadkar that some €12m originally earmarked for mental health will be redistributed to other areas of his department. That's more than one third of the total annual governmental spend on mental health and the decision has been met with a furious response from campaigners in the area.

"The money is greatly needed," Jim says, "but it's also sending out the worst possible message about how mental health is viewed."

It's difficult, he adds, not to feel demoralised by the decision.

For Joan Freeman, founder of Pieta House, the nationwide suicide and self-harm centre, news of the re-allocation is very disappointing, but not at all surprising.

"Sadly, in the 10 years that Pieta House has been in existence, we've seen money being re-allocated time and time again. I'm sorry to say it, but mental health is always the area that will suffer and the Government knows that charities such as Pieta House will be there to step up to the mark."

It's a charity that has really captured the imaginations of many. Earlier this morning - at 4am - up to 150,000 people, in Freeman's estimation, took part in 5km walks nationwide as part of Pieta House's Darkness into Light campaign.

"The Irish have a deep love of humanity," she says, "and when they see that there are groups in society that really need their help, they're generous and quick to respond.

"Where would this country be without charities such as St Vincent de Paul or Simon or Focus or Peter McVerry or Pieta House? The charities are the third arm of this country and it would be nice for the Government to say 'thank you' to them and to those members of the public who keep them going. Despite that, we do need to look at exactly where the money the Health Department has is spent."

For Caroline McGuigan, founder of Suicide or Survive, the latest Government action is symptomatic of how mental health remains in the margins when it comes to policy. "I've been involved in this work for over 20 years," she says, "and depression is now a major issue for society and is screaming out for attention from everyone, including politicians. We're not in a position to be making any cuts. It's time mental health came to the top of the agenda and I think we are seeing that now with how people are reacting to recent events."

McGuigan contends that money alone won't solve the problem.

"But funding, combined with collaboration and partnership, will make the difference," she insists. "What we really need to see is a continued unified effort between the state, civil society and the country as a whole as we know this works. This is something that is already happening as part of Connecting For Life, Ireland's national suicide-prevention strategy where Suicide or Survive and many other groups are signed up to joined-up-thinking, partnership and collaboration, so there's already a lot of good work happening on the ground."

She adds that this approach can be seen in action through the development of yourmentalhealth.ie, which provides information on services and supports throughout the country.

Social campaigner Ruairí McKiernan has worked in the field of youth mental health for the past 15 years. He is angered by Varadkar's decision.

"Mental health has continually been ignored and neglected but I think the recent announcement has triggered a turning point where people are saying enough is enough," he says. "The outcries have sent a timely signal to the Government that people are hungry for change, not just in mental health, but a change in our politics.

"Money alone isn't going to solve the issue of suicide. We need a total culture shift for that. Not least we need to invest in becoming a more compassionate society. That's up to everyone. However, we do need resources, especially when it comes to 24/7 service provision and the chronic under-staffing and burn-out issues faced by HSE staff."

McKiernan is heartened by the hard work of charities such as the Soar Foundation and Suicide or Survive but says that as their services become more in-demand they face increased funding challenges.

"They need the support of the state, and also the wider public," he says. "There is a lot of good work happening on the ground but it is no harm to look abroad for ideas also. I am particularly interested in the work around suicide prevention in Scotland, which seems to be getting positive results.

"One area that needs particular attention is the area of suicide among young men. It's something I'm passionate about and I'm looking at how we can create new approaches in terms of meaningfully engaging young men. Ultimately, creating a more just and equal society will go a long way towards tackling issues like suicide."

Joan Freeman says the courageous testimonials from men such as musician Niall 'Bressie' Breslin and ex-hurler Conor Cusack have brought about a sea change in the way people think about mental health.

"When this charity started, people didn't talk about depression," she says, "but now we have many people who are inspiring others by talking about their own situation, such as those students in Limerick who posted videos about their experiences a few weeks ago."

This week, another voice was added to the conversation - that of former RTÉ journalist Olivia O'Leary. In a candid radio interview, she talked about how "hopeless" she felt her situation was during her 20s, when she was holding down a high-pressure job and being a mother.

"It's still hard to talk about," she told presenter Sean O'Rourke. "It's still skating on thin ice because I never want to go back there again and I guard against it. It was that feeling of not being able to raise a hand to get to the phone. That feeling of lying there, doing nothing because you couldn't think of any way of getting out of it."

She talked about how family members and work colleagues provided much of the support she needed and, together with the help of a psychiatrist, she got through an especially challenging period in her life.

"When I think of young people out there depending on the public health system," she says, "and having to wait to see a psychiatrist because there isn't a psychiatrist available... when I think of those young people and how lonely and lost they must feel, and how helpless their families must feel, that's when you have to say, 'Let's talk about this. Let's develop a proper constituency of support for this so that politicians and governments can't ignore it any more so they can't go stealing from the mental health budget'."

They are words echoed by Cycle Against Suicide's Breen.

"If we're truly serious about this, we can reduce the number of suicides in Ireland by a third," he says. "And one of the ways we can go about doing that is by ensuring that money allocated to mental health is not taken away. 32pc of people who die by suicide here have never reached out to anyone, any support service, charity, you-name-it. We have to work hard to make sure that changes. After all, precious lives are at stake."

The mental health crisis in numbers

€23m

the amount allocated to mental health by the Department of Health this year. The original amount, earmarked by Junior Health Minister Kathleen Lynch was €35m.

€12m

the amount originally devoted to mental health that has been reallocated by Health Minister Leo Varadkar.

500

estimated number of people in the Republic who take their own lives each year. The actual figure could be far higher.

10%

the percentage of Irish adults who are estimated to be on anti-depressant medicine today. Some estimates put the figure closer to one in five.

400,000

the number of Irish people who have depression at any one point, according to support group Aware.

20%

a World Health Organisation estimate of the percentage of children and young teenagers globally who experience a disabling mental-health problem.

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